More Than 100,000 Cancer Cases Likely To Go Undiagnosed Every Month During The Pandemic

Lockdowns and fear of contracting Covid disrupted cancer care delivery services, which led to delays in diagnosis or treatment initiation and interrupted cure, resulting in progression of the disease and poor survival.

Approximately 1,00,000 cancer cases are likely to go undiagnosed every month in India in the midst of the coronavirus pandemic, and the figures could change depending on travel restrictions and lack of easy transport availability, according to a paper published in the Asia Pacific Journal of Oncology Nursing.

During the Covid 19 Age, the paper—Cancer care delivery challenges in India: Are we prepared for the post-pandemic shock? —inferred that the pandemic would potentially lead to worsening of the disease in cancer patients, advanced diagnosis, and thereby adverse effects on patient outcomes.

The paper was written jointly by doctors from All India Institute of Medical Sciences, New Delhi, Lady Hardinge Medical College (LHMC) and Smt Sucheta Kriplani Hospital (SSK) Hospital, Sitaram Bhartia Institute of Science and Research and researchers from USA and UK.

The paper noted that most cancer patients living in rural areas are usually forced to travel to major cities to obtain adequate care.

Challenges in Lung Cancer Care

Current challenge is to balance the risk of admission to the hospital with the possible risk of a coronavirus exposure, which could have an emotional impact on patients and medical staffs also.

Chemotherapy sessions, radiotherapy, palliative care, follow-ups etc. have been significantly affected. Even diagnosis is delayed as bronchoscopy and other interventional procedures have been deferred. In addition, the nationwide lockdown has restricted access to transport and flight services.

Patients in rural parts are suffering significantly. Effect of all this on the outcome of the disease is creating anxiety and distress among patients. Limited availability of intensive care facilities because of COVID-19 patient’s needs has further put
the strain on the care of such patients even if aggressive curative treatment in the form of surgical resection is required.

Cancer That Went Undetected During The Pandemic An ‘Impending Disaster’

Dr. Abhishek Shankar, Department of Radiation Oncology, LHMC, and lead author of the paper, said that this pandemic has broadened the disparities in inequalities and disparity in care delivery associated with insufficient cancer care infrastructure that can not accommodate the current cancer burden.

Currently, no data are available on the number of cancer patients affected by covid 19 in India, but the care of cancer patients has definitely been stalled, according to public health experts.

The number of people diagnosed with cancer worldwide reached 19.3 million in 2020 with the number of people dying rising to 10 million.

According to the WHO, there were 2.3 million new cases of breast cancer in 2020, accounting for almost 12% of all cancer cases. It is also the leading cause of cancer death among women worldwide.

Patient Needs during Crisis

Ensuring the safety of patients with effective care is most important. The stress, anxiety and fear of disease progression due to treatment interruption are a constant cause of psychological distress in lung cancer patients. Counselling by treating physician and measures like being physically active, taking a healthy and balanced diet and maintaining good sleep can alleviate the distressing symptoms. Other important measures include peaceful mind strategies, social connectivity and avoiding misleading information. Virtual meetings of societies and cancer support groups are other sources of encouragement and mental support during a pandemic.

(Paper was written jointly by Dr Abhishek Shankar along with Drs Sachidanand Jee Bharati, Wasimul Hoda, Abhinav Kumar, Sanjay Kumar and Chandrashekhar Choudhari)

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