Filling in for missed cancer treatment at hospitals

In Southeast Asia, research has shown that over two million people were diagnosed with cancer in 2020. With the emergence of COVID-19, all eyes have been focused on managing the public healthcare crisis at hand, and so the silent struggle of the community facing cancer may have been overlooked.

Phoebe Ho, CEO of the Integrated Oncology Centres

Based on research, those with pre-existing co-morbid conditions are most likely to experience COVID-19 more severely. That said, cancer patients are estimated to have a two-fold risk of contracting the virus as compared to the general population. Cancer patients regularly go through treatment for their cancer, and this may render them more immunocompromised, exposing them to a higher risk of infection.

Further complicating things for patients is their treatment routine. What was seemingly easy and ordinary before becomes a challenge because this aspect is greatly affected as healthcare providers need to implement numerous protective measures such as swab tests and social distancing.

Furthermore, cancer patients as a whole may need to make alterations or postponements to their treatments such as surgery, radiotherapy, chemotherapy, or immunotherapy in order to minimise their risk of contracting COVID-19. Unfortunately, the necessary adherence to such standard operating procedures (SOPs) will lead to interruptions of their treatment plans. This will create a feeling of anxiety and frustration – none of which are conducive to their wellbeing.

The SOPs set in place to help contain the virus are necessary but may be too much to handle for the patients. Still, while the pandemic may be a challenge, it does not mean that the quality of care should be sacrificed.

The Integrated Oncology Centre’s (IOC) in the Philippines, Central Luzon Integrated Centre (CLIOC), created a unique algorithm to help triage patients for them to safely receive treatment even with SOPs in place, under the directives of medical director Dr. Misael Cruz. Due to this method being effective, other cancer centres have incorporated the same system as well.

Some important preventive measures in triaging of patients, according to Dr. Cruz, include:

- Use of rapid antigen or COVID-19 test prior to consultation;

- Appointment and scheduling system carried out via online or telephone for patients;

- Creation of our own screening data sheet to be accomplished by patients/relatives;

- Strict adherence to minimal health measures: hand washing/sanitising, physical distancing, wearing of masks;

- Enforcing a no-relative policy or if needed at most 1:1 relative and patient ratio; and

- Wearing of personal protective equipment by staff.

This system proved to be successful as the entire team of doctors and staff were well-prepped and aligned with the strategies, which also resulted in a better work-flow structure. Furthermore, using our very own screening data form helped us keep better track of patients.

Cancer care and treatment requires full involvement of multi-disciplinary teams throughout the trajectory from diagnosis to rehabilitation. Patients will receive a collaborative assessment from different clinicians and undergo necessary/appropriate laboratory or imaging tests for diagnosis, staging, and monitoring of treatment efficacy. During this pandemic, it is important that healthcare providers take the best treatment measures/approaches while minimising the risks that stem from COVID-19. They must also weigh the pros and cons of continuing anticancer therapy.

Taking all these into consideration, when it comes to cancer care, we must adopt a patient-centric mindset in terms of addressing the impact of the pandemic on cancer patients. They go through quite a journey and we need to provide the necessary support when it comes to resource allocation, clinical care, and the consent process.