The Impact of COVID-19 on Radiation Oncology and Cancer Care: A Perspective from the Cancer Belt Region of India

Abstract

A pandemic coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a respiratory illness called coronavirus disease 2019 (COVID-19) that is often severe or life threatening. Considering the low immunity status of cancer patients due to multimodality treatment, they seem to be more prone to COVID-19. Given the rapidity with which the novel coronavirus (SARS-CoV-2) is spreading, we can expect an increased burden of cancer patients diagnosed with COVID-19 at oncology treatment clinics and a need to address the issues associated. As of the date of this writing, United States has been witnessing an increase in confirmed cases, not far behind are the large outbreaks of European countries. Patients with cancer may have compromised immunity due to their disease or its ongoing treatment, and early reports suggest cancer is a risk factor for severe COVID-19. Since the outbreak in Wuhan, Chinese researchers have published on their experience with COVID-19 and have highlighted high-risk groups, including the elderly and patients with comorbidities, including cancer. In one of the largest series reported from Wuhan, elderly patients were at a higher risk for disease severity with an 8.0% case fatality rate in those aged between 70 and 79 years, and 14.8% in those aged 80 years and older. The case fatality rate for cancer patients in that cohort was notably higher than noncancer patients at 5.6 versus 2.1% in the whole sample. This review focuses on the pandemic-driven strategies that need to be adopted to overcome the radiation oncology clinics burden, especially in this region of India popularly termed as the cancer belt. Although colleagues around the world have dealt with enormous service pressures in the face of natural disaster or infection previously, the global scale and challenge of COVID-19 are unprecedented. Our aim is to highlight the quintessential point that even within these circumstances the morbidity and mortality associated with cancer should not be taken lightly. Departmental protocols should be regularly upgraded to provide smooth and efficient functioning of the department.