Cancer Surgery in Challenging Time of COVID-19 Pandemic – A Pragmatic Approach

Introduction

SARS-CoV-2 virus pandemic has invaded most nations all over the world. Countries which are among the best in health-care infrastructure and resources, too, are struggling to combat the pandemic effectively.

SARS-CoV-2 can spread via cough or respiratory droplets, contact with body fluids, or contaminated surfaces.[1] Recent studies suggest that anyone who is infected with SARS-CoV-2 and is asymptomatic can spread the virus speedily. In this scenario, conventional measures of protection such as face masks provide insufficient protection.[2]

People suffering from cancer are more susceptible to SARS-CoV-2 infection and its complications than non-cancerous patients.[3] Liang Wet al. found that cancer history represented the highest risk for severe events among all comorbidities that a patient has at the time of getting the infection. In cancer patients who are infected with SARS-CoV-2, the risk of hospital admission for respiratory distress is four times higher and the risk of death ten times higher than in the patients without cancer. This is more marked in cancer patients who have neutropenia or lymphopenia, a feature commonly seen in the patients treated with multiple therapies.[4] This is also due to systemic immunosuppressive state due to cancer and anticancer treatments such as surgery and/or chemotherapy and the risk of nosocomial infections which cancer patients have when they come to the hospital for treatment or routine follow-up.[5],[6],[7] Liang W et al. found a significantly higher risk of fatality in patients who have a prior history of surgery in the month preceding the infection.[2] They also reported that the condition of cancer patients deteriorated faster than that of the patients without cancer and hence cancer patients should visit the hospital facility only when it is utmost required.

Publication History

Received: 01 April 2020

Accepted: 19 April 2020

Article published online:
23 May 2021

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