Cancer patients were initially considered to be susceptible to Covid -19 due to their reduced immune response status or due to cancer or cancer directed treatment.
By Dr. Tejinder Kataria,
Sars CoV-2 is a virus responsible for Covid-19 pandemic and has led to a public health emergency worldwide. The severity of SarsCoV-2 infection depends upon the age, underlying comorbid conditions like chronic kidney disease (CKD), chronic obstructive airway disease(COAD), obesity, hypertension, a pre-existing or ongoing cancer treatment in affected persons.
Cancer patients were initially considered to be susceptible to Covid -19 due to their reduced immune response status or due to cancer or cancer directed treatment. However, factors related to a higher risk of severe disease &/or mortality in cancer patients are pre-existing smoking history, coronary heart disease, COAD, diabetes and obesity.
Two large studies have found no increased risk of death in cancer patients after getting Sars CoV2 infection. Covid-19 & cancer consortium enrolled >900 cases from USA, Canada and Spain and did not find a correlation between severity of Covid-19 or adverse outcomes in cancer patients. The second study with 400 cancer patients from New York, did not find a higher risk of complications with Covid-19 in cancer patients undergoing either surgery or chemotherapy.22,900 patients with recent history of completion of cancer treatment were followed up by Veterans Affairs group and there was no record of higher incidence of poorer outcomes in hematologic cancers(blood cancers).
Cancer care has significantly suffered this last one year due to restrictions put on travel, preventing patients from seeking scheduled treatments. In addition, there have been delays in regular follow ups, postponement of scheduled surgeries following neo-adjuvant chemotherapies, unavailability of palliative care facilities, and an absence of cancer screening programs. There is also a general fear among patients to report to hospital due to risk of getting infected with Covid-19, which has also contributed to further treatment delays. This has resulted in a greater number of cancer patients progressing to advanced stages. The other pressing issue in cancer patients is their lower immunity due to active malignancy and the ongoing chemotherapy which makes them more susceptible to Covid-19 infection.
But we as doctors have been treating cancer patients throughout the pandemic and we have not observed major complications in patients developing Covid-19, while receiving treatment. The main difference that we found was a higher stage at diagnosis due to fear of visiting hospital even in patients having symptoms as well as patients avoiding screening tests for asymptomatic cancers.
Vaccination among cancer patients:
Cancer patients, of all ages, need to receive vaccination as a priority as compared to the general population. The reason is that if & when they contract Sars Cov2 infection, there is a gap of 2-4 weeks in their definitive treatment. The delay in receiving Surgery, Chemotherapy or radiation Therapy can lead to adverse control of cancer. Both vaccines available in the country are safe for cancer patients. Before the vaccination, it is recommended that the patient discuss the scheduling of their treatment with respect to timing of vaccine and expected side effects/precautions.