COVID-19 is here and will take some time to go away from this earth. Based on the experience in affected countries we know it is causing mild illnesses, in vast majority, treated at home in isolation, some may have more serious illness, requiring hospitalization and few unfortunate require intensive care and probably ventilation. While majority recover and become normal, some may require time to recover, about 1 to 10 % die according to the age, preexisting lung problems, diabetes, cancer, immunosuppression, heart problem.
Based on the studies, it is now well understood that cancer patients are:
- More at risk of contracting the infection
- The infection is more severe in cancer patients.
- In case of severe infections, the outcome in cancer patients is worse.
- The outcome is worse in lung cancer patients or with lung diseases.
- The increased age, preexisting diabetes, and their conditions, contribute to the outcome.
What about cancer patients?
First of all, there is no need to panic and stress yourself neither for cancer no COVID. Let the oncologists take care of the cancer and you look prevention for COVID 19 infections.
Only you can prevent it and along with your family members.
- Don’t stress! Don’t panic!! Don’t be pessimistic. Both will be looked after! You are not alone in this battle.
Before we ask questions, few basics…
- The risk of contracting the COVID 19 infection and morbidity, mortality is somewhat higher in cancer patients.
- Therefore, precautions in cancer patients should be very stringent and no chances taken.
- If required, cancer patients with some predisposing factors should be isolated form all others to minimize the chances of infection. Like an elderly cancer patient, with diabetes, heart problem etc.
- The risk of cancer, risk of COVID infection, preexisting circumstances must be considered.
- Any decision about treatment, follow up, should be arrived at after consulting the treating oncologist or an oncologist nearby, in any manner.
- Please do not act on your own, by your own thoughts, fears, perceptions, myths, and without consulting, it may be harmful to the patient, or the family.
- Understand the risk of COVID, travel risks, on one hand, cancer and its effect on the body, treatment, its effects and finally overall benefits and problems.
- As far as possible, avoid invasive options of surgery unless emergency exists,
- Check from your oncologist if the hospital or OPD has any risks of COVID 19 infections. Please understand that nobody can give you an assurance of the risks, beyond taking reasonable precautions.
Please remember, that questions below have been addressed as much as possible.
I have been just diagnosed to have cancer in this critical period. What to do?
- From your oncologist, understand the risks of cancer, its stage, options of treatment, curability, interim treatment.
- If the treatment of all kinds can wait, without much damage, please do that.
- If the treatment is essential, please choose the simplest one which can be done at home.
- If there life threatening, and or is an emergency, you hardly have any choice.
I have been undergoing chemotherapy. Shall I continue?
It depends upon the situation. If the treatment continuation is curable or lifesaving, or very effective or discontinuation would result in adverse outcome, better to continue. Please do not travel far for the same. Minimize the travel and have it in your city, nearby place.
I am on follow up and due for tests next week.
If you do not have any symptoms, you are safe right now. Please wait for the situation to improve. Please do continue the treatment. Be in touch with your oncologist.
If you have some symptoms related to cancer, please do consult your oncologist and decide.
My cancer requires surgery. What shall I Do?
If the tumour is fast growing, or likely to cause any complications soon, or already causing the symptoms it may be better to go for surgery. If there is any treatment to postpone the surgery or some interim treatment, please go for that.
I am on hormonal tablets. What shall I do?
Hormonal therapy does not compromise the immunity in general and is safe. Please continue the same treatment.
I am due to PET CT next week. Shall I undergo the test?
PET CT is safe to have provided the center is taking all precautions to disinfect the machine. If the PET CT is making a decision to change the therapy, please go ahead and have it.
I had cancer in the past and doing fine now. Am I at a risk?
If your treatment is over and you are on a follow up, not having any symptoms, you are at normal risk. Please take your precautions well.
I am cancer patient and have diabetes, and other medical problems.
In this situation, please continue all your medication and ensure you sugars, BP and all parameters are well under control. Please consult your physician for the same.
My father has terminal cancer patient at home. He is sick. Should I take him to the hospital or stay at home?
Your situation is precarious. Please consult the treating oncologist. As far as possible, please keep him at home and manage him under the telephonic consult with an oncologist. One is unsure to understand that any intensive management is going to help in the situation. Please ask for home care services for help regarding special requirements rather than hospital. Understanding the situation that his outcome is going to be similar in both situations. On the other hand, travel, hospital, intensive treatment is more risky under the situation for him, and the family members from COVID 19.
Should I do something else apart from normal precautions?
Please indulge in some kind of indoor exercise and keep your lungs in good condition, by deep breathing exercises, pranayama, yoga, meditation.
Is there anything to improve my immunity?
Good balanced, diet, including spices, green leaves, all fruits, vegetables, exercise, good rest and sleep would help. There is nothing specific to improve immunity as such.
My close relative is just returning from an infected place.
Please let him be quarantined for the specified period (14 days) in a different place than your place. Please be sure anyone of his contacts do not come near you.
My son has contracted the infection from outside the country. What shall I do?
Please go as per the treating doctor for his treatment or isolation. You should certainly stay away from him, his contacts completely, in a different place.
I heard that there are many infected persons in my neighborhood and colony/ What shall I do ?
This is the time, you have to be extra careful. No contacts from there at all, no things from there, no visits to that place, no movements at all. Isolate yourself and protect.
I have been diagnosed to have COVID-19 by the test.
No need to panic. Start your isolation and consult the doctor. If the symptoms are mild, please stay at home and isolation.
To conclude, please do not panic and consult the oncologist on telephone or personally and discuss everything. It will be better to write down your questions and doubts.