The COVID 19, an infectious illness caused by a new type of coronavirus, that emerged from Wuhan city of China in December 2019 and declared by the World Health Organization as pandemic on March 11, 2020 causes serious complications. Incidentally, the cancer patients have been at a higher risk of complications because cancer and its treatment can weaken the immune system and reduce ability to fight infections. Needless to say, the immune system protects the body against illness and infection caused by viruses like coronavirus.
The extremely vulnerable groups of people include those having chemotherapy; having radical radiotherapy for lung cancer; people with cancers of the blood or bone marrow such as leukemia, lymphoma or myeloma (who are at any stage of treatment), people having immunotherapy or other continuing antibody treatments for cancer; people having other targeted cancer treatments which can affect the immune system such as protein kinase inhibitors or PARP inhibitors and who have had bone marrow or stem cell transplants in the last six months, or who are still taking immunosuppression drugs. An international consortium was established to discuss clinical evidence and to provide expert advice on statements related to cancer management during the COVID 19 pandemic. The steering committee prepared 10 working packages addressing significant clinical questions from diagnosis to surgery.
During a virtual consensus meeting, including global experts and led by the European Society for Medical Oncology (ESMO), statements were discussed and voted upon. When consensus could not be reached, the panel revised statements in order to develop consensual clinical guidance. The expert panel agreed on 28 statements that can be used to overcome many of the clinical and technical areas of uncertainty ranging from diagnosis to therapeutic planning.
An international consortium was established to discuss clinical evidence and to provide expert advice on statements related to cancer management during the COVID 19 pandemicThe ESMO Interdisciplinary Expert Consensus had prepared a guide to better understand the impact of the COVID 19 pandemic on cancer care. It also provides information on the impact of the COVID19 pandemic on various aspects of cancer care, including possible changes to treatment plan to keep patients safe from infection. Expert Nicole Kuderer and colleagues, in their studies, found that among patients with cancer and COVID 19, mortality was high and associated with general and cancer-specific risk factors (with a mortality of 13•3%).
The cancer patients in India suffered during COVID19 lockdown as the patients found it difficult to manage the cancer care delivery system, an oncologist had said. A recent report of 'Cancer Care Delivery Challenges Amidst COVID 19 Outbreak' published in the journal of Asian Pacific Journal of Cancer Prevention has pointed out that cancer patients are more susceptible to coronavirus than individuals without cancer as they are in an immunosuppressive state because of the malignancy and anticancer treatments. Oncologists should be more attentive to detect coronavirus infection early, as any type of advanced cancer is at much higher risk for unfavorable outcomes. Lady Hardinge Medical College assistant professor (radiation oncology) Dr Abhishek Shankar had said that coronavirus has made it difficult to manage cancer care delivery system.
"As we are having a lockdown in the whole country, patients cannot travel from one place to another. About 95% of the cancer care services are restricted to the urban areas but we also know that 70% of the people live in rural areas. So, there is a lot of disparity in cancer care. For cancer patients, stress is more disturbing for the patient rather than cancer itself," Dr Shankar had said. "It is very difficult to manage these people as they are unable to come to the hospital as we are running only emergency services. We have published the paper on cancer care delivery, although guidance is that you shouldn't delay and you should continue with the treatment. But there are many challenges that are coming right now. We have also advised cancer patients about the precautions and they should verify social media messages coming in from a credible source, like the Indian Council of Medical Research (ICMR) and WHO," he had added.
"It is a dilemma for healthcare professionals and patients because there is an issue regarding what to follow and what not to. To date, there is no scientific guideline regarding the management of cancer patients in the backdrop of coronavirus outbreak," Dr Shankar had concluded.