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A Double Whammy – Cancer and Corona

A-Double-Whammy---Cancer-and-Corona-(-14.07.2020)

When a health pandemic occurs, and the nation goes into lockdown – everyone is on edge. The outbreak of the coronavirus is having a serious impact on cancer patients, their families, and caregivers. Meanwhile, oncologists around the world have been struggling to help all their patients and protect them from the virus. “There is a higher (odds ratio 4.5 times) chance of both contracting corona virus and suffering from Covid 19. Unlike general public, Cancer patients are among those at high risk of serious illness from an infection because their immune systems are often weakened by cancer and its treatment” said Dr. D Raghunadha Rao, Former Director of Homi Bhabha Cancer Hospital and research centre (HBCH & RC).

However, those suffering from cancer, especially, those on chemotherapy must take extra care with social isolation and personal protection. Risk for health care personal of contracting corona virus is equally high. Hence, wearing of appropriate personal protection equipment, appropriate for their roles in the hospitals is required. Need of the hour is reducing the number of radiation fractions, while increasing the dose per fraction. Also, oral drugs are preferred to intravenous drugs.

While categorising the risk factors for cancer treatments Dr.Rao said patients suffering from lymphomas, chronic leukaemia, breast cancer with low risk of progress over next three months no definitive treatments started. While immediate risk of progression, patients can go on treatments that are not likely to increase their risk of dying from Corona infection other than cancer. For the patients suffering from cancers like cervical, ovarian and acute leukaemia and intermediate and high-grade lymphomas, we should initiate and complete treatment. He also said, hospitals should postpone all kinds of treatments that are not life-saving. Palliative chemotherapy and radiation, 2nd and 3rd line drugs that are very toxic and produce fall in counts, may need intensive care after surgery and chemotherapy.

All cancer hospitals around the world strongly advised cancer patients and their families to avoid unnecessary travel to the hospital and to postpone any OPD appointments at this time. Because, overcrowding at the hospital will not only increase the risk of infections in cancer patients, but also the hospital staff and the cancer patients that are currently being treated at the hospital said Dr. Rao

Dr. NS Raju, Managing Trustee of Sneha Sandhya Age Care Foundation, which provides comprehensive palliative care and hospice services to people with terminally sick patients (like advanced cancer) said aged people are the most vulnerable with respect to severity of illness and caregivers must be extra careful about hygiene apart from simple precautions like maintaining a safe distance, washing hands and quick identification of anyone who is ailing. Also, caregivers must change their clothes and bathe thoroughly should they ever venture out. Not to forget, caregivers should be it that they do not miss their medication. All in all, while social distancing should be strictly observed, the elderly need to have enough support to fight loneliness.

The cardinal question that poses to Doctors: Do you treat a critical patient first as they need more help but risk more of the hospital staff and potentially delay other patients help? Or do you treat a patient that can be cured sooner? Typically, doctors make choices of which patient should be treated on priority and depending on the availability of critical care beds – but in a pandemic with overburdened healthcare systems, the choice becomes strangled. Doctors opined that these are private battles doctors and patients are fighting. It is an unnatural situation in oncology where we don’t have such emergency situations.

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