The COVID-19 pandemic has brought with it unprecedented impact to economies and healthcare systems worldwide.

As a result, it has disrupted healthcare delivery and treatment for other life-threatening diseases, including cancer. This has brought anxiety among cancer patients, survivors, and caregivers, and, at the beginning of the pandemic, even healthcare professionals.

The good news is, hospitals, healthcare professionals, and patient advocates continue to work together to define a new normal for cancer care, to help patients safely navigate their cancer journey, amidst the time of the pandemic.

Patients can better equip themselves by knowing more about the virus, its impact on cancer patients, and how best to avoid contracting it.

What is COVID-19?

The 2019 Coronavirus disease, or COVID-19, is an illness caused by a novel strain of coronavirus (SARS-CoV-2). It was first reported in Wuhan, China, in December 2019. The virus can spread from person to person through droplets of saliva or discharge from the nose when an infected person coughs, sneezes, or talks.

A person can also contract the virus by touching a surface or object with the virus in it, then touching the face, specifically the mouth, nose, or eyes.

Most people infected with COVID-19 will experience a mild to moderate respiratory illness. However, according to the World Health Organization (WHO), the people who are most likely to develop a severe illness if they contract the virus are older people and those with health conditions such as cardiovascular diseases, diabetes, chronic respiratory disease, or conditions affecting the immune system.

The most common symptoms of COVID-19 are fever, dry cough, and tiredness. The less common symptoms are muscle aches and pains, sore throat, diarrhea, headache, loss of taste or smell, and rashes on the skin or discoloration of the fingers or toes.

On the other hand, the most severe symptoms that a person may feel are chest pains, loss of speech, loss of mobility, and shortness of breath.

What to Do to Avoid Contracting It?

Currently, tests for a viable COVID-19 vaccine are underway. In the meantime, the best way to lessen the possibilities of contracting it is to avoid exposure to the virus by adhering to set guidelines, such as proper handwashing and strict social distancing.

The World Health Organization (WHO) has set these guidelines on how to reduce the risk of getting infected by the virus: first, stay at home as much as possible and avoid close contact with other people. However, if it is necessary to go out of the house to do errands, wear a face mask and distance yourself from other people for at least 1 meter – these should help you stay protected in a public setting.

Further, wash your hands frequently and properly, or in the absence of soap and water, use 70% alcohol or hand sanitizer. For people with underlying medical conditions, more stringent measures are needed to keep them safe from the virus.

Impact of COVID-19 on Cancer Patients

As mandated by the Philippine Government, people aged 60 and above, as well as those who are immunocompromised, are encouraged to stay home.

For some who are in this situation and need medical attention, their treatments may be hampered. Cancer patients in particular stand to face complications in the continuance of their cancer care, as their weakened immune systems may be more susceptible to viral infections.

Here are some tips on how to navigate the cancer patient’s journey, amid COVID-19.

1. Consult your oncologist for a proactive approach to cancer management.

Have an open dialogue with your oncologist about the next steps after a cancer diagnosis and the goals of your upcoming or ongoing cancer treatment. Schedule a consultation via video conferencing or by phone to discuss the different cancer treatments available, like immunotherapy, chemotherapy, radiation therapy, or targeted drug therapy. Ask your doctor about the benefits and/or side effects of the different procedures.

The doctor can help point you to the right treatment option, let you know which treatments are available at which hospital, and guide you through the “new normal” procedures and precautions.

2. Observe a healthy lifestyle to improve your immune system.

Like any other time, protecting yourself from any sickness involves strengthening your immune system. You can help boost your immune system through a healthy lifestyle: having optimum sleep and keeping yourself adequately hydrated; eating a balanced diet rich in protein, fruits, and vegetables, and keeping active, as your condition allows.  Make sure to ask your doctor about the appropriate activity and diet for you.

3. Practice social distancing and incorporate preventive habits.

As indicated by WHO guidelines, social distancing could lower the chances of getting infected by severe respiratory diseases like COVID-19.

