Caring for cancer patients in the Covid pandemic: choosing between the devil and deep sea

Abstract

Background: Healthcare is an essential service at any time more so in the crisis like Covid. With increase in number of cases and mortality from Covid, the primary focus is shifted to the management of the Covid crisis and other health emergencies thus affecting normal health services and routine treatment of other diseases like cancer. Methods: This article reviews the published literature and guidelines on Covid and cancer and discusses them to optimize the care of cancer patients during Covid pandemic to improve treatment outcomes. Results: The results of the review of published literature show a twofold increase in probability of getting CoV2 infection by the cancer patients and a four-fold increase in chance of death. On the other hand, if left untreated a 20% increase in cancer death is expected. Data further show that none of the medicines like remdesivir, hydroxy chloroquin, dexamethasone, or azithromycin improves survival and response to Covid in cancer patients. Surgical results too show similar outcome before and after the pandemic though most of these report on highly selected patients populations. Conclusions: The Covid 2019 pandemic places cancer patients in a very difficult situation wherein if they seek treatment, they are exposing themselves to a risk of developing CoV2 infection and if they do not, the probability of dying without treatment increases. Hence, for them it is a choice between the devil and deep sea, and it is for the healthcare providers to triage patients and treat who cannot wait even though the data from the carefully selected cohort of patients show no increase in mortality or morbidity from treatment during Covid.

Cancer management during the COVID-19 pandemic: Choosing between the devil and the deep blue sea

“…Adding to this, lockdown and isolation imposed by the emerging of COVID-19 have created a sense of collective hysteria, and delaying treatment could be an important factor of increased stress ( Cancarevic et al, 2020 ). In other words, constant fear and uncertainty caused by the pandemic could harm cancer patients’ quality of life ( Chakraborty and Pandey, 2020 ), and this was illustrated by more than one survey in cancer population.…”

Radiotherapy based management during Covid-19 pandemic – A systematic review of presented consensus and guidelines

“…In the beginning, the radiotherapy of some cases was postponed; however, the pandemic has been taking an unexpectedly long time. Therefore, patient selection and prioritization protocols proposed alternative treatments and modification of delivery techniques ( Chakraborty and Pandey, 2020 ). Making proper treatment comments require weighing the risk of infection exposure and the benefit of treatment in a careful manner.…”

“…In contrast, the other cohort or review ones conclude a higher prevalence and morbidity risk of COVID-19 in the cancer population. Some cohort studies reported a higher fatality rate than the other COVID-19 infected patients ( Garassino et al, 2020 ; Zhang et al, 2020 ; Kuderer et al, 2020 ; Lee et al, 2020a ; Poortmans et al, 2020 ; Chakraborty and Pandey, 2020 ).…”

Associação da COVID-19 com: idade e comorbidades médicas

“…Pacientes oncológicos já dispõe de imunidade deprimida, desse modo os cuidados com esses indivíduos necessariamente precisam ser redobrados. No gráfico 2 é explanado que neoplasia maligna de mama e próstata, tende a possuir níveis mais altos de óbitos por COVID-19 em relação a outras comorbidades como: diabetes, cardiomiopatia e obesidade, sendo observado também que, a curva relacionada a letalidade de todas essas comorbidades eram em pessoas com aproximadamente 39 anos, isto, sendo consequência de apresentar a maior Research, Society and Development, v. 9, n. 10, e1299108285, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i10.8285 quantidade de indivíduos que contraem a COVID-19, resultando em óbitos por decorrência das morbidades apresentadas (Brasil, 2020;Chakraborty & Pandey, 2020;Jin et al, 2020).…”