The impact of cancer is more than physical. For many patients, the emotional and psychological challenge of absorbing a new diagnosis or progression of the disease is just as difficult as the physical effects. As doctors, our ability to inform and support patients with compassion is a critical aspect of care and treatment.
During the COVID-19 pandemic and associated precautions, the delivery of compassionate medical care for patients with cancer is more important than ever. We know that patients with cancer are experiencing high levels of anxiety and stress. Calls to Cancer Council’s information and support line have increased in number and duration.
Many patients are feeling anxious about coming to hospital, concerned they may be at increased risk of contracting COVID-19 and worried they are more vulnerable to its effects. At the same time, we are seeing a reduction in patient consultations with GPs and in referrals to cancer specialists, raising concerns that people are delaying getting care.
Medical professionals across the state are concerned that people may be putting off treatment for their cancer or in getting a diagnosis in the first place. Fortunately, Australia has managed to flatten the curve with excellent control of the COVID19 infection to date, giving health services precious time to put in place measures that ensure cancer care remains very safe for patients, carers and health care workers.
Across health services providing acute care, there has been more than a 50-fold increase in telehealth using video calls for consultations on smart phones or computers within the last month. Many patients actually prefer this approach as it means they are comfortable at home, supported by a loved one and without the anxiety that many people experience when coming to hospital. For elderly patients, or those with special care needs, GPs, aged care workers and other primary care practitioners continue to play a critical role in cancer care – including participating in telehealth calls. This is a new experience for many but once the initial call has been made, any concerns are usually alleviated.
If someone does need to come to hospital or to see their doctor face-to-face, that has been made as safe as possible too. A patient with a new diagnosis seeing a doctor may well seek the reassurance of a face-to-face interaction, even if it is from a safe physical distance. Hospitals have implemented precautions to optimise the safety of patients coming to the hospital, particularly in areas where patients with cancer attend. These may include strict hand hygiene, physical distancing amongst staff and patients, changes to visitor policy and temperature check at entrances. It’s a careful balance. Physical safety must come first but the emotional and psychological wellbeing of patients is also fundamental and is not forgotten - especially at times like these.
For a small percentage of patients, COVID-19 precautions have meant some changes to their usual treatment plans but at this stage cancer treatments are largely continuing as usual in Victoria. This will only change if COVID-19 infections escalate in the community and the health system comes under significant pressure. Therefore, we urge Australians to comply with social distancing laws and hygiene recommendations.
If you become unwell, however, getting checked or going to hospital is absolutely safer than staying at home. The potential risk of delayed cancer diagnosis or treatment outweighs the COVID-19 risk.
Anyone with concerns should contact their health care provider or call Cancer Council’s information and support line and speak to one of their cancer nurses on 13 11 20. For further information, you can also call the Coronavirus Health Information Line 1800 020 080.
Our message is clear. If you are worried about cancer, we are here and we always will be. Cancer care never stops, even if it changes in some ways. We are all in this together.
The Victorian COVID-19 Cancer Network (VCCN) is a joint initiative of the VCCC alliance and Monash Partners Comprehensive Cancer Consortium (MPCCC).
VCCN Co-chairs
Professor Grant McArthur, Executive Director, Victorian Comprehensive Cancer Centre
Associate Professor Sue-Anne McLachlan, Medical Director of Oncology and Cancer Services, St Vincent’s Hospital Melbourne
Associate Professor Andrew Haydon, Joint Clinical Director, Southern Metropolitan Integrated Cancer Service (SMICS); Medical Oncologist, Alfred Health
Associate Professor Zee Wan Wong, Joint Clinical Director, SMICS; Head of Oncology, Peninsula Health