February 16, 2021 2:23:31 am
EVEN AS the number of cancer patients visiting the Tata Memorial hospital has inched back to pre-pandemic times, the crucial treatment time lost during lockdown has had a detrimental effect on patients, especially children. According to oncologists, more children have returned with advanced or relapsed cancer.
Parel-based Memorial Tata hospital sees around 75,000 cancer patients annually, the maximum for such a facility in India. Between 2019 and 2020, the number of new paediatric cases fell from 2,086 to 1,191 due to the Covid-19 pandemic. Several patients with planned surgeries to remove their tumours had to postpone the same and take chemotherapy to limit the cancer spread. In some cases, children from outside Maharashtra were unable to travel to Mumbai for treatment.
The hospital noted a fall in monthly new paediatric cases— from 155 in February, 101 in March to just 17 in April when the lockdown was in full force. Till August, the hospital was seeing 50 per cent of its expected cases. It was only in September that the numbers rose back to 159.
“About 40 per cent of children (at the facility) have blood cancer or leukaemia; another 25 per cent have brain tumours. Both are fast-growing and aggressive cancers. A delay in treatment by even seven-eight months can advance the disease. In some cases, there is no curative treatment possible,” said Dr Girish Chinnaswamy, head of paediatrics oncology. Chinnaswamy added that such advanced cases have increased in children ever since lockdown restrictions eased and patients started returning to the hospital to resume treatment.
Hospital social worker Rajesh T said that an eight-year-old boy from Uttar Pradesh, who was suffering from leukaemia, could not visit the hospital in June 2020 for his follow-up session. He was only able to visit the facility in February this year. “His disease has relapsed and we will have to begin treatment again,” Rajesh said.
In another case, Wardha-based Nazma Khan and her five year old son, Aamir, sat in the hospital OPD waiting for their turn for consultation. Due to the pandemic, they could not immediately reach Tata hospital to begin his treatment. Aamir started developing fever last August and by end of the year, he was diagnosed with B-cell lymphoblastic leukaemia in Nagpur. He is now undergoing chemotherapy at Tata hospital. A social worker said the medical report labels Aamir as a ‘high-risk’ case.
Dr Shripad Banavali, director (academics) at Tata hospital, said that the hospital began tele-medicine for existing patients and at least 3,000 children with cancer were personally contacted via phone calls. The hospital doctors referred them to local doctors in their respective cities for treatment. “It is possible that a lot of new cancer cases have not yet been diagnosed due to the lockdown. In several tier-II and tier-III cities, general physicians had shut their clinics. The impact will be seen in one or two years when the cure rates for cancer dip,” he said.
“Adult cancer patients mostly have solid tumours, which can be tackled even with a delay of six to eight months. But children commonly have blood-related cancer, which is aggressive. If delayed, a child may require palliative care,” Banavali said.
In emergency cases, the hospital made use of donations to arrange taxis for patients for inter-city travel and in some cases, medicines were couriered.
“In the initial three months, several NGOs and donors helped with nutrition, financial support and food for patients who were stuck here during the lockdown,” said Shalini Jatia, secretary, ImPaCCT Foundation.
However, the lockdown and associated economic losses have affected the overall funds the hospital receives through corporate social responsibility and donations, with a dip recorded this year. Even dharamshalas, that house such patients, have strict rules to observe physical distancing and limited the number of family members who can live with a patient.
While tele-medicine continues and WhatsApp support groups have also been created for patients to limit the need for travel to Mumbai, the hospital is once again bustling with patients, its OPDs as full as they were last February.
Around 25 beds are reserved for those who test positive for Covid-19. Since the inception of the pandemic, 149 children tested positive for Covid-19, nine of whom died.
“Of them, three succumbed to cancer progression and not Covid-19 directly. We observed that Covid-19 was less severe in children with cancer,” said assistant professor Dr Badira Parambil.
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