As India battles the second wave of the pandemic and braces itself for the possible third wave of COVID-19, there’s an urgent need to prioritise vaccination for patients with cancer. According to a recent Lancet article, this is essential to aid recovery of cancer care systems as they seek to mitigate the impact of delays and backlogs in diagnosis and treatment.

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“Although a good majority are getting vaccinated, not all cancer patients are vaccinated. We encourage all patients coming for follow-up and also on treatment to get vaccinated,” said Dr Hari Menon, Senior Consultant, Haemato-oncology, Cytecare Cancer Hospitals, Bengaluru.

“The Coronavirus has always been highly transmissible through airborne transmission and the current, presumed mutant variant, responsible for the second wave is showing a higher transmission rate. More individuals are getting affected by the disease, although it may not necessarily translate into greater severity of the disease and mortality,” explained the oncologist.

The Bengaluru-based hospital has created an intensive care unit (ICU) facility with separate air handling exclusively to take care of COVID patients with cancer. “Our intensive care unit is on the job 24/7, delivering different levels of management as merits the situation - ranging from oxygen support, non-invasive ventilation and invasive ventilation, when absolutely required,” noted Dr Menon.

Banking on teleconsultations

As the second leading cause of global mortality, cancer calls for early diagnosis and timely treatment, despite the myriad challenges posed by the pandemic. Patients with cancer can be at high risk of severe COVID-19 due to their age, disease, cancer treatment, and medical comorbidities. Cancer and its treatment can weaken the patient’s immune system and reduce one’s ability to fight infections.

Due to the immunosuppressive state of cancer patients, oncologists are recommending teleconsultations (via phone or video call) as an alternative to hospital visits. “Patients on follow-up should be reviewed over a tele-consult and requested to come to the hospital only if there is any suspicion warranting a physical examination or any investigations, especially if it is related to the safety of the patient or suspicion of any progression,” said Dr Menon.

With easy access to remote and virtual-care technologies today, it’s possible for patients to get timely medical advice and care from the comfort and safety of their homes. “Treatment that the patient is already on may be continued, except if they require intravenous therapy which cannot be delivered at home. "One has to triage the need for treatment, whether it can be delayed, and if so how detrimental that delay would be to the eventual outcome in a planned cancer treatment", said the oncologist, even as he advocated strong adherence to social distancing principle and wearing masks the right way.

Vaccination gives hope

According to the Lancet article, emerging data from countries that are more advanced in their vaccine rollout have found no additional safety issues so far for patients with cancer. The benefits are said to outweigh the risks.

While there have been concerns about vaccination in vulnerable populations, experts agree that the concern is not so much about the vaccine itself, but whether the patient, being mildly immunocompromised, will be able to generate the protective antibodies after the vaccination. However, the current emphasis is to vaccinate cancer patients who are or were on cancer treatment.

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Cancer patients who are currently on chemotherapy or radiotherapy are advised to plan their vaccination schedule in consultation with their doctors. It’s equally important for the family members, caregivers and others in close contact with immunocompromised patients to get vaccinated. “Getting vaccinated definitely attenuates the intensity of the infection. There is no reason to think otherwise,” asserted the oncologist.