The COVID-19 pandemic has disrupted the Indian health-care ecosystem leading to concerns about its subsequent impact on non-communicable diseases, Cancer being one of them. As per reports, more than 1.3 million new patients are diagnosed with cancer and over 850,000 patients die of the disease annually in India. Cancer usually presents as a painless lump or is in the form of an ulcer during the initial stages. Due to lack of pain in most cases and the fear of hospital visits due to the pandemic scare making many patients are deferring their hospital visits for early screening. This is one the primary reasons why many patients are getting diagnosed at an advanced stage of the disease.  

65-year-old Rao (name changed) had noticed a breast lump in March last year. She had contacted her General Physician who had told her that she will need further evaluation and advised her to meet an oncologist. With the fear that she might get infected with COVID, she decided to delay her hospital visit. By the time she visited the hospital in May, the oncologist evaluated her and told her that the cancer had spread to her lungs. Three precious months were wasted with no treatment. Unfortunately, incidents like that of Rao are fairly common. The diagnosis and treatment of cancer is time sensitive and is likely to be substantially affected by these disruptions. 

There are many reasons why people delayed seeking treatment for diagnosed and suspected cancer during the peak of the COVID pandemic. Fear of contacting COVID in hospitals was one of the primary reasons. Scarcity of diagnostic facility and difficulty in travel due to lockdowns were other reasons. Doctors and hospital beds too were not easily available. Whatever be the reason this caused progression and spread of cancer in a good number of patients. Therefore, spreading awareness about cancers and the risks associated with delayed treatment is the need of the hour. Studies from India and abroad have shown that community-based cancer screening leads to a significant reduction in cancer-related deaths.  There is a need to introduce cancer screening hubs at the community level to screen for common cancers. 

While some of the fears of patients were genuine a lot of them were unfounded. The spread of cancer in the body does not stop because of the pandemic. The evidence for this stems from the greater number of patients who presented with advanced cancer when the second wave of the COVID pandemic started receding. 

As we have realised by now COVID is not something which will go away in the near future. We will have to learn to live with this. Any diagnosed or suspicion of cancer should be taken seriously. Early diagnosis of cancer has the best chance for successful treatments. When cancer care is delayed, there are lower chances of survival, greater risks related to the treatment and higher costs associated with the care are usually higher. The usual treatment of cancer involves surgery, chemotherapy and radiotherapy. Usually the overall treatment ranges over a period of a few weeks to a few months, depending on the type of cancer. 

There is no need to be afraid of COVID as simple precautions could help in preventing the transmission of the virus. Take proper precautions like wearing face masks properly, follow hand hygiene and social distancing protocols when you are at the hospital. Seek online consultations whenever possible. Discuss with your oncologists regarding the different options of treatment which can minimise visits to the hospital or delay surgery to a safer date. In certain situations, patients will have to accept the smaller risk of acquiring COVID as compared to the greater risk of cancer spread. On the other hand, one should not delay cancer treatment. There are guidelines to help treatment of cancer, especially, if the patient gets infected during the course of treatment.