A Study on Challenges to Health Care Delivery Faced by Cancer Patients in India During the COVID-19 Pandemic

Abstract

Introduction Access to health care and care delivery during the COVID-19 pandemic may be challenging for cancer patients. Several guidelines have been developed, which recommend treatment adjustments depending on the site of cancer, grade, and stage. However, few studies in India and across the globe have looked into the real challenges faced by cancer patients and assessed the effectiveness of the adopted interventions. This study was undertaken with the objective to study the challenges faced by cancer patients in India during the COVID-19 pandemic. Materials and Methods This was a cross-sectional study undertaken between May 1, 2020 and May 15, 2020. A link to a prestructured questionnaire was sent through email to 100 randomly selected cancer patients in different stages of treatment and follow-up. Data were decoded and entered in Microsoft Excel 2010 and analyzed using descriptive statistics. Results Slot availability for teleconsultation, network issues, deferral of radiotherapy dates and long waiting hours beyond appointment time, transportation problems from residence to hospital, restriction of visitors/attendants, deferral of surgery, deferral of tumor boards, delay and deferral of advice of the nutritionist, problems faced in extension of visa, unavailability of peer group support services and psychological counseling sessions, difficulty in maintaining precautionary measures, availability of chemotherapy medications and availability of chemotherapy slots in day care were cited as problems faced by cancer patients. Majority (91.7%) of the study respondents mentioned an increase in their anxiety levels. Conclusion As highlighted in the study, cancer patients faced challenges in cancer care delivery during the COVID-19 pandemic. This study suggests the need for larger studies on cancer patient care during a pandemic.

Cancer Services During the COVID-19 Pandemic: Systematic Review of Patients’ and Caregivers’ Experiences

“…(II) Experiences of accessing cancer treatment and care services Participants in the majority of the included studies reported experiences of treatment delays [17,18,20,22,24,[25][26][27][28][29][30][31].…”

“…Reasons ranged from hospital cancellations, city lockdowns and swabbing requirements. Deferral of radiotherapy dates and long waiting hours beyond scheduled appointment times was a problem cited by a number of participants in one study conducted in India [30]. Another study conducted in Italy reported that radiation, infusion therapies and surgical tumour removal experienced the most disruption [31].…”

“…Emotional distress was common in patients who had experienced disruption to cancer treatment [28]. Uncertainty surrounding medication availability and the lack of nursing care available for patients who were living alone added to their worries [22,30]. For example, patients with cervical and oral cancer struggled to source certain dressing materials and so were left with defective dressings [22].…”

“…Whilst the interruption of treatment was most apparent, one study based in India explored other implications of the pandemic including the deferral of advice from the nutritionist, unavailability of peer group support services and psychological counselling sessions [30]. Although some of the participants had access to online counselling services, appointments were scarce.…”

“…In another study, almost two-thirds of patients felt that despite virtual means, they were still able to contact the healthcare team and so expressed feelings of reassurance [35]. However in one study conducted in India, patients reported di culties in booking a virtual appointments and unpredictable network issues [30].…”