Chemotherapy During Impact of Covid-19 Pandemic

Introduction: A novel corona virus 2019-nCoV or COVID – 19 OR SARS Cov 2.” A viral infection was reported in late December 2019 from Wuhan city of China.World Health Organisation (WHO) announced COVID – 19 outbreaks as pandemic on March 11, 20201. Millions of lives are affected due to serious disease like cancer around the globe2. Patients with cancer are required to visit oncology centres more than patients with other diseases due to the disease nature and treatment modalities. The cancer patients require a full involvement of multifaceted health care teams throughout the disease course from diagnosis to treatment or end-of-life care3. People living with NCDs have higher risk of severe Covid-19 related illness and death.The survey report of countries declared that patients had partially or completely disrupted health care services among which 42% are of cancer treatment and reason behind that is declaration of Covid-19 Pandemic1. Cancer patients with delayed Chemotherapy and surgery have adverse impact on survival 4, 5. Hence, extending the treatment time of definitive cancer treatment can have detrimental effects on the expected treatment response and quality of life (QOL) of the oncology patients6.

Objectives: 1. to understand COVID-19 in brief. 2. To know the consequences of Covid-19 on cancer patients. 3. To discuss the impact of Covid-19 on cancer patient with chemotherapy.

Conclusion: The cancer patients on active chemotherapy or radical RT for lung cancer and blood or bone marrow cancer are at highest risk7. Delays in diagnosis of blood cancer such as leukaemia which require immediate treatment, put patients’ lives at more risk and lower life expectancy8. Delay in diagnosis of cancer can lead to patients requiring more treatment and with a worse prognosis and in certain cases, losing chance of survival.Depending on the extended disruption of the routine services, it is possible to have delaying in accurate diagnosis or best practice treatment which could have a detrimental effect on outcomes & survival for cancer patients9.Delaying diagnoses and treatment of new cancer cases will lead to their presentation at a more advanced stage which then leads to the reduced benefit of treatment and poor survival10.Cancer patients are considered to be at higher risk of developing life-threatening complications from COVID-19 and at the same time treatment delays can lead to poorer oncological outcomes. Appropriate planning is therefore important to continue with cancer treatment services and simultaneously avoiding the risk of infection to the patients and healthcare staff and not allowing community transmission of viral infection11.What if you skip chemotherapy during this lockdown? Ideally cancer patient should never skip any chemotherapy procedure but if it is missed for more than 3 months due to lockdown or between two consecutive cycles than the therapeutic effects of CT treatment is loss in cancer patients12. 

Keywords: NCDs, CT, QOL, Poor prognosis of cancer patients in pandemic.