Pandemic may cause rise in advanced cancer patients: Doctors

Cancer patients are now rushing to hospitals in large numbers, after they turned away from hospitals at the onset of the Covid-19 outbreak due to suffering in getting treatment without having a Covid negative certificate and the fear of contracting the coronavirus in hospital.

Doctors predict the number of patients with advanced cancer will rise in the next few months.

Dr Muhammad Rafiqul Islam, assistant professor of Medical Oncology at the National Institute of Cancer Research Hospital told The Business Standard that the hospital got hardly any cancer patients during the first four to five months of the coronavirus outbreak in the country but now the pressure of such patients has increased so much.

The patients who will come to hospital in the next three to four months are expected to be advanced-stage cancer patients, he said.

"In general, more than 1,000 patients come to the outpatient clinic of the cancer institute every day but the number dropped to one-third since March last year.

"Even though the number of patients in the hospital came down to one-third of the normal figure, the disease did not decrease to one-third. The post-coronavirus effect will be worse because many cancer patients could not be diagnosed and screened due to the pandemic. The Covid-19 pandemic will lead to a rise in cancer-related deaths this year."

Rafiqul Islam thinks cancer patients need to be vaccinated on a priority basis.

Mentioning that there are a lot of differences of opinion over whether the Covid-19 vaccine can be given to cancer patients, he said any cancer patient other than a critical patient in the ICU should be vaccinated.

More than a year since the new coronavirus crisis began, its impact on cancer care has been stark, with "50% of governments (having) cancer services partially or completely disrupted because of the pandemic", said Dr Andre Ilbawi, from WHO's Department of Noncommunicable Diseases. 

"Delays in diagnosis are common. Interruptions in therapy or abandonment have increased significantly," he continued, adding that this would likely have an impact in the total number of cancer deaths in coming years.  

Shantana Khatun (40) from Gaibandha was diagnosed with breast cancer in January last year.

After being diagnosed with cancer, she came to the cancer institute in the capital twice and took chemotherapy.

However, her cancer treatment came to a complete halt due to worsening coronavirus situation across the country after March last year. She could not take the required chemotherapy.

Shantana could return to the hospital in November last year after the coronavirus situation came under control. Meanwhile, her physical condition has deteriorated further.

Cancer patients have to undergo Covid-19 tests every time they take chemotherapy or radiotherapy. This is because giving chemotherapy to a Covid-19 positive patient increases the risk of death.

Again, cancer patients are immunocompromised, and Covid-19 increases the risk of death for them. The coronavirus has increased the suffering and risk of cancer patients.

According to a 2018 report of Globocan, a global project on cancer research, around 1.5 lakh people are diagnosed with cancer in the country every year. The number was 1.22 lakh in 2012.

The report also said 1,08,137 people died of cancer in the country in 2018.

No local institution compiles statistics about the total number of cancer patients in the country.

Dr Golam Mohiuddin Faruk, joint secretary of the Bangladesh Cancer Society, told The Business Standard, "There are 14-15 lakh cancer patients in the country. Around two lakh new patients are diagnosed with cancer every year."

According to the Hospital Cancer Registry Report 2015-2017 unveiled 14 January this year, "From January 2015 to December 2017, some 76,543 new patients attended the outpatient department of the National Institute of Cancer Research and Hospital (NICRH). Of them, some 35,369 had confirmed or provisional diagnosis of cancer and they were included in the final analysis."

A total of 5,887 people with lung cancer were admitted to the hospital in these three years.

Besides, 4,998 breast, 2,719 cervix, 1,582 oesophagus, 1,366 stomach, 1,224 liver, 1,177 lymphoma, 1,054 rectum, 884 cheek /oral mucosa and 485 gallbladder cancer patients received treatment from 2015 to 2017 at NICRH, the report stated, adding that 77.2% patients did not receive any kind of cancer treatment before attending NICRH.

Dr Md Habibullah Talukder, head of NICRH Cancer Epidemiology Department, said one-third of cancer patients in Bangladesh are admitted to hospital.

"We don't know about the rest of the patients. The government must take initiatives to protect people from the disease and improve treatment facilities. If a cancer is identified at the first stage, then patients will recover fast. So, awareness among people is also needed."

4 February is World Cancer Day. This year's theme of the day is "I am and I will".