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?
Dr. Marcin Hetnał, MD : 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. Prompt treatment is their only chance for survival. That's why it's so important that cancer treatment facilities operate 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 tremendous amount of extra effort and organization. It also demands a great deal of responsibility from our patients. We ask them to arrive exactly at the scheduled time for their therapy, ensuring that as few people as possible are in the facility at any one time. They must have their temperature taken before arriving for therapy, and they must adhere to all hygiene rules, such as wearing masks and gloves. Patients have had to become accustomed to contact with technicians separated from them by protective visors and waiting to enter the building. This is all for the sake of safety. As long as we adhere to the sanitary regime, we have a chance to function normally, minimizing the risk of having to close the Center, which is increasingly common in various hospitals. Fortunately, we have an adequate supply of protective equipment, and the Krakow Anti-Cancer Committee and a group of students from the Krakow Academy of Fine Arts in Modrzewski supported us with several hundred masks. Such gestures of support are crucial right now.
How does the epidemic affect the emotions of patients?
MH: People are different, and their reactions depend on many variables. However, we are certainly seeing more fear, anxiety, and sometimes apathy and helplessness. Patients are now terrified not only by their own illness, which they must face, but also by the additional threat of the virus and the thousands of daily difficulties resulting from this exceptional situation. They are afraid to use public transportation, find it more difficult to organize logistical matters such as basic shopping, and are unsure whether they can safely enlist the help of loved ones. We strive to maintain constant contact with our patients, and even if in some cases we offer telephone consultations, this constant contact is crucial for them.
How many patients are you currently treating?
MH : For example, on Monday, April 20th, we had 149 patients undergoing radiation. I would like to point out that at the end of March, we were treating 180 patients per day. This is very concerning, as we are clearly seeing a decline in the number of patients being treated, even though we know perfectly well that the incidence of cancer is certainly not decreasing. Everything indicates that in time, there will be more patients with very advanced stages of cancer who did not start treatment at the appropriate time. Cancer detection in Poland has never been a strong point. We are still treating patients in more advanced stages than in many other countries around the world. Much has been done in terms of prevention and screening in recent years, but the coronavirus could set us back by a dozen or even decades in this regard.
What it comes from?
MH: Unfortunately, the coronavirus has dismantled the healthcare system. Patients are afraid to go to the clinic, sometimes having trouble finding a place to go, or even finding it difficult to reach a doctor during a phone consultation. Not all hospitals offer diagnostic tests, and patients have no idea where they could get a biopsy, for example. We are controlling the epidemic, but at a great cost. More and more doctors are warning that we are facing a deterioration in the health of many people. This applies to chronic diseases, cardiology, and, of course, oncology.
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 unequivocal. Not starting treatment is a death sentence. As I said earlier, we are taking all necessary safety measures. Cancer patients must be treated now, without any delay. Some treatments, such as chemotherapy, can already be conducted in patients' homes in some places. However, radiotherapy requires regular visits to a medical facility. In March, we postponed some planned treatments, provided this was medically indicated. However, we are now resuming some of these treatments and calling patients to schedule consultations. We are convincing 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 treatment and to seek medical help at facilities that are still operating.
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