Weekend Argus (Saturday Edition)
Covid-19 impacts cancer
Oncology patients are having procedures postponed for lack of space – and fear of infection
FEAR of contracting Covid-19 has led to a decrease in new cancer patients referred to Groote Schuur Hospital in the last two months and a decrease in those going for chemotherapy, said a specialist at the hospital.
Breast cancer patient Katherine de Lange, 27, from Fish Hoek, was among those whose treatment was affected.
She had part of her chemotherapy during the lockdown, but her breast reconstruction had to be cancelled and she underwent a “flat-chested” mastectomy instead.
“I was diagnosed with quite an aggressive form of breast cancer. So I’ve had eight rounds of chemotherapy,” said De Lange.
She told Weekend Argus that she was due to start three weeks of radiation therapy in the next few weeks.
“Nobody was allowed into the wards. I hadn’t been told of any changes,” she said.
She went in on a Monday and the doctor informed her that the operation was going to be the next day, but they could not do her reconstruction.
“Going in with a completely different view of what is going to happen, it was scary and stressful.”
Her surgery went well, but the hospital couldn’t provide a drain bag to receive excess fluid so it doesn’t build up in the chest cavity.
“I had to come home with my drain in and normally they keep you at hospital until your drain is ready to come out.
“I went home, then had to go back in to get it removed,” she said.
Despite challenges, she thanked the breast clinic, breast cancer surgery assistance programme Project Flamingo and the surgical team at Groote Schuur Hospital.
Breast cancer in all patients might be overlooked during the pandemic, said Professor Francois Malherbe, clinical lead at the hospital’s diagnostic breast clinic.
“Our clinics are open for patients with palpable lumps only. The reason for having smaller clinics is because it’s impossible to practise social distancing in large outpatient clinics,” said Malherbe.
Many of the clinic’s patients are afraid to visit the hospital and are postponing going to see their doctors, he said.
“Patients who already had chemotherapy for aggressive cancers are refusing their surgery at the moment because they’re scared of coming to the hospital,” he added.
Head of radiation oncology at the hospital, Professor Jeannette Parkes, said a fear of the coronavirus saw a decrease in the number of new cancer patients referred to them in the last two months.
She added they had not been doing any routine follow-ups since lockdown.
Health specialist at the Cancer Association of South Africa (Cansa), Professor Michael Herbst, said there were cases of cancer treatment being postponed or delayed because of unavailability of infrastructure.
“Fear is always a factor in health-seeking behaviour, especially among men. This often results in going to the doctor later, and this impacts directly on prognosis,” said Herbst.
Specialist surgeon Justus Apffelstaedt said the underlying principles of breast cancer diagnosis and treatment did not change due to the virus but could inform the management of diagnostic and therapeutic procedures.
“This should not lead to the delayed diagnosis and treatment of cancer with inevitable unnecessary loss of life,” he said.