The COVID-19 pandemic severely affected prevention and treatment services for non-communicable diseases (NCDs) like cancer as healthcare facilities were forced to completely shift their focus to containment and treatment of the novel coronavirus. Cancer care in terms of screening, diagnosis and treatment comprising chemotherapy, radiotherapy, surgery and even palliative care dropped significantly worldwide. 1

Implications for diagnosis

Cancer screening got delayed for millions of asymptomatic patients across the globe due to the diversion of healthcare staff and resources towards the pandemic. The U.S. Centers for Medicare & Medicaid Services classified screening as a low-priority service because of which healthcare organizations have been postponing them. Besides, many patients have been less likely to show up due to their fear of contracting the infection at the healthcare centers.

Implications for surgery – To provide critical care to the COVID-19 patients, the capacity for surgical procedures has also gone down since the use of ventilators and operation theatres have been redirected. Also, patients have been hesitant in opting for surgery in these times because of the fear of getting infected with COVID-19.

Implications for systemic treatment – The fear that systemic treatment modalities, including chemotherapy, could expose a patient to COVID-19 infection has also led to a drop in patient footfalls.

Implications for ongoing care – Oncology societies across the globe have classified the management and treatment of cancer during the pandemic as low or medium priority and this reprioritization has led to a shift to virtual, tele-consultations. This reprioritization, however, may reduce the opportunities of detecting cancers, symptoms of recurrence, etc.

Implications for clinical trials – COVID-19 has also resulted in the suspension of multiple clinical trials in cancer care worldwide. This might result in a loss of potential health advantages for enrolled patients and account for a huge financial burden from replanning ongoing trials, impacting the approval of critical drug candidates. 2

The way forward

 Clinical oncology teams and regulatory agencies must take the necessary steps to mitigate the negative impact of COVID-19 on cancer diagnosis, treatment and clinical research. Screening, diagnostic and management pathways need to be readapted in a way to ensure the exposure to the virus is minimum and cancer treatment outcomes are not affected. Plus, it is exceedingly important to reassure patients to resume their treatment. It is also important that patients can access advanced care like surgical and other invasive procedures using stringent infection containment policies and dedicated oncology hubs. The concerted efforts can go a long way in dealing with the growing backlog of patients needing cancer treatment. Cancer care protocols should focus on holistic care that maximizes support to patients while minimizing the risk of infection.

This World Cancer Day, resolve to make a difference

February 4 is observed as the World Cancer Day to inspire people across the globe to come together to raise awareness and work towards creating a cancer-free future. Since 2019, the theme for World Cancer Day has been, “I Am and I Will” which reinforces that each one of us can contribute towards reducing the cancer burden. 3

Some Useful Links:

  • COVID-19 and Cancer | ESMO: COVID-19 resources, reference materials, educational videos, latest news and updates to support the oncology community in the pandemic era.

Link: https://www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic

  • ICMR Guidelines for Cancer: Cancer guidelines from the apex body in India for formulation, coordination and promotion of biomedical research

Link: https://main.icmr.nic.in/content/guidelines-0

References

  1. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30392-2/fulltext
  2. https://www.nature.com/articles/s43018-020-0074-y
  3. https://www.worldcancerday.org/about/2019-2021-world-cancer-day-campaign

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