Cancer care takes ma­jor hit dur­ing lock­down

Hindustan Times (Jalandhar) - - 100 DAYS OF PARENTING COVID 19 - SANCHITA SHARMA

Cancer treat­ment took a massive hit in April and May, when roughly 70% of pa­tients could not ac­cess life-sav­ing surgery and treat­ment, ac­cord­ing to data from some of In­dia’s largest su­per-spe­cial­ity hos­pi­tals.

Cancer surg­eries in April and May in the af­ter­math of the lock­down en­forced from March 25 to curb the spread of the coro­n­avirus disease pan­demic were one­fifth the surg­eries per­formed in the cor­re­spond­ing pe­riod in 2019. Cancer ser­vices de­clined by 50% in April and May com­pared to the same pe­riod last year, shows data from lead­ing pri­vate hos­pi­tals for cancer across In­dia.

Even af­ter the lock­down was re­laxed grad­u­ally, the fear of Covid-19 in­fec­tion is keep­ing some cancer pa­tients away from hos­pi­tals. Those who seek treat­ment don’t get it be­cause of health sys­tems pri­ori­tis­ing coro­n­avirus disease treat­ment over all else, lead­ing to life-threat­en­ing delays in di­ag­no­sis and treat­ment.

In Fe­bru­ary, a 52-year-old man who re­quested anonymity de­vel­oped a small swelling on the left side of his neck, but it took six hos­pi­tal vis­its and twoand-a-half months for him to be di­ag­nosed with cancer. By the time his treat­ment be­gan at Max Su­per Spe­cialty Hos­pi­tal at Saket in New Delhi in June, his tu­mour was ooz­ing blood and he had lost 10kg, which brought his weight down to 61kg.

“Most hos­pi­tals turned us away say­ing they did not have beds free. Two hos­pi­tals said no to dress­ing my wound be­cause by the end of May, I had de­vel­oped fever be­fore I was di­ag­nosed with lym­phoma,” the pa­tient said af­ter un­der­go­ing a sec­ond round of chemo­ther­apy at the hos­pi­tal on June 18.

At least 51,100 live-sav­ing cancer surg­eries were can­celled in In­dia from the end of March to the end of May, es­ti­mated Covid­Surg Col­lab­o­ra­tive, a re­search net­work of sur­geons and anaes­thetists in 77 coun­tries, in­clud­ing In­dia, which pub­lished its find­ings in the Bri­tish Jour­nal of Surgery in May.

“Cancer pa­tients are among the most vul­ner­a­ble as they need early di­ag­no­sis and un­in­ter­rupted and of­ten hos­pi­tal-cen­tric treat­ment for good out­comes to pre­vent high mor­bid­ity and mor­tal­ity. He ar­rived here with a more than 10cm lym­phoma, which is cancer in in­fec­tion­fight­ing cells of the im­mune sys­tem. A col­league’s fa­ther was di­ag­nosed with lung cancer on March 20, but missed treat­ment for two-and-a-half months. Now his lung cancer is at an ad­vanced stage,” said Dr Harit Chaturvedi, chair­man, cancer care, and di­rec­tor and chief sur­gi­cal on­col­o­gist at Max Health­care.

One out of eight men and one in nine women in In­dia has prob­a­bil­ity of de­vel­op­ing cancer in their life­time (0-74 years), ac­cord­ing to the In­dian Coun­cil of Med­i­cal Re­search-Na­tional Cen­tre for Disease In­for­mat­ics and Re­search (ICMR-NCDIR), Ban­galuru, which im­ple­ments

In­dia’s na­tional cancer registry pro­gramme through 36 pop­u­la­tion-based reg­istries and 236 hos­pi­tal-based reg­istries across states. It es­ti­mated there were 1.45 mil­lion new cases of cancer di­ag­nosed in 2016, which will dou­ble in the next 20 years.

Cancer killed 813,000 peo­ple in 2016 and ac­counted for 8.3% of to­tal deaths in In­dia that year, ac­cord­ing to the ICMR-led In­dia State-level Disease Bur­den Ini­tia­tive study on cancer pub­lished in the jour­nal The Lancet On­col­ogy in 2018.

“There is pre­lim­i­nary ev­i­dence that cancer surg­eries and treat­ment have re­duced post lock­down, but the na­tional registry will have ma­ture date on the im­pact of this dis­rup­tion on cancer out­comes af­ter a year, where we can an­a­lyse data sys­tem­at­i­cally to say whether delays in treat­ment have in­creased death,” said Dr Prashant Mathur, di­rec­tor, ICMR-NCDIR.

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