Ways to manage breast cancer treatment during Covid-19 pandemic

The Covid-19 pandemic and the subsequent lockdowns have impacted our lives in ways we never imagined.

While everyone has been affected in some way, those with co-morbidities, like cancer patients, and their families are especially having a hard time. “The fear of being vulnerable to contracting the virus which may lead to complications has been a cause of concern for patients as well as their caregivers,” said Dr Deepak Jha, senior consultant and clinical lead – breast surgery, Artemis Hospital, Gurugram

Quoting a study published in Lancet Oncology, the expert added that patients with cancer history are at a higher risk of complications such as “ICU admission or even death if they contract the Covid-19 virus”.

Cancer treatment has had to adapt to the new normal. The hospital experience, as well as treatment protocols, have undergone a few changes to suit the current patient needs. As a patient and as a caregiver, one must be aware of the immediate steps to be taken if a breast cancer patient tests positive for Covid-19, says Dr Jha who listed some essential dos and don’ts.

*Continue consulting with your oncologist

If the patient has mild symptoms and is not admitted to the hospital, regularly tele-consult with the oncologist to keep them updated about the patient’s recovery status. Even though the symptoms might be mild, it’s important to have a plan of action in place in case complications arise, said Dr Jha.

Reach out to nearby hospitals or your oncologist to keep yourself updated about bed availability and the necessary procedures for admission. If you are under home quarantine, check your oxygen saturation levels routinely. “Once you are on the path to recovery, consult with your oncologist to find a suitable timeline to restart treatment. Since timely treatment is crucial for cancer, make sure you do not delay treatment beyond a point. Get a full blood work and chest CT done to make sure that you can withstand cancer treatment,” said Dr Jha.

*Be aware of adversities of current treatment modalities

Chemotherapy and/or radiation are usually administered after surgery in order to reduce the risk of recurrence. If a cancer patient who is undergoing treatment tests positive, it’s advised to postpone anticancer treatments such as immunotherapy or chemotherapy mainly because they tend to have an adverse impact on the immunity of the patients. This can make them vulnerable to infection.

*Modified treatment protocols

Oncologists have had to make a number of changes to cancer treatment protocols, noted Dr Jha. “For instance, for some patients we insist on reduced dosage or change the chemotherapy from IV to oral administration to reduce their visit to the hospital.

“Based on the patient’s circumstances and the severity of cancer, oncologists are customising treatment. The option of deferring surgery and at the same time administering hormonal therapy (in the form of oral pills) before surgery in hormone-receptor-positive patients is evaluated, without compromising on treatment,” he shared.

But not all patients who have undergone surgery require chemotherapy, especially in case of early stage breast cancer patients. Prognostic tests help to identify patients who may need chemotherapy. These prognostic tests that predict the risk of recurrence have been helpful for low risk patients to avoid chemotherapy. A patient who has a low risk score can safely avoid chemotherapy thereby avoiding the adverse impact of the aggressive treatment on their immunity.

*Don’t ignore the impact of the pandemic on your mental health

Testing positive for Covid-19 as a cancer patient adds an additional layer of anxiety and stress for the patients and their families. While you focus on regaining your physical strength, make sure you pay close attention to your mental health as well. “Family members and caregivers must actively reach out to the patient and speak about what the patient may be going through. Seek help from a psychologist/counsellor who can help the patient deal with the range of emotions that they are experiencing and find ways to manage stress,” said Dr Jha.