August 16, 2021

Challenges faced by medical experts while treating breast cancer patients during COVID-19 pandemic

COVID -19 is a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and spreads through human-to-human transmission first emerged in Wuhan, China, in December 2019. On March 11, 2020, the World Health Organization (WHO) declared that COVID-19 has become a global pandemic which means that disease spread widened and cases were present in multiple countries.

The pandemic has created a number of challenges for healthcare professionals across the globe. From doctors to nurses, the last seven months have been extremely difficult for those involved in delivering treatment and care. Social distancing norms, lockdowns, fear of contracting the virus have added to the stress and anxiety of patients. This is more severe in the case of cancer patients. Over the last few months many cancer patients have delayed their treatment due to the fear of contracting the virus. On the other hand, oncologists have faced challenges in delivering treatment due to changed protocols, social distancing norms, travel restrictions and many other changes. This pandemic has posed many challenges to the routine delivery of safe oncological treatment to all cancer patients including screening, diagnosis, treatment, follow ups and supportive care.

Breast cancer is one of the most common cancers and most of the patients are facing challenges at various steps of their treatment. One of the key challenges that patients and oncologists face is when a patient gets diagnosed with COVID. For instance, a young 29-year-old girl was diagnosed with rapidly growing breast sarcoma (type of malignant tumor). We were planning for a simple procedure without any flap (plastic surgery) cover so as to start her adjuvant treatment as early as possible. Unfortunately, her preoperative COVID-19 test turned out to be positive and we had to postpone her surgery till she became negative. After two weeks when she was taken up for surgery her tumor had almost doubled in size and we had to take plastic surgical help to provide necessary cover post resection. This not only delayed her entire cancer treatment but also had become difficult to manage as the cancer had progressed. This also creates severe psychological trauma for the patient. Same was the cause with another 64 year patient who had to delay her chemotherapy treatment when she tested positive for the disease.

Some of the main problems faced are as below

Delay or avoidance of hospital visit: A number of times even if patients notice a lump on the breast, they tend to ignore it and delay seeking consultation. This is mainly due to the fear of contracting COVID infection by visiting a hospital. Due to the delay in seeking consultation, there is an increasing number of locally advanced and metastatic breast cancer as compared to early breast cancer being diagnosed these days. Unless the lump is quite large with significant symptoms, patients tend to avoid visiting hospitals. According to a recent survey, almost half of breast cancer patients experienced delays in cancer care and treatment as a result of the present pandemic due to various reasons.

Changes in hospital experience: Patients who visit the hospital for consultation and treatment often have to follow strict social distancing norms. Not many family members are allowed into the hospitals. This makes the whole experience quite lonely for them. They tend to miss the physical and emotional support of their family and friends during treatment and consultation. Dealing with the treatment, stressing about contracting the infection, the lack of human touch and physical support during hospital visits and a number of other aspects can mentally impact the patients. Now is the time they need more support. Patients must seek help from mental health professionals who can help them talk about what they are going through. Family members must step up and ensure that the patient is eating healthy and talking to their loved ones to overcome anxiety.

Fear of treatment: Due to compromised immunity due to chemotherapy or because of the disease, cancer patients are at high risk of catching the infection. They are inherently immunosuppressed from their malignancy and therapies which they are undergoing. A number of patients delay their treatment and consultation due to fear of visiting the hospital and contracting infection. Patients and their families must understand that treatment cannot be delayed for cancer. It’s important to balance the risk of exposing themselves to COVID-19 with the risk of advancement or progression of disease.

Continuity of consultation and treatment: Oncologists across the country have had to make significant changes in their treatment protocols and consultation procedures in order to meet the changes in the current environment. To ensure continuity of treatment, oncologists are now offering tele consultation services to help patients manage the disease better. Though oncologists have successfully adapted to tele consultation and other modes to interact with their patients, it becomes fairly challenging to ensure continuity of conversation with their patients. The effectiveness of in person consultation can never be replaced with tele consultation. This is a challenge that oncologists have been continuously working to address.

Financial challenges: The pandemic has led to job losses and decreased incomes for many families. Covering the cost of the treatment and consultation, managing insurance in case of job losses, travel expenses for those from other towns all these factors creating financial difficulties for patients and their families.

After having faced pandemic for more than six months most of the cancer centers have initiated recommended cancer treatment as per the guidelines with fewer deviations following all the precautionary measures. Major challenge is if a patient is diagnosed with COVID before or during the treatment which imposes threat of delay in treatment and progression of the disease is unavoidable. Hopefully, with better drugs available and possibly even vaccines, we can give cancer patients a more level playing field to complete their cancer treatment.

Disclaimer Statement

This website is built with intention of providing basic details about the various diseases. The contents of the website is not meant to replace an in-person consultation. Please follow the advise of your doctor via in-person consultation. This website will not assume any legal responsibility for the patient’s medical condition.
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