As the world grapples with the coronavirus pandemic, cancer patients as well as cancer survivors are among the worst affected. This is because the pandemic has affected cancer patient management to a large extent all over the world. These patients are facing a particularly unique challenge as delaying treatment worsens the outcome of the disease.
According to Dr Dharminder Nagar, Managing Director, Paras Healthcare, there are evidence to suggest a higher rate of mortality from COVID 19 among people with cancer.
“Cancer patients and survivors are already dealing with a lot of difficulties. The COVID 19 crisis has only made it more challenging for them to manage their illness. Cancer patients and survivors are often immuno-compromised because of the disease or its treatment. A very critical element of disease management in them, therefore, is the need to safeguard them from all sorts of infections. People with compromised immune systems are not just at higher risk of contracting infections including COVID-19 but are also prone to severe complications from them. This translates into the need for additional precautions and care. Healthcare providers must adopt a comprehensive approach to the treatment of cancer patients during these times including ensuring the continuation of highest standards of care, unhindered treatment as well as psychological support,” said Dr Dharminder Nagar, Managing Director, Paras Healthcare.
There are several issues being faced by cancer patients. They are at the receiving end if the hospitals providing them treatment have been converted into COVID 19 centres. These patients are also concerned about being de-prioritized as care receivers in the ‘new normal’.
According to Dr R Ranga Rao, Chairman, Paras Cancer Centre, Paras Hospitals, Gurugram, not only patients, but hospitals too are grappled with several questions.
“For example, the pros and cons of starting or continuing chemotherapy at such a time because chemotherapy suppresses the immune system and makes patients more vulnerable to infections. On the other hand, stopping or delaying treatment puts cancer patients at greater risk of disease progression. Till now we have tried to ensure that no treatments are delayed or stopped. It is also extremely important to completely isolate the wards for cancer patients so that the risk of infection is minimized. At Paras Healthcare, we have been highly considerate of the needs of cancer patients and survivors. We have initiated special measures to ensure that they continue receiving highest standards of care while mitigating risk of infection during treatment, diagnosis as well as imaging,” said Dr R Ranga Rao, Chairman, Paras Cancer Centre, Paras Hospitals, Gurugram.
Mental health management of cancer patients is one of the aspects that is often overlooked. It takes a major hit even in normal circumstances. And during the time of the pandemic, they are finding it extremely difficult to cope with the anxiousness and heightened risk of infection.
“We clearly see a rise in the incidence of anxiety and depression among cancer patients in the current circumstances. Offering psychological support, counseling, and medication support if needed to deal with mental health deterioration is important in these circumstances,” adds Dr Rao.
Two studies published recently in The Lancet journal indicate a high rate of mortality among COVID-19 patients who also have cancer. In one of the studies, data from more than 900 COVID-19 and cancer patients from the US, Canada, and Spain showed a 13 per cent mortality rate. Another study of 800 UK patients with COVID-19 and cancer found a 28 per cent mortality. The studies also concluded that male patients with other COVID-19 mortality risk factors, such as older age and additional comorbidities, had an increased risk of death. However, cancer treatments such as chemotherapy did not appear to have an effect on mortality in either study.
Another study conducted in the US found that 10.4 per cent of 1018 patients with cancer and COVID-19 had died between March and April. As compared to this, the mortality rate was 5.8 per cent for each 100 confirmed cases.