The risk of morbidity and mortality due to late stage detection of cancer is higher than that due to COVID-19.
By Dr Raj Nagarkar
Doctor’s Day 2020: The coronavirus pandemic has redefined the hospital experience for both doctors and patients. This is even more evident in hospitals that specialize in cancer because cancer patients are more vulnerable to infection. Right from entering the hospital to the actual treatment, a “new normal” is now in place. Because of the possibility of asymptomatic transmission of the disease, hospitals have to treat every person who walks in as a potential carrier of the coronavirus.
Friends and family are no longer allowed to accompany patients inside, to help maintain social distancing in the out-patient areas and also reduce the risk of any cancer patient contracting COVID-19 within the hospital.
Temperature checks before entry have now become a routine practice in hospitals. At my hospital we also use a pulse oximeter to screen anyone who enters. Since low oxygen levels can be a sign of COVID-19, this is an additional safety measure in place to protect staff and patients. Use of PPE is mandatory for both the hospital staff and patients. Enhanced cleaning and disinfection procedures have been implemented in the waiting areas, doctors chambers, and examination rooms. Where possible, visits are converted to telehealth consultations to further reduce risk of exposure.
COVID-19 impact: Additional stress and anxiety among patients
In this “new normal”, one thing I have observed is additional stress and unease faced by patients. A diagnosis of cancer is already accompanied by dread and anxiety, which has now been magnified by the COVID-19 pandemic and all the restrictions it imposes. It was often common to see patients accompanied to appointments by multiple family members. This support system has now been taken away.
Even doctors and nurses are mandated to maintain adequate distance from patients, making their hospital experience even more lonely. The lockdown and travel restrictions add another layer of isolation, because friends and family are not able to visit and boost the morale of patients. I see a greater need to support the mental health and wellbeing of cancer patients during this time. That is why I recommend all patients to speak to the psycho-oncologists at the hospital.
The field of psycho-oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. COVID-19 has really given an impetus to the role of psycho-oncologists in cancer care.
Teaching patients to cope with distress and trauma
Patients are taught techniques to cope with emotional trauma and psychological distress, and caregivers are also counselled on how they can meet the emotional needs of the patient. Pre-COVID, maybe about 10% patients would opt to speak to a psycho-oncologist.
In the “new normal”, it is now a routine practice in my hospital that really helps patients cope. I have just completed a study on the psycho-social aspects of cancer care during COVID-19. This study, involving over 700 cancer patients, caregivers and hospital workers, is soon to be published and I hope it encourages all hospitals to increase the focus on counselling support.
COVID-19 impact on cancer: Avoid delays in seeking medical advice
My advice to patients would be to avoid delays in seeking medical advice due to fear of visiting hospitals and contracting COVID-19. The risk of morbidity and mortality due to late stage detection of cancer is higher than that due to COVID-19.
Early detection gives you the best chance to beat the disease.
The columnist is Managing Director and Chief Surgical Oncologist, HCG Manavata Cancer Centre. Views expressed are the author’s own.