An estimation of the Indian Council of Medical Research says that about 1300 people die of cancer every day in India. Recently, two legendary stars of Indian Cinema – Irrfan Khan and Rishi Kapoor – died of cancer.

An estimation of the Indian Council of Medical Research says that about 1300 people die of cancer every day in India. Recently, two legendary stars of Indian Cinema – Irrfan Khan and Rishi Kapoor – died of cancer. As the whole world is in the grip of Corona pandemic, how cancer patients are coping with. How much cancer patients are at risk in Covid era, Dr. Anshuman from Dharmashila Cancer Institute, our guest on Medlarge.com, unfolds the risk associated with cancer patients in Covid-19 era.

1. If someone is suffering from Cancer, how much he/she is on the risk of getting infected with Covid-19?

Let’s discuss first the origin of Covid-19. This is not a new virus.  Corona is a family of a virus, call it SAARC. It has been named as SAARC COV 2. Whether it is cancer patients or normal people, it can be transmitted to anyone. But, we need to understand that there is a great difference between infection and the disease. Infections mean that a virus has entered inside your body cell and the patient can test positive.  Talking about the disease, the most common disease of Covid-19 is pneumonia. Infection can also be of two types – Symptomatic and Asymptomatic. Being Asymptomatic is good for patients as they have an infection but no disease. However, being asymptomatic is dangerous for the community. Because, unaware of the infection, the patient can spread it in the community.  Asymptomatic cases are common with persons having good immunity. In such condition, the person continues to fight the virus inside without any sign of disease externally.

On the contrary, people with weak immunity of 60 plus age group, suffering from dangerous diseases like cancer, diabetes, or AIDS, is more prone to infection (which in medical language is called a subset). If such a person gets infected, symptoms will be like sever like fever, difficulty in breathing and considerable cough. And, many such patients can go into a very serious condition. Their lungs may be damaged; leading to pneumonia, even ventilators will be required and will have higher death risk.

2. Cancer has devoured two legendry starts of India – Irrfan Khan and Rishi Kapoor. But, Rishi Kapoor’s report mentions pneumonia. Can it be linked to the corona or is it cancer behind it?

Both links can be attributed to pneumonia that led to his death. However, Rishi Kapoor’s medical report is not in the public domain, so nothing can be said with accuracy. His bone marrow transplantation is in public domain. This treatment is usually done in the case of Lymphoma or blood cancer. His chemo-therapy was also done and so, resultantly, immunity must have been gone downwards. As pneumonia is mentioned in his death report, it is most common with Covid-19. As an expert, we say in medical language that ‘consider all pneumonia as COVID pneumonia or prove otherwise’.

3.  The untimely death of veteran actor Irrfan Khan has also been caused by cancer.

Yea! Irfan Khan was suffering from a neuroendocrine tumour. There are many veins inside our body that become capable of producing hormones where they end. In neuroendocrine tumours, the hormone-producing neuroendocrine cells start producing too much or fewer hormones. It can occur in any parts of the body like lungs, gastrointestinal tract, thyroid, or in the adrenal gland. Depending on which part of the body the tumour is, the cancer is determined. If such serious and grave disease is detected on time only then treatment is possible. There are many types of tumours in it.

Gastrointestinal neuroendocrine tumours can occur in any part including the large intestine and appendix. Lung neuroendocrine tumour leads to difficulty in breathing and breathing while coughing. Blood sugar is significantly affected due to hormone attachment in pancreatic neuroendocrine tumours.

Irfan Khan was actually suffering from a malignant neuroendocrine tumour that spreads from one organ to another.

4. ICMR estimates about 1300 death every day from cancer. In an ongoing pandemic, is it likely to increase more in the coming time?

For the last 18 years, I have been asserting it to be extra careful in every public presentation. Changing our lifestyle is the only option to stop the spread of cancer in India. We need to purify our environment. Environmental pollutants cause cancer mostly. If we cannot change our lifestyle, India will become the global capital of cancer in 2020. The maximum number of cancer cases will be in India across the globe.

5. What steps have been taken by the government for cancer patients during this corona pandemic?

People from other states and territories across the nation mostly come to Delhi and Mumbai for getting the treatment for cancer. Currently Delhi AIIMS and Delhi State Cancer are closed. Now the question is where those cancer patients are going during this pandemic? The answer is nowhere.     

From the very beginning, I have been saying that if everything is closed down in such a situation, where will the cancer patients go for treatment. The government did not think anything separately for the cancer patients. The government lacks management. If a pandemic like Covid has taken everything in the grip, it doesn’t mean that other disease like cancer doesn’t exist in India. Suppose, in this Covid era, if more people die of non-covid disease like cancer, heart and others, who will be responsible for that? Obviously, the question will be raised towards the poor management of govt. machinery. Cancer patients are afraid of going to hospital. As their immunity naturally remains at the lowest point, if they visit the hospital and gets infected, they will be more prone to death. All this is a result of the lack of vision of the government and management failure.

Dr Anshuman Kumar, National President-Tara Cancer Foundation (NGO), Director & Chief Cancer Surgeon, Delhi

6. So, what changes you advise for government machinery to deal with the situation.

I advised 3S concept in the beginning. But unfortunately, no heed was given to my suggestion. 3S concept means Surveillance, Segmentation and Segregation. First of all, there is a need to keep surveillance on the corona spread from every corner of the country.  Segmentation meant to divide the healthcare facilities across the nation area-wise irrespective of private and government institute. And in last phase, each health care facility should have been dedicated to only one disease.  Like, one healthcare facility should have been dedicated for cancer only. And, no other disease could have been treated there. Such management does make much difference and this kind of chaos have been prevented.

7. What would you like say to cancer patients to avoid corona infection?

There is no vaccine for Corona. Keeping physical distance is the only option to keep the Covid-19 away. I will strongly suggest that cancer patients should not consume hydroxychloroquine at all.  By the way, I would advise anyone not to take hydroxychloroquine. The rest is the common advice which is applicable to everyone. Pay special attention to physical distance and hygiene. Do not step outside. Avoid external exposure. Avoid visiting the hospital during an ongoing pandemic if it is not much needed.

Thanks!

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