George Kebaso @Morarak

Cancer specialists are using telemedicine to help patients afraid of contracting Covid-19 in hospitals access medical care. 

Dr Lalit Varadpande, an oncologist at Mediheal Hospital, Eldoret branch, is treating five of his 30 cancer patients through the online method launched in 2015.  

“Covid-19 has created a lot of fear among cancer patients. They are afraid to come to hospital because they may get infected on the way to hospital or in the health facility. 

“So this has somehow delayed the treatment,” he told People Daily yesterday in an interview to establish how treatment of cancer patients is ongoing given that they are considered at high risk of contracting the virus.

The other 25 patients that Dr Varadpande treats, he said, still attend hospital visits on scheduled days.

“My suggestion to the cancer patients is that they need to have a close conversation with their treating oncologist on what to do with their treatment; to stop, postpone or whether to modify the treatment,” he said.

Postpone therapy

Asked how patients with cancer and Covid-19 are managed, the medic said with little evidence to support changing or withholding some sensitive treatment such as chemotherapy or immunotherapy in the patients, some doctors may opt to change treatment.

He said since patients with cancer are uniquely vulnerable to the virus due to a weaker immune system, it is reasonable to withhold or postpone therapy until the patient is asymptomatic.

“However, at least chemotherapy has the scope to change the treatment, from an injection treatment to tablet treatment which a patient can take home,” the cancer specialist said, adding that this intervention minimises possible exposure to Covid-19.

However, a patient with a general condition may communicate to the doctor through phone or via WhatsApp and send the blood or scan reports to their treating oncologists for further advice.

“It is very important that the patients observe the social distancing guidelines…” said Dr Varadpande..

Strategies to treat patients with cancer during the Covid-19 pandemic include splitting healthcare teams, implementing tele-multidisciplinary tumor boards, minimising myelosuppressive agents, expanding the use of personal protective equipment (PPE) and limiting visitors.

Other strategies are scanning patients thermally, using oral therapy options when applicable, delaying therapy when in an adjuvant or palliative setting, and allowing certain deviations or violations in protocol patients.

The World Health Organisation (WHO) has recommended the testing of all cancer patients for Covid-19 before the initiation of induction and delaying or de-intensifying treatment in diseases such as acute myeloid leukemia, where intensive chemotherapy is considered emergent.

The UN body has instructed that healthcare workers taking care of patients with cancer must be uninfected with Covid-19, among other guidelines.