Cancer being a lethal disease, delay in treatment may be fatal. International organizations have come up with useful guidelines for cancer management. Still the availability of resources, infrastructure, state health policy, COVID incidence and approach of healthcare professionals differ. This study aims to find out the perception and approaches of Indian oncologists - which might prove to be useful in nation specific delivery of cancer care during COVID Pandemic.
After taking consent, a survey form was circulated online amongst oncologists (haemato/ radiation/ medical/ surgical) across the country and responses collected.
79.2% oncologists represent private sector, 16.8% government sector. 50% oncologists were willing to postpone investigations for stable cancer patients. 42.6% willing to start treatment without knowing the COVID status, while 44.6% were against the idea and 12.9% were indecisive. 73% willing to perform surgery right away for operable nonemergency cases with a negative COVID status and rest 27 % willing to postpone surgery. Concurrent Chemoradiation (57%) was preferred over sequential approach (43%). Majority (53.5%) were comfortable prescribing chemotherapy via telemedicine. Asymptomatic COVID positive patients requiring chemotherapy 64.4% were willing to wait for the virus to resolve and then start therapy and 35.6% were suggesting some form of oral therapy and ongoing isolation. 89.1% preferred oral route if option present. 83.7 % preferred targeted therapy, 8.2% immunotherapy and rest went for other options. 93.1 % preferred day care chemotherapy during COVID and not admission. 61 % thought extended course of dexamethasone given as premedication during chemotherapy did not have a protective role for patients during COVID outbreak. Treatment initiation criteria in descending order - 39.6% stage of the disease, 36.6 % performance status, 22.8% COVID status and for rest it was the cost. 91% oncologists thought nurses were at a higher risk of exposure to COVID infection than the doctors. 54.5% were not taking anti COVID prophylaxis..
Greater homogeneity in practice was noticed amongst oncologists of a developing nation during COVID outbreak. The above information might be useful in policy making.
The author.
Has not received any funding.
The author has declared no conflicts of interest.