February 5, 2021 10:53:24 am
“We cannot let them go. Please go find the patients,” was the simple instruction Dr Sushmita Ghoshal, professor and head, department of radiotherapy, PGIMER, gave to her department the moment she heard that the OPDs were not operational because of Covid-19.
She knew many patients would have already reached the hospital, waiting for their check-ups. “I went to the hospital, and we had our OPD. I led from the front, with the solid backing of my entire department. I have to mention here nurses, technicians and Class IV staff who came forward selflessly to support my decision,” recalls Dr Ghoshal.
As an oncologist whose area of work for the last three decades has been the treatment of cancer, on World Cancer Day, which was observed on Wednesday, she recalled with pride how that one decision, which she defines as a “knee-jerk reaction”, helped save many lives. The department helped provide cancer directed service throughout, not stopping services even for a day.
While managing Covid patients was their first priority, the doctor said cancer wouldn’t wait till the end of the pandemic. Hence, along with her team, the department maintained services, though limited due to logistic issues, after taking due precaution. “The entire department worked as one in order to provide much-needed healthcare to cancer patients. The lockdown affected patient care as many could not reach the hospital or were misinformed,” she said.
According to Dr Ghoshal, the department published the experience of management of cancer patients during the initial part of the pandemic. A total of 160 patients were treated in the department during this study period and as many as 44.4 per cent patients under treatment had associated co-morbidities. That says Dr Ghoshal, posed as an added challenge in management. Seventy-six per cent patients continued treatment with their initial plan of radiotherapy or chemotherapy.
Providing details of services provided by the team from April 2020 to January 2021, as many as 20,525 patients were seen in the Radiotherapy OPD, with the number of day care patients being 9,587 and medical oncology OPD patients being 2,972, with 2,385 being under palliative care and around 2,500 per month under tele-consultations.
Dr Ghoshal said that initially, they had to work with limited PPE kits, and available logistics, as everyone was fearful of the unknown. Gradually, they got gloves, face shields etc. to carry on work.
“I had a patient with voice box cancer, who came from a red zone in Punjab for a follow-up and was coughing…We didn’t know if it was because of cancer or Covid. Testing was limited and over the weeks, the department of virology stepped in to sort this problem, so that patients could be tested. We were assessing the situation, as the Covid-19 cases were rising, and continued palliative care, with 574 new cases seen, and 1,811 patients followed up. Treatment plans were prioritized based on severity of symptoms and whether the expected outcome would significantly affect their survival and quality of life. Patients were monitored for treatment-related toxicities and Covid symptoms, and we changed or modified treatment as per the situation, like we say in cancer treatment, a sliding scale. But these challenges have been worth it, for compassion and experience guided our decisions,” she said.
The department works in many ways to spread cancer awareness and according to Dr Ghoshal, if detected early, cancer has 90 per cent chance of being cured. “As an oncologist, my appeal is to look for signs and symptoms, and breast cancer, oral cancer and cervical cancer can be identified early with screening. Make use of screening facilities in government centres and seek immediate treatment,” she added.
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