Patients with advanced cancer should not sit at home for fear of COVID: Says Gangaram Hospital’s oncology head Dr. Shyam Aggarwal

The effects of Covid-19 has loomed over the world for over 7 months now. While the attempt to contain the spread of the deadly virus and to develop a clinically approved vaccine is still underway, doctors and specialists have shown a grievous concern towards the negligence of non-Covid diseases in the process. Cancer is a fatal disease, which needs immediate diagnosis and treatment. However, in the recent times, especially when the fear of Covid is still very persistent, people have failed to see the severity of the situation.
In conversation with TOI health, Dr. Shyam Aggarwal (MBBS, DM - Oncology, MD – Medicine), who heads the Oncology department at Sir Ganga Ram Hospital in New Delhi, discusses the very issue of how Covid-19 has impacted the lives of people suffering with other acute non-Covid diseases like cancer.

He begins by stating the behaviours of two groups of cancer patients whom he had closely observed during this pandemic.
The first group of patients, he says, “were being treated for metastatic diseases – that could spread to various parts of the body like liver, lymph nodes – in terms of colon cancer.” However, in spite of having the disease, they had few symptoms, which made them feel that they don’t need to go to the doctor for a period of time, especially for the fear of Covid, he adds.

The fact that the coronavirus poses a greater risk to the life of old people and those with underlying medical conditions – of which cancer is one – many people have overlooked the urgency for a required treatment for their pre-existing conditions. As per Dr. Aggarwal, “Although patients were advised to come for treatment at two, three weeks of intervals, just because of the fear of Covid, they decide on their own and believe that delaying the treatment by two to four months may not make a difference, because they have no symptoms at that time.”

However, “once they start becoming symptomatic and visit the hospital for a treatment, it is already too late as the disease has already progressed and gone beyond treatment,” he says.

Moving on to the second group of patients, Dr. Aggarwal emphasizes on the colon cancer patients, who regularly experience bleeding from the rectum and have blood on their stool. However, they find it reasonable to skip diagnosis and treatments because they feel no pain and feel ‘reasonably okay’.
“Normally if somebody has persistent bleeding for a few weeks, they should go for immediate checkup so that the reason for bleeding is identified and captured,” he states. “But patients are so scared to come for diagnosis and treatment that they’re getting upstaged because of the delay in seeking treatment,” he adds to his previous statement.

Delving deeper into the debate of whether coronavirus has impacted the diagnosis and treatment of cancer, Dr. Aggarwal provides us with a certain data regarding the same. As per the data provided not just by Sir Ganga Ram Hospital, but also by Tata Memorial and AIIMS (All India Institute of Medical Sciences, he says, “During the last four or five months – especially in the period of lockdown – the number of cancer surgeries have declined tremendously, by more than 50% to 60%, which is a clear indication that patients who were coming earlier at an early stage have stopped coming to the hospital, for fear of Covid.”

Further into the conversation, Dr. Shyam Aggarwal reflects on the imbalance that exists between the treatment of Covid as against the treatment of cancer in various hospitals across the country, along with Sir Ganga Ram Hospital. He says, “Covid is a disease which was non-existent in the world nine or ten months ago. Now depending upon the number of cases in the city, town or village, it has occupied similar number of beds. In Ganga Ram Hospital, we have 800 beds. Currently 300 beds at the moment, are dedicated to Covid patients, which means, for non-Covid patients we are left behind with 500 beds – nearly 2/3rd of the bed strength… So we are having difficulty in finding beds for non-Covid diseases.”

According to him, the government is not focusing on the non-covid situations, which is becoming a great issue for the patients with diseases other than Covid.

Finally, he concludes with a strong message by saying, “Non-covid patients are getting neglected. On the one side, we’re giving so much importance to one disease and on the other side people are dying of other diseases. Therefore, there needs to be a balance.”