ONCOLOGY DURING AN EPIDEMIC
The disease does not choose a convenient date or check the surrounding circumstances. Cancer patients face additional difficulties during the epidemic, feel more anxiety and feel more lost. – We need to support cancer patients more effectively – says Marcin Hetnał, M.D., medical director of the Amethyst Radiotherapy Center in Krakow, which treats patients continuously every day.
Canceled treatments, specialist doctors' offices closed, consultation with a doctor possible mainly by phone. We have been learning to function during the epidemic for over a month. Doctor, what about cancer patients?
Marcin Hetnał, MD, PhD: Oncological treatment cannot wait for the situation to stabilize and for the number of people infected with the coronavirus to decline. Cancer patients don't have time. Quick treatment is their only chance for survival. That is why it is so important that oncology treatment facilities are able to function responsibly and safely during the epidemic.
The Amethyst Radiotherapy Center is open and accepting patients. Did it require a lot of changes? Do you have the appropriate amount of personal protective equipment?
MH.: Working in the current situation requires a huge additional effort and organization from us. It also requires a lot of responsibility from our patients. We ask them to arrive exactly at the therapy hour so that there are as few people in the facility at the same time, they must measure their temperature before arriving for therapy and follow all hygiene rules, such as wearing masks and gloves. Patients had to get used to contact with technicians separated from them with protective visors and waiting for entry in front of the building. It's all for the sake of safety. As long as we comply with the sanitary regime, we have a chance to function normally, minimizing the risk of having to close the Center, which is happening more and more often in various hospitals. Fortunately, we have an adequate supply of protective equipment, and the Krakow Cancer Committee and a group of students of the Krakow Academy of AF Modrzewski supported us with several hundred masks. Such gestures of help are very important nowadays.
How does the epidemic affect the emotions of patients?
MH: People are different, their reactions depend on many variables. However, we are definitely seeing more fear, anxiety, sometimes apathy and helplessness. Patients are now terrified not only by their own disease that they have to face, but also by the additional threat of the virus and thousands of everyday difficulties resulting from this unique situation. They are afraid to use public transport, it is more difficult for them to organize logistical matters such as basic shopping, and they do not know whether they can safely use the help of their loved ones. We try to be in constant contact with our patients and even if in some cases we offer them telephone consultations, this constant contact is very important for them.
How many patients are you currently treating?
MH.: For example, on Monday, April 20, we had 149 patients who underwent irradiation. I would like to point out that at the end of March we treated 180 patients a day. This worries us very much, because we clearly see a decrease in the number of people treated, and yet we know perfectly well that the incidence of cancer is definitely not decreasing. Everything indicates that in time there will be more patients in very advanced stages of cancer who did not start treatment at the right time. Cancer detection in Poland has never been a strong point. We still treat patients in more advanced stages than in many other countries in the world. In terms of prevention and screening, a lot has been done in recent years, but the coronavirus may set us back a dozen or even several dozen years in this matter.
What it comes from?
MH: Unfortunately, the coronavirus has dismantled the healthcare system. Patients are afraid to go to a clinic, sometimes they don't really have a place to go or they can't reach an agreement with a doctor during a telephone consultation. Not all hospitals conduct diagnostic tests, and patients have no idea where they could, for example, have a biopsy done today. We are controlling the epidemic, but at great cost. More and more doctors are warning that many people's health condition will deteriorate. This applies to chronic, cardiological and, of course, oncological diseases.
However, cancer patients are in the main risk group for COVID-19. Wouldn't it be better for them to stay at home and avoid contact?
MH.: These are difficult decisions, but in the case of cancer, they are clear. Failure to seek treatment is a death sentence. As I said earlier, we take all necessary safety measures. Cancer patients must be treated now, without any delay. Some treatments, e.g. chemotherapy, can already be carried out in patients' homes in some places. However, radiotherapy requires regular visits to a medical facility. In March, we postponed some planned therapies, if this was, of course, in accordance with medical indications. However, we are now resuming some of these treatments and calling patients to schedule a consultation. We convince them that it is important to start treatment as soon as possible, even in this difficult situation. Therefore, I appeal to patients not to delay therapy and seek medical help in facilities that are still operating.
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