Coronovirus (Covid-19) and Palliative Chemotherapy

I have known a few people who are dealing with cancer for several years – they have been on treatment off and on for years. Amazingly, we have managed to keep disease under control. Some on cytotoxic chemotherapy, some on hormone blockade, some on immunotherapy, some on wait-and-watch and so on so forth.

The Coronovirus (Covid-19) has changed everything. We are worried about people who are immunosuppressed with steroids or chemotherapy. People who have had several lines of treatment and can still get some form of cytotoxic therapy are now being counselled about stopping chemotherapy. The benefit of 4th or 5th line of treatment is small, but the risk of immunosuppression is very high.

The risk of death higher.

Very difficult conversations. Most outpatient consultations now are either with the patient alone or with one relative/friend or via a teleconferencing platform. Really difficult conversations as hard as they are… and now with more restrictions – it is even harder. The heartache is felt by the patient, their families, friends, treating doctors and the nurses. The reception staff who have known these people for years are also struggling with the circumstances.

Terrible times. Most of us with overcome this. I feel sad for people who will not.

Covid19 (Coronavirus) and Cancer Chemotherapy

Covid-19 is creating havoc across the world.

This illness started off in China and has now travelled across the world. Large megacities to small villages are being affected severely.

Most of the real-time data we have is from China, Italy, Spain, UK and the USA.

The people with highest risk of dying are: age above 70, heart problems and immunosuppressed.

The immunosuppressed cohort include people on steroids and cytotoxic chemotherapy. This is a massive decision to be made in clinics on a daily basis.

What is the true benefit of 3rd or 4th line chemotherapy in someone with gastric or pancreatic cancer? The benefit is very marginal, but the chances of getting severely immunosuppressed are fairly significant.

It is a very difficult discussion. In the times of social distancing – only one family member is allowed for the consultation – the discussion is even more challenging.

Stay safe. Godspeed.