Focus on battling COVID-19 deals deadly blow to cancer care as lockdown disrupts early diagnosis, treatment

Over the past six months, the COVID-19 pandemic has dramatically altered our lives. The strict enforcement of lockdowns, mandatory use of face masks and social distancing norms have kept us at home, away from friends, family and our daily routines. As the cases across India continue to rise, the attention of government authorities and frontline workers has rightly been focused on testing, isolating, treating and tracing COVID-19 patients. But as it becomes clear that the virus is here to stay, doctors and medical practitioners are warning that the trained focus on COVID-19 is resulting in the neglect of a far deadlier disease that silently stalks millions of Indians and has a far higher fatality rate - cancer. India has a cancer crisis, with statistics presenting a bleak and frightening picture. According to the World Cancer Report: Cancer Research for Cancer Prevention, nearly one in every 10 Indians is likely to develop cancer at some point in their lives and one in 15 Indians will succumb to the disease. According to the National Institute of Cancer Prevention and Research, nearly 11 lakh new cases of cancer are registered every year even as an estimated 2.25 million Indians are already living with the disease. The top six types of cancer that are most prevalent in India include breast, oral, cervical, gastric, lung and colorectal cancers. While cancer treatment has significantly advanced in the last few decades, prevention, early detection and treatment are still key to survival. Alarmingly, in India, almost 50-60 percent of patients already have an advanced form of the disease (stage 3 and 4) at the time of diagnosis. There are several factors that are responsible for this, including a lack of awareness, absence of screening programs, limited diagnostic and medical facilities, particularly in rural and remote parts of the country, concentration of tertiary cancer care centres in urban cities and a significant financial burden associated with cancer care. Added to this long list is COVID-19. Cancer care has received a deadly blow during the pandemic. Over the past few months, media reports and first-hand accounts from medical practitioners have reported harrowing stories of cancer patients whose treatment has been disrupted due to the imposition of the nationwide lockdown, closure of state borders, and disruption in travel and movement. As per media reports, many who had travelled from their hometowns and cities to urban centres like Delhi and Mumbai to receive treatment found themselves stranded during the lockdown, even as many newly diagnosed patients have been unable to travel to receive treatment. Doctors and cancer care hospitals also report their own challenges in providing cancer care in the time of a pandemic. These include having to make difficult decisions about cancer surgeries, chemotherapy and radiation, particularly in the case of patients who are vulnerable due to their age and other medical conditions, such as heart disease, diabetes and kidney disease. The growing demand for hospital beds to treat COVID-19 patients and confusion over home or hospital quarantine has also put many tertiary care hospitals in a dilemma. Often COVID-19 beds have come at the cost of beds that would have been otherwise reserved for cancer patients. Amid a global pandemic, cancer patients themselves face an impossible dilemma. Patients whose immune systems have been weakened and compromised due to their illness, chemotherapy, radiation and other treatments are at higher risk of contracting and succumbing to COVID-19. At the same time, the risk of postponing check-ups, surgeries and other cancer treatments represents a far greater threat to their long-term survival. As a cancer survivor, I can well understand and relate to this fear. Three years ago, I was diagnosed with a rare and extremely aggressive form of breast cancer. As a fit and active 35-year-old, it was a devastating diagnosis, one that took me and my family completely by surprise. What gave me strength and confidence at the time was the speed of the diagnosis, clear line of treatment and the rapid start of treatment. Within a few days of diagnosis, I underwent surgery and then commenced a regime of chemotherapy and radiation under the care of a fantastic team of doctors at Apollo Indraprastha Hospital in Delhi – Dr Ramesh Sarin, my surgeon and the head of my team of doctors, Dr Manish Singhal, medical oncologist and Dr Sapna Nangia, radiation oncologist. From start to finish, my treatment took a marathon nine months. Over the past few months in lockdown, as I reflect on this experience and my own fear and anxiety during and after treatment, my heart goes out to patients whose treatment has been so brutally disrupted and who find themselves in uncharted territory because of the pandemic. Being diagnosed with cancer at any stage is a life-changing moment for the patient, family and caregivers. While we all wait for the COVID-19 pandemic to ebb and for a vaccine to be found, we must not forget that there is still no cure for cancer. Prevention and early treatment are still the best lines of defence. So it is imperative for the government – national, state and local – to take measures to ensure that cancer patients continue to receive the attention, quality of care and treatment that they need to ensure the best chance of survival. At the same time, tertiary and primary cancer care cancer facilities need to be allowed to treat patients in a safe and hygienic environment. Additionally, it is imperative for tertiary care hospitals to put in place systems and protocols to separate COVID-19 patient wards and OPD from their regular investigation and treatment of cancer patients. For cancer patients and survivors, such as myself, there is a continued need to take precautions such as practising hand hygiene, wearing a mask, avoiding large social gatherings and taking necessary steps to remain fit and healthy during and after treatment. This article was written by Mandakini Surie. She lives and works in New Delhi. A writer and development practitioner she has been working in the social sector for over 15 years. As a cancer survivor, she hopes to raise greater awareness about cancer and its treatment through her writing. In her spare time, she loves to cook, dance and travel in no particular order. For more information, read our article on Cancer: Types, Stages, Symptoms and Treatment. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.