Breast cancer: Care during Covid-19

When it comes to breast cancer diagnosis and treatment, this has been a very trying year for cancer experts, as they have been working out on safely delivering services to patients. Many women have also felt wary — some may not have followed up on their symptoms — feeling reluctant to get to the hospital because of the risk of catching coronavirus.

Breast clinics around the world have also reported big decreases in numbers of women attending appointments. While coronavirus cases continue to surge and breast cancer patients are at a huge risk, doctors are reminding people that staying home is not the best call as cancer doesn’t wait for anyone.

“Women or men who are on treatment for breast cancer or any other type of cancer, do have a high risk for Covid-19,” says Dr Zoe Vlamaki, Consultant General Surgeon, Burjeel Hospital, Abu Dhabi.

“Their defense mechanism, their immune system, is fighting to overcome cancer. Their resilience to fighting a new virus such as coronavirus is limited, which has caused the worse humanitarian damage and taken so many lives. Our knowledge of Covid-19 is still limited to eradicate it. It will happen but until then we need to inform people of its dangers and protect those with high risk. Even survivors who are free of breast cancer need to take precautions and follow the advice of health authorities.”

Risks outweigh benefits

The Covid-19 outbreak has affected consultations between patients with breast cancer and oncologists in a big way. Now cancer specialists are keen to convey that their services are very much open and they are doing everything possible to make them safe and accessible to everyone who needs them. “To counter the global pandemic, many hospitals are minimising patient visits to the hospital,” says Dr Medhat Faris, Consultant Medical Oncologist, International Modern Hospital. “We are seeing new patients in the hospital and treatment is being provided if they need urgent help. However, we are trying to minimally see patients coming for a second opinion. In the early stages of breast cancer, routine radiology imaging exams and drawing blood are being avoided as much as possible.”

Specifically, targeted therapies, chemotherapy and radiation can weaken the immune system and compromise its ability to fight off the coronavirus. “People who have weakened immune systems or lung problems have a much higher risk of complications if they become infected with the virus,” says Dr Faris. “However, for patients in the early stages of breast cancer, who require timely implementation of surgery, chemotherapy or radiation, doctors have concluded that the risk of contracting Covid might outweigh the benefits of cancer treatment.”

Follow the rules

Breast cancer patients are further urged to take extra caution in their daily activities to help reduce the risk of contracting Covid-19. The rules given by health authorities for the high-risk group patients should be strictly followed.

“Diet and nutrition with adequate hydration, sufficient sleep, exercise and stress management, should be maintained,” says Dr Vlamaki. “Remember your friends and socialise even via social media, keep your mind open, speak and discuss what matters.”

Women with breast cancer are depleted of vitamin D so a good supplement of vitamin D3 can be safely taken by all women. “If you keep a healthy diet, it can provide most of the vitamins and minerals your body needs to keep the immune system strong,” explains Dr Vlamaki. “The paradox that stays with vitamin D, even in sunny countries, is that it is the most depleted vitamin in the body and research suggests that women with low levels of vitamin D have a higher risk of breast cancer.”

Family and caregivers of breast cancer patients should be proactive to safeguard the patient’s health against Covid-19, advises Dr Faris.

“Try to keep a positive attitude and ask other family members and friends to pitch in as well. Stand by your loved ones when they are going through an emotional upheaval.”

Stress is a normal reaction to a pandemic, especially when you are battling breast cancer. So, how can breast cancer patients stay calm? “Take a break from the news stories on Covid-19,” says Dr Faris. “Stay in touch with friends, family, caregivers and online support groups for emotional support. Sleep well and do things that keep you happy such as gardening, trying a new recipe, or yoga.