LAST year brought on a global health crisis that impacted the effectiveness of healthcare systems worldwide.
Countries with top-notch healthcare facilities saw interruptions and sometimes a complete system breakdown of their state-of-the-art facilities.
The pandemic exposed patients, who were already vulnerable to begin with, to an even higher health risk.
This is especially worrying for patients who are undergoing treatment for cancer as they are often at risk of being immunocompromised.
An immunocompromised state is when the body is weakened and the patient has low immune system to fight off potential infections.
Cancer patients fall into this category, usually due to the disease and as a result of the treatment they are receiving.
This puts them at heightened risk of contracting Covid-19 compared with the general population. They may also develop serious complications as a result of the infection.
However, the pandemic has led many oncologists to reflect and adopt new treatment guidelines for cancer patients to the reduce patients' exposure to the hospital environment.
One of the main changes adopted is to reduce radiotherapy sessions. These changes have been adopted and applied for some patients with early breast cancer.
To further ensure the safety of patients, doctors may also consider switching treatments — for instance, patients who require treatment via intravenous medication may be switched to oral medication.
Of course, some treatments do not offer the oral medication option, so this cannot be applied to cancer patients across the board.
In addition, prior to treatment initiation, treating doctors will review the patient's wellbeing, perform blood checks to ensure normal biochemical parameters as well as tailor the treatment to suit the changes faced by each patient.
OVERWHELMING SITUATION
Covid-19 has strained the Malaysian healthcare delivery system and this includes treatment and services for cancer.
Throughout the Movement Control Order (MCO), hospitals have had to reschedule or even postpone routine follow-ups and check-ups.
This disruption may cause anxiety and stress to patients, particularly those with cancer as they are in a vulnerable state.
In addition, there is the underlying concern that as more hospital resources are being directed to flatten the Covid-19 curve, the funding for new cancer therapies may be affected.
Restrictions may be implemented, especially in the public sector, to channel funds towards the fight against Covid-19.
This will probably halt research of new treatments for cancer as the management of the pandemic becomes a priority.
DELAYED DIAGNOSIS
There is also the possibility of delayed diagnosis among cancer patients.
A patient may wait and avoid seeking early treatment due to fear of being at a hospital.
Elective cancer surgery may also be postponed to minimise the risk of transmission to healthcare workers, especially in asymptomatic patients.
Apart from this, certain treatments may be deferred to optimise usage of limited resources, such as ventilators and bed occupancies in intensive wards.
Aside from the standard operating procedures in place during this pandemic, hospitals have had to deploy other measures to ensure the safety of cancer patients.
These measures include deferring non-essential clinic visits and using telephone or telemedicine consultations for selected groups of patients.
This is, however, emphasised by advising the patient to come to the hospital immediately should they become unwell.
There is also strict restriction on the number of visitors allowed into wards during visiting hours, while patients on oral therapy can request their medications be delivered to their homes.
Despite putting all these procedures in place, there will still be patients who struggle to cope with their diagnosis.
Healthcare workers understand that cancer patients face additional stress in coping with their disease and treatment in the face of this pandemic.
Patients are also exposed to the prospect of finding themselves and family members suffering from job loss and earning capabilities.
As cancer treatment can often be very costly, all these factors can add to the psychological stress in cancer patients, which in turn may affect compliance with treatment.
When faced with this, it is advisable for patients to have a discussion with their doctors regarding their concerns so they can be addressed early.
It is also good for patients to have strong support, and this includes family members and close friends, as well as cancer support groups.
As for financial assistance, there are non-profit organisations offering financial aid to cancer patients.
*The writer is a consultant clinical oncologist at Sunway Medical Centre.