By Dr. Ashu Abhishek, Senior Consultant & Unit Head, Radiation Oncology, Fortis Hospital, Gurugram
The last one year we all have witnessed unprecedented changes in our life where the Corona or COVID-19 infection has put down new normal for all of us. Be it our personal life, health, socioeconomic status or even future plans for so many things.
This world cancer day, obviously we all are expected to talk about cancer, its causes, effect, prevention, treatment and so on. But we all also know, this year any major write up cannot neglect the effect of Covid that has had on so many things in or life. So why not to discuss some finer unknown and not so commonly discussed points as to how Covid has effected oncology world both from patient and also healthcare professionals stand point.
Cancer has always been a difficult disease to diagnose, understand and treat. With our inclination towards urbanization and adopting lifestyles measures that have inherent risk factors which have been well cited as causative agents for cancer (be it pollution, smoking, tobacco, sedentary life style, etc), we have not made our life any better.
From almost rare diagnosis of cancer in past when I might have been in my undergraduate days to now where we are almost threatened to reach to appoint where by next 10 years almost 1 out of every 9 Indian will have cancer in his life time.
Also the challenge in cancer management lies in the vast diversity in the presentation and type of cases with varied responses too to planned therapy. That is why no two cancer patients can exactly be compared in terms of disease and treatment effect even if almost of same stage.
Moreover, especially in India, lack of awareness and good screening and detection programs for the mass population – stage progression, detection at late stages and poor prognosis has always made life of an oncologist difficult. That is the enigma of cancer treatment.
With the recent pandemic, we have been more so burdened by yet another challenge that has literally made things go worse. With the onset of the pandemic, being a totally new disease it had played a lot upon the psychology of the patient and also the healthcare professional, and in a way it was justified too.
With scare in reporting to hospitals, timely identification of early signs of cancer has been delayed, resulting in cases presenting now with stage progression. People missed there planned treatment schedules, leading to irregularities in treatment protocol and inadequate responses and progression while on treatment.
No one could have been blamed for this considering the threat of this deadly virus and also understanding the problems faced and risks associated especially in cancer patients who are already immune-compromised to begin with. All this has played upon the cancer management and decision making.
But the beauty of mankind is that no big problem is a problem and we find our own ways to deal with it. The second half of last year of pandemic has seen people understanding the importance of timely detection and cancer being a disease where we cannot afford to let it grow unchecked.
Teleconsultation and Cancer
There came the welcome move by the Govt to set new guidelines for teleconsultation which at least has made it easier for health professionals to reach to even a remote corner of the country and based on available history and video consultation at least understand and prioritize the symptoms of an ailing patient and guide them rightly if suspected of a possible cancer.
Understanding the possible severity of the disease in an particular individual, triaging and decision for urgency in evaluation and treatment has helped many patients and saved them from slipping from a totally curable stage to stage of no treatment and dismal prognosis.
Even for patients who have been diagnosed with cancer, various oncological societies have formulated new guidelines to how adequately manage cancer patients with alternate and shortened and less toxic regimes of cancer management where patients have least possible risk of exposure and also curtailing the treatment to shortest is effective duration.
Now we understand covid is here to stay and human race will take some time to have full control over it. Till then the life has to go on.
Cancer specifically may not give us that much time to wait and so best foot forward is to understand and accept existence of covid, take all due precautions and then follow all principles of cancer detection and management as we would have normally done.