Dubai: Cancer patients undergoing chemotherapy need to be careful and must follow protocols of wearing a mask, hand wash, social distancing and using hand sanitisers as they studies reveal they are twice at risk of mortality if they contract severe COVID-19 due to weaker immunity, doctors have cautioned.
Take the case of 39-year-old Filipin o expatriate Mary J, a UAE resident for 11 years. A unit manager at a popular amusement centre in Abu Dhabi, Mary, a breast cancer patient, was diagnosed with COVID-19 on May 11 and has been undergoing chemotherapy since March 2019 at the NMC Specialty Hospital in Abu Dhabi. The hospital has been very pro-active in educating all chemotherapy patients of COVID-19 prevention and Mary J, a UAE resident for 11 years.management. It conducts regular COVID 19 tests once every two weeks for all cancer patients undergoing treatment at their oncology centre and thus, was able to discover Mary was positive, in time to manage her condition well.
Mary told Gulf News that earlier she had a lumpectomy in 1997 in the Philippines. In addition, her sister was diagnosed with breast cancer and her maternal grandmother was also suffering from skin cancer. So she had been very regular in her medical check-ups and was diagnosed with hypertension and high cholesterol earlier.
Providing her case history, Dr Mohannad Diab, Head of the Department of Oncology at NMC Specialty, said Mary, a non-smoker and non-drinker, was diagnosed with a right breast invasive ductal carcinoma in 2018 as she had a family history of cancer and had been undergoing screening regularly.
The young mother of two underwent excisional biopsy and had completed 15 cycles of chemotherapy when she was found COVID-19 positive during a routine nasal swab test as per hospital protocol. Bracing herself for a long haul, Mary told Gulf News: “I had a lot of mixed emotions when diagnosed with COVID-19 as there was so much stigma attached to it earlier. I was confident about my cancer treatment under Dr Diab but also very focused on beating COVID-19. I am the single earner in the family as my husband is a stay-at-home dad, I had no choice but to make myself get better. I am thankful it was caught early and managed well by the hospital.”
The hospital wasted no time in stopping chemotherapy and asking the patient to quarantine at home. With early diagnosis of COVID-19 and effective management by the hospital, Mary was able to recover soon and after testing negative, resumed her chemotherapy from June 14 said Dr Diab.
Why cancer patients are at greater risk?
Explaining the high risk of contracting COVID-19 in case of cancer patients undergoing chemotherapy, Dr Diab said: “Cancer treatments such as chemotherapy, radiation therapy, surgery, stem cell or bone marrow transplant, or steroid treatment usually suppress or weaken the immune system. Most of these treatments lower the count of white blood cells in our body which makes the patient highly susceptible to catching any kind of infection as they lack the WBCs called neutrophils which destroy germs. The patient has a low neutrophil count or is said to have neutropenia.”
He further explained how chemotherapy destroys the white blood cells in the bone marrow along with the cancer cells. “When the WBCs are destroyed, our body has lesser number of neutrophils which makes cancer patients at high risk for infection and exposure to COVID-19 during these times has to be minimised at all costs. Cancer patients are usually put on special diets owing to their weaker bodies and their restricted ability to absorb nutrients from food. They are said to be immuno compromised and are highly susceptible to testing positive for COVID-19.”
Patient safety steps
Dr Diab said the oncology centre educates all patients about this possibility and advisesthem on how they could remain COVID-19 free. “We have a separate building for oncology treatment so there is no change of fever patients coming in there. All precautions are undertaken including point of entry screening of the Oncology Department, entry with mask only, hand hygiene, social distancing and all medical staff don full PPE against viral infection. We do not take in more than eight patients at a time for chemotherapy to observe adequate social distancing. All our patients are tested once in two weeks for COVID-19.”
He added: “Our aim is to reduce the number of visits to hospital and to reduce the hospital waiting time during every visit. There was no major change in protocol for patients on chemotherapy treatment. Each patient comes only through proper appointment system. All are checked and screened for fever or any other COVID- related symptoms before entering the department and we have also reduced the number of visitors coming with patients. We allow only one attendant with one patient.”
Tips for cancer patients to avoid COVID-19 infection:
• As far as possible, restrict movement outside the home
• Avoid any crowded places, if one has to step out for a change and choose going to a secluded area such as a beach instead of a mall
• Sanitise your home well and restrict entry of outsiders to your home
• If one has to go for chemotherapy or any other active hospital session, make sure to observe the COVID-19 protocol and go into the hospital only after a proper appointment to avoid unnecessary exposure
• Mandatorily undergo the nasal swab test once in 15 days to a month to assure one is COVID-19 free
Source: Dr Mohannad Diab