Cancer patients suffer as care for chronic cases takes a hit

As cancer treatment weakens the immune system, medicos are advising halting or at least reducing the dose of chemotherapy. It is also a challenge for the doctors as the patients are likely to develop complications post-chemotherapy. “Immunosuppression can make patients more prone to acquiring infections and lead to further complications. Since cancer is a chronic disease, the treatment can be continued after the risk of COVID-19 comes down,” said Dr R Ranjith of Rajiv Gandhi Government General Hospital.

Doctors at the Cancer Institute say chemotherapy is scheduled only if the patients have undue morbidity as most of the private hospitals are not doing it to avoid further infections. “A cancer patient is likely to develop fever-like symptoms after chemotherapy. This might lead to mismanagement of the case as fever-like symptoms are being screened for COVID-19,” said an oncologist from the hospital.

Hospital policies and oncologists recommend video call instead of a hospital visit, taking the help of a home nurse and nearby hospitals for immediate post-operative care after discharge. Oncologists say less toxic chemotherapy regimens with lesser hospital visits and oral chemotherapy regimens may be used to minimise exposure of both patient and the caregiver to COVID-19 sources.

“Certain planned chemo schedules may be delayed. However, patients requiring chemotherapy for the day-to-day control of disease may continue their therapy under strict monitoring,” said Dr Krishnakumar Rathnam, head, Department of Medical Oncology, Meenakshi Mission Hospital and Research Centre.

Doctors say radiation therapy can be tailored with shorter durations and modalities with lesser side effects which might be done on an outpatient basis.

“Adjuvant therapies with chemo and radiation can be shifted from weekly regimens to once in three weeks, oral instead of intravenous chemotherapy and judicious use of targeted therapies with lesser adverse effects. Those who need booster shots and intravenous medications can ask for a home nurse visit,” said Dr Rajasundaram, an oncologist at Gleneagles Global Health City.