OP-ED: Talking cancer in the time of Covid

Bangladesh is battling coronavirus for more than a year now and the struggles continue every day with the exponential rise in coronavirus cases. The health care sector is struggling to provide coronavirus treatment to patients, and ensuring continuity of care for patients with non-communicable diseases while fighting Covid-19 has been hugely challenging.

People are not visiting hospitals unless they are bound to do so, to avoid the Covid-19 transmission risk. But what about cancer? There is no way to interrupt cancer treatment. Cancer damages the immune system of a patient severely, and if the patient is affected with Covid-19 as well, there is no option except to count days.   

Amid this situation, cancer units of many hospitals are closed for days. In an ordinary time, about 1.5 million cancer patients of the country are solely depended on the 300-bed National Institute of Cancer Research and Hospital for treatment. The expenses of private hospitals, meanwhile, are beyond the capacity of low and lower middle income people.

Obviously, the crisis for cancer treatment is at its peak right now. The World Health Organization already expressed concern over catastrophic impact of Covid-19 globally on cancer care -- its detection and diagnosis. Interruptions in identification, postponement, and cancellation of chemotherapy have increased significantly. 

Warnings have already been made that delays in diagnosis and interruptions in therapy or abandonment would likely have an impact in the total number of cancer deaths in coming years. They have emphasized vaccination, as it is important for people with cancer.

Since the coronavirus pandemic broke out last year, experts have been making special mention for people with comorbidities that include diabetes, heart disease, hypertension, and other similar health conditions, and asked those patients to take extra precautions.

An article published in medical journal Lancet in June last year says that the effect of Covid-19 among cancer patients is dangerous. People with cancer have a five times higher risk of mortality, than any other general Covid-19 patient. 

Meanwhile, another Lancet report citing findings of a joint research by scientists from US, Spain, Canada, and the UK finds cancer patients face high mortality from Covid-19. Also, people with cancer and Covid-19 positive at the same time are found dying within a month.

Based on findings by the Covid-19 and Cancer Consortium (CCC19) conducted during March 17 and April 16, 2020, Lancet observed that 13% cancer patients had died within 30 days of Covid-19 diagnosis. This clearly indicates that Covid-19 patients with cancer have a high death rate.

People with cancer who develop Covid-19 are much more likely to die from the disease than those without cancer, according to physician-researchers at Montefiore Health System and Albert Einstein College of Medicine. The study assesses outcomes for patients with cancer who have also been infected with Covid-19. The study involved 218 cancer patients who tested positive for Covid-19 from March 18 to April 8, 2020 at Montefiore Medical Centre in the Bronx, New York City, one of the regions in the US hit hardest by the pandemic. A total of 61 cancer patients died from Covid-19, a dramatically high case-fatality rate of 28%. 

The situation in Bangladesh is obviously quite similar. Considering all the sides, can we be more kind to the people suffering from cancer? Isn’t there any way we keep separate cancer hospitals and cancer units for treating non-Covid patients?

Bangladesh’s Health and Family Welfare Minister Zahid Maleque in August last year said cancer hospitals will be built in eight divisions of the country by 2022 in an effort to improve overall health system against the killer disease. 

Also, initiatives are underway to modernize oncology departments in eight old medical college and hospitals, and they will be equipped with modern equipment including radiotherapy machines. The National Institute of Cancer Research and Hospital will also be upgraded to 500 beds from existing 300 beds.

We want to be hopeful. Amid the Covid-19 realities, the world is observing World Ovarian Cancer Day on May 8. On this day, we urge women across Bangladesh to be open for discussion about ovarian cancer and tumours. Keeping in mind the high treatment cost for cancer, there is no better way than prevention. On this day, we want to at least ensure early detection facilities for all cancer patients. We have to put importance on any form of tumour and have to be open to discussions. I have lost my mother because of cancer, and do not want any other son to lose their beloved. 

It is high time for cancer awareness. With this aim, 170 countries joined their hands with the World Ovarian Cancer Coalition, a not-for-profit organization that aims to create a world where every woman with ovarian cancer has the best chance of survival, and the best quality of life -- wherever she may live. While all the countries are emphasizing early detection, why will we be left behind? Certainly we will win against cancer someday, together.

Rafe Sadnan Adel is a communication professional and founder chairperson of Cancerbd.net, the first ever Bengali language web-based initiative in Bangladesh to raise cancer related awareness.