Cancer Management in India during COVID-19
Cancer is one of the leading causes of concerns in India’s health landscape with an estimated 13.9 lakh people suffering from this disease in 2020 with tobacco related cancers, breast cancer and gastrointestinal tract cancers being the main types of cancer in India. As per a recent report by the ICMR and the Bengaluru-based National Centre for Disease Informatics and Research, looking at the current estimates the number may increase by 12% or 15.7 lakh cases by 2025. The current COVID-19 pandemic has drastically changed the dynamics of the medical industry and created a dilemma around the treatment of cancer patients, given their weak immunity. After the lockdown announcement, a lot of cancer patients too were afraid to resume their treatments and procedures due to the fear of going to hospitals and risking getting an infection. Given that a lot of these procedures do compromise the immune system, even medical practitioners were in a conundrum regarding cancer care. But the nature of this disease is such that putting a pause on procedures altogether is not a wise thing to do. A delay or postponement in severe cases might lead to the patient’s health to deteriorate and cause extreme conditions or emergencies.
With COVID-19 cases spiking up expeditiously, cancer management in India has also undergone changes and updates to keep up with a difficult situation. Given the immunosuppressive state of cancer patients and the restrictions in travel as well as the socioeconomic condition of many patients, the biggest challenge is administering timely care and medication to them. So multiple factors need to be assessed while making crucial medical decisions by both the doctors and the patient. The constraints have made it necessary for medical practitioners to prioritize the patients and their procedures after assessing the risk factors and reviewing the medical condition of the patient. Some the categories in high risk are:
- Patients receiving extensive radiotherapy
- Those currently undergoing chemotherapy, or have received chemotherapy in the last three months
- Patients who have had bone marrow or stem cell transplants in the past six months,
- Patients who are still taking immunosuppressive drugs
- People with some type of blood or lymphatic system cancer which damages the immune system, even if they have not needed treatment
With the healthcare system facing a shortage of staff and overworked medical professionals, it is essential to schedule the visits and treatment based on weighing these assessments against the potential exposure to the virus. Unless the patient has been exposed to the virus, the care for high-risk patients should not be kept on hold. For each patient, screening has become mandatory with the check-up area being separate for cancer patients. During the consultation, the doctor, as well as the patient, needs to follow extreme safety and sanitization protocols.
Before starting or resuming any treatment for cancer patients, it is vital to get all the tests done to ensure an effective and safe course of treatment and medication. Cancer patients need to take precautions and be extra careful during this time to lower their risk of being exposed to the virus. For patients who don’t require immediate surgeries or procedures, tele-consultation and tele-medication should be encouraged wherever possible.
The present situation demands a lot of quick thinking, micromanagement and detailed planning to provide the necessary care to cancer patients. In a country like ours, with so many factors at play, a proper pandemic management system needs to be developed better to effectively manage the check-up schedules for other acute diseases like cancer
Inputs from Surgical Oncologist, Apollo Cancer Centre, Navi Mumbai