The Coronavirus is more dangerous for cancer patients as their immunity is low. Hence, they must prevent exposure at all cost
Ever since the Coronavirus outbreak in Wuhan, China became a global pandemic, it has dominated all discourses and platforms with information flowing in from all sources, be it newspapers, electronic or digital media. Amid the worldwide hue and cry, medical professionals are analysing how infective the Coronavirus is, how much damage it can cause in terms of casualties and who are the people most at risk.
It is quite evident from all available information from other countries that COVID-19 or SARS CoV-2 infection has a higher infectivity as compared to other SARS viruses, though lesser mortality. What has been clear so far is that the elderly and people with co-morbidities like diabetes, hypertension, cardiac and lung diseases are at a higher risk of infection and also mortality. To make matters worse, it is being discovered that smokers have a higher risk of infection as their lungs are already compromised due to smoking.
In India, with 113 confirmed cases and two deaths so far, we are yet to know how things would turn out in the next 15 to 20 days and whether those who came into contact with the patients would turn symptomatic or not. A pandemic spreads in four phases and the country is entering the second phase where person-to-person contact has already caused others to turn positive.
Oncologists encounter cancer patients who are either under treatment or on follow-up. What concerns doctors is whether this illness behaves the same way in cancer patients or differently from the normal population. Cancer patients under active treatment have a weaker immunity due to the disease as well as the treatment than cancer survivors or healthy people. This means they can catch an infection much more easily than others. Age and co-morbidities are other factors that increase the chances of the Coronavirus infection being fatal in this population.
A recent research published in a leading international journal says that data of Coronavirus patients collected in China showed that there was a higher proportion of cancer patients among those affected by it, with most of them being lung cancer patients. These were older patients and many had baseline computerised tomography (CT) scan abnormalities in their lungs. Figures from the research showed they had more intensive care unit (ICU) admissions. Mortality was also higher in cancer patients, lesser in cancer survivors and least in the rest of the population.
The medical profession demands healthcare professionals to be available for the care of their patients, especially during an outbreak, even if it adds to the occupational hazard of catching the infection themselves.
A breakthrough advancement grossly underutilised in medicine, which could prove to be a boon in the prevailing situation, is telemedicine. Most of the Government institutes like the Tata Memorial Hospital, PGI Chandigarh and AIIMS in various cities and many more, are well-connected through the NKN (National Knowledge Network) and this should be activated now as this is the need of the hour. In the current scenario, it appears to be an intelligent and resourceful way of allaying patients’ apprehensions and attending to patients who are on follow-up and also those who are asymptomatic. Also it would help in basic care to be provided near their homes in coordination with the treating expert. This would eventually help limit the movement of patients and relatives and protect them from not just inadvertent exposure but also reduce the risk of exposure of doctors and other paramedical staff.
As the old adage goes, prevention is better than cure. It is best to avoid exposure to the virus, which essentially means avoiding non-essential travel or going to crowded places and observing high measures of hand hygiene. Patients on active treatment and more so old patients and those with the mentioned co-morbidities need very strict implementation of these preventive measures and should be more cautious of signs and symptoms.
They should continue to take cancer treatment as per instructions from the treating oncologist along with preventive measures. Whether their treatment should be continued or can be delayed would depend on the diagnosis and has to be discussed with the treating oncologist in detail. Fear of catching the infection should not prevent them from approaching their doctor. Another important preventive step is for the patients to be accompanied by the minimum number of caretakers. Though everyone has to be aware and take preventive measures, it is more relevant for cancer patients undergoing active treatment and in cancer survivors as well.
(The writer is Consultant Radiation and Preventive Oncologist, Paras Hospital, Gurugram)