In addition to Covid-19 presenting a higher risk for cancer patients, the pandemic has created a challenge for doctors managing them. A number of the patients have relapsed on treatment as a result of fear of exposure that comes with visiting a medical facility.
The Business Daily spoke to medical oncologist at Mediheal Hospital in Eldoret Dr Lalit Varadpande to gain more insights on the treatment innovations doctors are trying out to cope with the situation.
WHAT TRENDS HAVE YOU OBSERVED IN YOUR PRACTICE SINCE THE OUTBREAK OF COVID-19?
Covid-19 has created a lot of fear among cancer patients such that they are afraid to come to the hospital. They fear that they may get infected on the way or inside the facility. There has been a general decline in the number of patients coming to the hospital per day which has in turn delayed treatment for some.
WHAT SOLUTIONS ARE YOU OFFERING GOING FORWARD?
My suggestion is that the patients have close discussions with their oncologist to see what measures can be taken; whether they should stop, postpone or modify the treatment.
In chemotherapy at least there is a scope to change the treatment from injection to an oral form like tablets that can be taken at home. With this the patient minimises the risks of getting exposed to Covid-19 since they don’t have to travel all the way to the hospital.
HOW ARE YOU HANDLING YOUR PATIENTS IN THE MIDST OF THIS COVID-19 STORM?
I have postponed few treatments that aren’t really essential and advised the patients to take oral forms. Additionally, they are under instruction be in touch with me regularly and alert me in case of side effects emanating from the treatment. We have reverted to telemedicine where patients send scanned blood reports or general condition reports to my phone, including through WhatsApp. Upon reading these, I am able to see how best to guide them.
WHAT’S THE AVAILABILITY OF CANCER TREATMENT?
We are experiencing some delays in availability of drugs for cancer treatment mostly due to logistical reasons complicated by the ongoing curfew and lockdown. It is taking two to three weeks more than before so treatment is delayed to the patient. Note that, any delay in treatment is detrimental to the cancer patient.
WHY ARE CANCER PATIENTS MORE SUSCEPTIBLE TO COVID-19?
Covid-19 in cancer patients is more lethal because the disease itself and also its treatments such as chemotherapy and radiation weaken a person’s immune system.
Additionally, patients with lung problems and diabetes are at a higher risk of getting more serious complications of Covid-19. As you may know most Covid-19 patients have recovered but a large number of those with underlying medical conditions haven’t been so lucky. So these are the patients that you need to really take care of through prevention and avoid unnecessary travel to big crowds.
HOW DOES CHEMOTHERAPY COMPROMISE A PERSON’S IMMUNITY?
Chemotherapy is going to affect a person’s bone marrow and this is where the haemoglobin, the leucocytes and the platelets are formed. The leucocytes in the body are responsible for the immune function. So chemo will affect the bone marrow therefore reducing the person’s immunity. And if by chance the person gets infected with coronavirus the patient can end up with serious adverse effects that can lead to loss of life.
WHAT ARE SOME EARLY SIGNS OF CANCER THAT PEOPLE SHOULD NOT IGNORE?
Seek cancer care as early as possible. Don’t ignore the early warning signs such as difficulty in swallowing, severe weight loss, a swelling in the body, abnormal bleeding and chronic cough. Once you observe these, see your general physician or an oncologist and get evaluated.
ARE THERE EXTRA PRECAUTIONS THAT CANCER PATIENTS SHOULD TAKE TO BE SAFE FROM COVID-19?
Same as everyone’s else — that is social distancing, wearing of mask, hand hygiene, avoiding crowded areas, being at home as much as possible, especially for people aged over 60 years and people with underlying medical conditions such as diabetes.
And these precautions are to be observed until the virus goes away and we don’t know when that will be or when the vaccine is going to come. It is a very long process.
WHAT ARE THE CURRENT STATISTICS OF CANCER IN KENYA?
It is estimated that there are 47,000 new cancer cases and 33,000 deaths from the disease registered annually. For a population of 47 million, these are huge numbers.
Up to 80 percent of these cancer patients come for treatment when the disease is at an advanced stage when cure is not possible. Note that cancer is curable if its detected early — any cancer for that matter.