It is best to avoid crowded places and avoid interacting with relatives and friends who exhibit COVID-19 symptoms or may have come in contact with people unknown to you. Take advantage of online grocery and medicine delivery services, and disinfect deliveries as soon as they arrive.

For cancer patients who make hospital visits for treatments or check-ups, make sure you are wearing safety garments such as face masks and face shields.

4. Ask for assistance.

Breast cancer and lung cancer are two of the most prevalent cancer indications in the country every year, based on a Global Cancer Index Report

. As such, those cancer patients, or even experiencing breast or lung cancer symptoms, may feel anxious and worried. Worse, a cancer diagnosis and the thought of undergoing a cancer treatment regimen may have physical and financial burdens on patients and caregivers. With the COVID-19 pandemic affecting world economies, financial problems may be worsened.

However, for the continuance of cancer care, there are many organizations providing health assistance in the Philippines. Different programs, such as Early Lung Cancer Support Group, also exist to help in disseminating awareness for the disease. Advocacies, such as The Cancer Game Plan PH and Hope From Within, have been established to help arm patients with the necessary resources to effectively fight cancer.

Prioritizing Cancer Care During a Pandemic

You may have higher chances of contracting COVID-19 in a hospital, so you must seek the advice of your oncologist regarding your treatment. Oncologists can intervene in classifying the cancer patients who should be seen in the clinic or a cancer center, based on their underlying cancer status and their risk of getting infected with the virus. Some cancer treatments can be safely delayed, but others cannot. An oncologist needs to determine if a patient has an urgent or non-urgent condition based on their patient assessment.9 Cancer patients with urgent conditions are those that need to continue their treatment, as any delay could be fatal. Cancer patients with critical conditions are those diagnosed with early or locally-advanced cancer who have not completed their treatment and are qualified for surgery or other therapy treatments. The advice of the attending oncologist for a patient to come to the hospital for their treatment should always be balanced with the risk of contracting the virus.

On the other hand, patients with stable conditions, are asymptomatic, and have already completed their cancer treatment are classified to have non-urgent conditions. Clinic visits may be delayed as they may warrant a less aggressive approach to cancer management.

The pandemic has greatly affected the health sector globally. Although it continues to pose serious respiratory illnesses to most people, particularly those with weakened immune systems like cancer patients, doctors and patients must work together to ensure the continuance and safety of cancer care, as this cannot be compromised. Consulting your oncologist can help you better understand the effects of COVID-19 on cancer care, and support you with a proactive approach to cancer management.

References

1 Inquirer Lifestyle. (2020, June 12). Retrieved from https://lifestyle.inquirer.net/364147/what-cancer-patients-need-to-know-in-the-time-of-coronavirus/

2 Merry Jennifer Markham, M. F. (2020, August 10). Coronavirus and COVID-19: What People With Cancer Need to Know. Retrieved from Cancer.Net: https://www.cancer.net/blog/2020-08/coronavirus-and-covid-19-what-people-with-cancer-need-know

3 Center for Disease Control and Prevention. (2020, June 1). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf

4 World Health Organization. (2020). Retrieved from https://www.who.int/health-topics/coronavirus#tab=tab_3

5 Coronavirus disease 2019 (COVID-19) Situation Report – 51. (2020, March 11). Retrieved from World Health Organization: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10

6 Official Gazette. (2020, March). Retrieved from https://www.officialgazette.gov.ph/downloads/2020/04apr/2020030-EO-112-RRD.pdf

7 World Health Rankings. (2018). Retrieved from World Life Expectancy: https://www.worldlifeexpectancy.com/philippines-lung-cancers

8 Hope From Within. (2019, February 14). Retrieved from Hope From Within: https://hopefromwithin.org/new-cancer-game-plan-for-the-philippines-launched/

9 Abarquez, Honey Sarita; Sacdalan, Danielle Benedict; et al. (2020). Treatment of cancer patients during the COVID-19 pandemic in the Philippines. Retrieved from eCancer Medical Science: https://ecancer.org/en/journal/article/1040-treatment-of-cancer-patients-during-the-covid-19-pandemic-in-the-philippines