Effects of COVID-19 on cancer treatment
There is no doubt that the delivery of cancer care will be disrupted. Cancer clinics may need to reduce clinical appointments, chemotherapy administration encounters, alter radiotherapy schedules, and cancel or postpone elective cancer surgeries. There may be a shortage of supplies, non-availability of drugs and consumables. Newly diagnosed and existing patients with cancer who experience chest symptoms (e.g. breathlessness) due to lung metastases may be denied care due to heightened suspicion of COVID-19 infection. For patients with cancer, these will have huge repercussions on their experience and management of cancer-related symptoms, quality of life and survival.
According to the American Society of Clinical Oncology(ASCO), “There is no direct evidence to support changes in cancer regimen during the pandemic” [7]. Therefore, routinely stopping anticancer or immunosuppressive therapy is not recommended. There are currently cancellations or postponement of elective cancer surgeries and in the coming days radiotherapy appointments may also be affected. Community-based palliative treatment of advanced cancers will also be affected significantly as health care workers are minimising their contacts through social distancing and due to the increase in demand for their expertise in the treatment of confirmed cases in the health facilities. Thus, there is a grave impact on disease control.
For us oncology professionals working in low-resource settings, we are faced with the dilemma of striking a balance between protecting ourselves and giving our patients a good chance to fight their cancers during the COVID-19 outbreak. We must tread with caution, as we are a critical workforce, highly trained and skilled in treating cancer, as well as being an endangered specialty with a limited human resource pool in the country. This is not the time to be careless in the frontline as we are all at risk and we must do all that is required to reduce our chances of getting infected. The World Health Organization’s recommendation for health care providers in this COVID-19 era is well articulated in an online resource [8].