Dealing with Cancer Treatment During a Pandemic
Virtually worldwide everyone is aware of COVID 19. The World Health Organization declared this a Public Health Emergency of International pandemic in March 2020. As of October 2020, more than 50 million cases of COVID 19 were reported in more than 188 countries and territories, and over 10 million in the U.S. There are well more than 1 million deaths worldwide. These are staggering and sobering statistics. However, for vulnerable people who are at higher risk of contracting COVID-19 – such as cancer patients – there are even greater concerns. The virus is spread between people during close contact by air droplets and aerosols. In response, health officials have provided best practices for everyday life, such as social distancing, frequent and effective washing of hands, and wearing a facemask. In Spring, governments worldwide issued emergency restrictions, such as Maryland’s Stay At Home order.
The coronavirus pandemic causes anxiety and disruption of care for all patients with chronic illnesses, including the many with cancer in our region. This anxiety is exacerbated by the varying and ever changing information about the virus circulated through social and mass media. They worry about their safety and health as they navigate a healthcare system consumed by the COVID-19 pandemic. As a result, some patients may have cancer treatments such as surgery or chemotherapy delayed as patients and physicians are forced to weigh the risk of progression of cancer versus that of a patient contracting COVID-19 or other serious ailments. (https://www.baltimoresun.com/coronavirus/bs-hs-cancer-and-coronavirus-20200618-rswyn2trlfcvxirk 2xu7h5kacy-story.html) In addition, patients with cancer are instructed to minimize contact except with those in their immediate contact groups (family and select friends), which deprives them of moral support, assistance at home, or even help with treatments. As a result, patients may feel more isolated and afraid. Anxiety can further worsen a patient’s condition emotionally and physically, which may hasten until the pandemic recedes. Some have experienced significant financial strain. Many cancer patients have said the pandemic has affected their healthcare in some way, reporting lack of access to doctors and delays in imaging, surgical procedures and supportive services such as physical therapy and mental health care. https://www.baltimoresun.com/coronavirus/bs-hs-cancer-and-coronavirus-20200618-rswyn2trlfcvxirk 2xu7h5kacy-story.html
Long term, delaying treatment may result in more complex disease and higher costs. Indeed, researchers have discovered that patients with cancer show deteriorating conditions and poorer outcomes from COVID-19. More than half of patients with cancer and COVID-19 infection have developed severe and life-threatening complications, with some resulting in death. Fear of contracting coronavirus may also impede other people in our community from receiving routine medical care, including preventive care and screenings designed to reduce the risk of or detect cancer.
What to Do
Doctors are still seeking answers, such as when cancer patients who do become infected with COVID-19 can resume chemotherapy if it had to be stopped to treat the virus, or, when it’s safe for such a patient to return to work, said Dr. William Nelson, director of Hopkins’ Sidney Kimmel Comprehensive Cancer Center.
“Patients were afraid and were canceling appointments,” said MiKaela Olsen, a clinical nurse specialist and operations chief in the Johns Hopkins cancer center’s COVID-19 Command Center. “We had to adapt to the circumstances and come up with a way to get them the care they needed while also protecting them from becoming infected with the coronavirus.”
For those with cancer who do not have the virus, treatment centers have procedures to keep patients safe. Cancer patients have an alternative to office appointments. Many appointments are now performed through telemedicine. Another option is to utilize curbside clinics where patients can have blood drawn and receive injections of certain drugs; however, such clinics cannot provide intravenous chemotherapy therapy. When appointments are required to be conducted in a hospital, regimented screening and separation (based on symptoms, recent travel, and temperature) are required to ensure patients are safe.
Patients need to find a balance between prevention and infection, between overlooking and overreacting. Far more people die of cancer each year than of COVID-19, but unlike cancer, everyone on the planet is vulnerable to this virus. If and when a vaccine is approved for the coronavirus, the numbers of fatalities will plummet. The same is true for cancer, but the big question is not "if" but "when."