Care of cancer patients during COVID – 19 Pandemic

All of you know that all there is pandemic of COVID – 19 all over world. the cancer patients are at particularly high risk of mortality and morbidity associated with corona virus infection. In this blog I will explain what are the precautions to be taken by cancer patients during this pandemic.

Cancer patients have suppressed immunity due to altered immune system and the treatment including chemotherapy radiation therapy and targeted therapy. This leads to more chances of lung infection in the cancer patients.

  1. All cancer patients should follow strict guidelines for social distancing and personal hygiene including hand hygiene.
  2. Patients should stay at home till pandemic is poor

Care of chemotherapy patients

Chemotherapy can cause neutropenia leading to decreased immunity which can cause complications associated with COVID – 19 infection. If you are living in pandemic area of corona virus and if it is possible to postpone the chemotherapy for few weeks then it should be postponed after discussing with your oncologist.  In few cancers like breast cancer where there is option of starting on less aggressive treatments like hormonal treatment should be started on hormonal treatment. Patients who are on palliative chemotherapy can be postponed their routine chemotherapy. If patients have any symptoms like fever, sore throat, cough and diarrhoea or present then chemotherapy should be withheld. Patients who are on high dose immunosuppressant chemotherapy should be shifted to low-dose chemotherapy if possible. Patients who need multiple days of admission can be converted to day care chemotherapy sessions. If it is possible to give chemotherapy at home then it should be encouraged.

Care of patients undergoing radiation therapy

Patients who are undergoing radiation therapy should follow strict social distancing norms. Radiation therapy does not cause profound immunosuppression so it can be continued unless patient has any sign or symptom of Corona virus. If there is concurrent chemotherapy is going on then all the norms as per chemotherapy patient should be followed. During this epidemic short course radiations including hypo fractionated radiation therapy regiments should be preferred. Hypo fractionated radiation is a form of radiation in which high dose of radiation is delivered in less number of fractions. By this way the treatment will be completed in shorter duration which causes less exposure of patient to infections.

Patients planned for cancer surgery

Patients planned for elective cancer surgery should be screened for any infection or contact with COVID – 19 infection. If it is possible to postpone Surgery by few weeks then it should be postponed provided the prognosis of disease is not altered significantly. If the surgery is life saving then it should be then t should be done immediately.

Care of newly diagnosed cancer patients

The patients who are diagnosed freshly should discuss the plan of treatment with your oncologists. In view of increased chance of infection the strategy should be made to decrease the intensive treatment and avoid immunosuppression during the epidemic period. At the same time the prognosis of the disease should not be hampered adversely.

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