The impact of the pandemic has brought about significant challenges for cancer patients. One of the key concerns is the higher risk of infection. A cancer patient is in an immunosuppressive state, which means that their immune system is not working at an optimal level. Anticancer treatments like chemotherapy, targeted therapy, and immunotherapy hurt their immunity status.
A study published recently in China by Liang et al showed that of the 2007 Covid-19 patients, those who had a cancer history were at a higher risk of an ICU admission requiring invasive ventilation, or worst-case scenario, death. Against this background, what are some of the things that cancer patients and caregivers must keep in mind during such as a time?
Ensure treatment continuity: Due to the fear of contracting an infection through hospital visits, many cancer patients discontinue treatment. Under no circumstances can we let the disease do more harm by allowing progression in absence of treatment. One of the ways to limit exposure without compromising on the treatment is through teleconsultations.
Check for a change in treatment protocols: Check for oral chemotherapy or emphasise on reduced dosing schedules to cope with the side-effects. If a patient needs radiotherapy, shortened cycles are used. For early-stage breast cancer, using a prognostic test such as ‘CanAssist Breast’ that predicts their risk of relapse, can help them avoid unnecessary chemo.
If a patient is at low risk of recurrence, chemotherapy can be avoided, thereby avoiding the adverse effects of chemotherapy on the current immunity level of the patient. Opt for counselling: Being diagnosed with cancer during a pandemic adds additional stress. The reason for this can be the lack of social security due to the fear of inability to access treatment when required.
Extra precautions should be taken to provide reassurance to ensure good mental health of the patients. Role of caregivers: They must actively seek information on change in treatment protocols such as oral chemo, hypofractionated dosage schedules and prognostic tests that can help minimise the impact on a patient’s immunity. The author is a consultant Oncoplastic Breast Surgeon at Sita Devi Hospital, Jaipur