Dear Doctor/ Dr C.S. Pramesh, director, Tata Memorial Hospital, Mumbai
FOR THE PAST four to five months, most cancer hospitals have seen a significant reduction in patients. The 220 centres attached to the National Cancer Grid have seen a cumulative drop of 30 to 50 per cent in the number of new patients. Now, it is open to interpretation whether they have been going to smaller centres, or they have avoided hospitals because of the fear of contracting Covid-19. Fortunately, we were able to convince many state governments to not convert cancer centres into Covid-19 centres.
Cancer patients who have have been staying away from hospitals are likely to delay diagnosis, which is bound to have an impact on outcomes, particularly if they are in advanced stages. This is particularly true for blood cancers such as lymphoma and leukemia, where days, and sometimes even hours, matter a lot.
It is true that cancer patients with their immunocompromised systems are at higher risk of contracting Covid-19. If the fatality rate is 3 to 4 per cent in the case of Covid-negative cancer patients, it is 8 to 10 per cent for those who have the disease. However, the chances of cancer patients contracting the infection in a hospital are very low. Hence, I would advise those with suspected or proven cancers to approach a hospital and get treated. I would also suggest that they seek an expert with reasonable experience—by reasonable I do not mean only an oncologist, but someone who is an expert in surgery so that the urgency of the situation can be assessed and care can be sought. The risk and fallout of not getting appropriate and timely cancer care is much higher than that of contracting Covid-19 in a hospital.
One of the things we have been promoting aggressively is tele- and video-consultations for follow-ups. Since we are a tertiary care centre, we usually get patients who have already done at least a few preliminary tests. If they come to us with symptoms alone, we ask them to get the tests done at a centre closer to their home, and then seek a second-opinion through tele-consultation, if needed. In terms of Covid-19 precautions, cancer patients need no extra precaution other than physical distancing, maintaining hand hygiene, wearing masks and avoiding crowds.
—As told to Namita Kohli
