“Cancer patients have chances of easily transferring COVID-19”: how a chemotherapist works during a pandemic

In 2020, doctors around the world had to take up the challenge. Coronavirus is a new disease that none of us expected to appear, unlike outbreaks of other diseases. Any health care system has a certain amount of resources that it spends on the planned number of patients. For example, we know that about a certain number of people have a heart attack per year. Accordingly, hospitals are deployed under these numbers, the number of doctor’s rates is set and medicines are purchased. The approximate number of heart attacks, pneumonia and even cancer can be predicted based on data from previous years. Coronavirus infection turned out to be an unexpected and unpredictable blow to medical facilities around the world

Neither the scientific community nor the healthcare organizations really know what to do with it – not enough information has been accumulated on how to treat this disease, they have not yet developed vaccines – and we need to help people now. Therefore, all medical systems in all states were overloaded.

Scientific approach

I am an oncologist-chemotherapist, graduated from the Faculty of Medicine of St. N.N. Petrov and the Graduate School of Oncology (GSO) is a charitable educational project of the Cancer Prevention Foundation. In 2020, she entered the Forbes rating of the most promising Russians under 30 in the Science and Technology category. 

In addition to working at the Luch clinic, where I conduct chemotherapy, treat patients on an outpatient basis and in a day hospital, I am the program director at the Higher School of Education.

This project aims to improve cancer care in our country by improving the quality of education. Talented graduates of medical schools undergo a multi-stage selection to become eligible to study at the Higher School of Economics. Competition – about 40-50 people per place.

The project program consists of two parts. The first is rotation in clinical bases (leading oncological institutions in the country), where the resident undergoes the bulk of the training, leads patients, and adopts the experience of more qualified doctors.

There are also additional classes in which young doctors are taught the basics of evidence-based medicine (an approach to medical decision-making based on scientific evidence – clinical research), critical reading of specialized literature – very important skills for any doctor.

There are also classes in medical English, epidemiology, courses in patient communication, medical statistics, molecular oncology, and so on.

My work within the framework of this project is to fill the program and ensure that the training is of the highest quality – that is, as close as possible to world standards. Conventionally, my position can be compared with that of the deputy dean. In this case, the dean is the main curator of the project, Vadim Gushchin.

New COVID reality

In connection with the coronavirus, doctors of any specialty face many serious questions. There are various unpleasant scenarios: for example, the oncology department may be quarantined due to an identified case of COVID-19. Patients need to be redirected somewhere for treatment – to other hospitals. But there is also its own flow of patients, and it is problematic to provide assistance to everyone on time. Queues are forming, doctors are overwhelmed.

The second possible scenario is when a hospital with an oncology department will be redesigned for coronavirus. Accordingly, patients also need to be accommodated somewhere.

It is important to note that our country is not at all unique in this situation: all other states, even those with the most developed healthcare systems, experience the same problems.

In this regard, the European, American and Russian medical communities have published temporary clinical guidelines that can be relied on during a pandemic. We are faced with the question of priorities – which patient can wait without harm to health and life, and which cannot. For example, if a patient does a CT scan a month later, as he is supposed to be once a year, there will be no disaster. But there are also priority tasks that cannot be postponed.

Crown + Cancer =?

A patient with cancer can contract a coronavirus infection, just like any other person. This is where its own difficulties arise – both technical and ethical. For example, a patient needs to be operated on. But how to do it if he contracted COVID-19? It cannot be put into the ward – it will endanger other patients. 

If the patient is generally in good condition, if he has not yet received anticancer treatment (for example, chemotherapy), then he has a chance to undergo a mild COVID-19 in two to three weeks and be hospitalized after receiving negative smears.

In the case of colon cancer, for example, two weeks of waiting usually does not affect the patient’s prognosis and does not worsen the results of treatment.

But there are more unpleasant situations. For example, when a patient becomes ill with coronavirus during chemotherapy. Continuing treatment with an active infection can result in more harm than good.

Against the background of chemotherapy, the patient is more susceptible to any infections – they can be more severe, including COVID-19.

Therefore, in such cases, we usually postpone chemotherapy until we recover. This applies not only to COVID-19, but also to other infectious diseases, such as bacterial pneumonia. The presence of an active infection in the body in combination with immunodeficiency due to chemotherapy can lead to very serious complications.

We are working!

In connection with the pandemic, the exchange of experience between doctors has become more intense: this is especially noticeable in the field of resuscitation and infectious diseases. A huge amount of research is being published, new communities are being formed. There have been no global changes in my area – nevertheless, cancer and coronavirus exist a little “in parallel” – although this whole situation has largely affected our field of medicine.

Fortunately, oncology does not fall under the definition of “routine medicine,” so we will not be redesigned for covid treatment. To be honest, I am glad of this – and not because I am afraid to go to an infectious diseases hospital.

I think it’s better to be a good oncologist than a bad infectious disease specialist.

Oncological diseases have not disappeared because of the coronavirus, they continue to be the second cause of death for the entire population of our planet, and they cannot be relegated to the background.

Yes, because of the pandemic, we have to work in new conditions: at any stage of treatment, we may face the most unexpected difficulties. Patients from other cities can find it difficult to get to us in St. Petersburg. I take it all as an opportunity to gain a new experience, a kind of challenge: how to help a patient during a pandemic and in an overloaded healthcare system. I am sure that even in such difficult situations we will cope. It’s just a matter of time.

Photo Shoot: personal archive, Getty Images