The latest respiratory illness, commonly known as COVID-19 has changed the way the world operates. It is quite alarming to view news reports about the virus spreading, taking a toll on millions of lives, and shutting down everything. Following the guidelines imposed by the WHO such as maintaining socSSSial distancing, practicing adequate hand hygiene, wearing a mask is the new normal. Although the impact of the pandemic has been dreadful for all, those with serious health conditions such as breast cancer, the uncertainty of the situation, possible delays in the treatment, and the need for social distancing can be especially distressing. Since the different treatments involved in breast cancer such as radiation, chemotherapy and targeted therapies, etc. can weaken the immune system, such people are also at a higher risk of developing complications if infected with the virus.
Precautions for Patients Undergoing Breast Cancer Treatment
According to oncology experts such as Dr. Sidharth Sahni Apollo cancer patients have an increased risk of acquiring the COVID-19 disease as well as developing complications thereafter. Therefore, they need to be extra cautious and take the following precautions:
- Wash hands frequently and avoid touching your face
- Cover your face with a tissue while sneezing and dispose it off after use
- Avoid contact with people who are sick
- Strictly follow social distancing to avoid contact with asymptomatic carriers of the disease
- Do not move out unless absolutely necessary
- Have a stock of essential medicines for at least a month
- Avail telemedicine services instead of in-person visits whenever possible
Stage-wise Guide for Breast Cancer Treatment during COVID19 Pandemic
- Patients diagnosed with preinvasive lesions of the breast post surgery can wait for the pandemic to subside before going for adjuvant radiotherapy.
- Early-stage breast cancer patients can wait for 6 months after the pandemic begins before availing further treatment.
- Patients who are to undergo surgery and are taking chemotherapy sessions as a consequence must undergo surgery on a priority basis. Advanced breast cancer patients and those at high risk such as HER2 positive and triple-negative must avoid any undue delays and undergo chemotherapy as planned.
- Elderly patients with small tumors and hormonal receptor-positive breast cancers post surgery can begin with adjuvant hormonal therapy instead of chemotherapy.
- Patients diagnosed with metastatic disease leading to organ dysfunction must start with chemotherapy straight away without any undue delays. Those harboring hormone receptor-positive diseases with metastasis must be put on hormonal therapy instead of chemotherapy.
To utilize the limited hospital resources and staff effectively during these tough times, the management of breast cancer patients has been prioritized on the basis of the urgency of treatment worldwide. High priority patients are those with life-threatening symptoms, those who are clinically unstable and those whose survival rates can increase post the treatment. Medium priority includes patients whose situation is non-critical while low priority are those with stable condition. Accordingly to experts such as Sidharth Sahni, each cancer patient must understand the risks associated with continuing or withholding the treatment. Let’s have a look:
Risks of Undue Treatment Continuation
- The risk of complications becomes higher in such patients
- Chemotherapy can lead to neutropenia that can decrease one’s immunity and increase the risk of complications
- Neutropenia induced chest infections can mimic COVID-19 changes in the lungs in rare instances
Risks of withholding treatment
- Risk of cancer progressing increases
- Uncertainty with regards to the end of the pandemic
- Risk of loss of treatment efficiency due to delays