DELAYS in screening and treatment procedures are among problems faced by cancer patients as a result of Covid-19, which has taken a toll on healthcare infrastructure.

Cancer patients, too, are considered highly susceptible towards contracting the coronavirus.

Dr Muralli Munisamy of the National Cancer Society of Malaysia (NCSM) said various stages of cancer care, including hospice services, have been affected due to the pandemic.

The NCSM general manager and medical director said there have been delays in the initiation of treatment for newly-diagnosed cancer patients as oncology treatment was only available at certain major state and university hospitals. These, however, have been converted into primary Covid-19 treatment centres.

“As a result, in order to reduce the risk (of Covid-19 transmission), cancer patients were not sent to these hospitals to start chemotherapy and radiotherapy,” he told a virtual press conference today on cancer care during the Covid-19 pandemic organised by AstraZeneca, a British-Swedish pharmaceutical company.

Invasive procedures such as bronchoscopy and colonoscopy, which are necessary to confirm diagnostics, have also been put on hold as part of reducing the risk of Covid-19 transmissions to health workers and within health facilities.

Meanwhile, as resources including lab personnels were diverted towards Covid-19 testing, molecular diagnostics for cancer also had to take a back seat.

“As a result, for cancer patients or patients who were suspected of having cancer, this meant that they were not getting diagnosed (soon enough),” he said.

Patients who were already receiving cancer treatment also faced their own share of problems, including being unable to travel to the hospital during the movement-control order.

Some were unable to proceed with cancer treatment due to financial difficulties as a result of losing their jobs, he added.

Some patients in need of aid were also unable to connect with the Welfare Department.

These were stress factors that added to the mental health challenges cancer patients faced, he said, noting that there was also a lack of access to mental health interventions, even before the onset of Covid-19.

“For cancer patients, mental health has been a very serious concern and accompanied with that, we have very, very poor mental health capacity in terms of specialists and healthcare professionals to deal with mental health overall,” he said of the situation in Malaysia.

He said the NCSM and its partners have come up with a series of solutions, including providing access to medicines, education and awareness, advocacy and psychosocial support for patients.

Asked whether the Health Ministry should rethink its decision of converting certain major hospitals into full-fledged Covid-19 treatment centres, Muralli said there might be a need to reprioritise the use of hospitals.

“Unlike certain countries, all our tertiary facilities are concentrated in one or two hospitals,” he said.

While moving cancer care to smaller hospitals may be an option, it is also a matter of whether these facilities are equipped with the necessary resources.

He added that the government could look to private hospitals for this matter. 

This echoes the call by the Malaysian Medical Association, which has been urgeing Putrajaya to delegate Covid-19 treatment to private healthcare facilities, which are underused compared to public facilities.

According to the non-profit Cancer Research Malaysia, one in four Malaysians are affected by cancer.

In January, the Health Ministry reported a 11.3% increase in new cancer cases from 103,507 in 2007-2011 to 115,238 in the 2012-2016 period, according go its Malaysia National Cancer Registry Report (MNCRR) 2012-2016, with a significant increase in breast and colorectal cancer.

Muralli was speaking at the virtual press conference which was part of AstraZeneca’s New Normal, Same Cancer campaign, held in partnership with a coalition of leading Asian oncologists from India, Indonesia, Malaysia, Philippines and Singapore. – December 10, 2020.