Cancer & COVID-19: Double trouble

It was challenging enough for cancer patients and their caregivers to battle cancer pre-pandemic. Aside from the physical and psychological burden, the financial costs associated with cancer can be quite overwhelming.

Add to that the risk of contracting COVID-19. Evidence shows that cancer patients, who are in active chemotherapy or intensive radiotherapy, are particularly vulnerable as these treatments weaken the immune system. Well, that means double trouble.

“With the ongoing pandemic, care for their condition has been put on hold,” said former Health Undersecretary Dr. Madeleine Valera during the virtual round-table discussion on “The War on Cancer: Leveling the Treatment Field with Equitable Access” on Zoom. 

The rapid spread of the virus is forcing the government to restrict travel and contact between individuals, as well as reduce access to hospitals to avoid straining the country’s health system.

“But the moment a cancer patient stops treatment, the chances of getting the virus are higher because his/her immune system is already compromised,” notes Dr. Valera. “Safety measures are in place in most hospitals. What the patient needs to do is follow the safety protocols and to maintain scheduled appointments with their doctors for treatment, which can now be done online.”

The coronavirus pandemic has compounded the problem of cancer in the country. During the outbreak, hospitals were busy attending to COVID-19 patients, leaving those that needed other forms of medical care on the back burner.

While the country hasn’t flattened the curve yet, cancer cases continue to rise.

In 2018, more than 141,000 Filipinos were diagnosed with cancer — lung cancer and breast cancer being the top indicators. Over 60 percent (approximately 86,337 lives) of those diagnosed with the dreaded disease succumbed to the illness.

“It shows that there are around 11 new cancer cases reported every day. And there are seven adults and eight children dying of cancer every hour,” notes Dr. Valera. “It’s tough and catastrophic for the family members they left behind. Financial toxicity is also a big issue.”

Veteran actress Susan Africa couldn’t agree more. She had been a loving caregiver to her husband, the late Spanky Manikan, who himself was a highly regarded film and theater actor.

As a caregiver, Susan held Spanky’s hand throughout the physical, emotional and financial challenges of the cancer patient journey.

“We were blessed to have family and friends who generously provided resources to help fund Spanky’s medication and hospitalization,” shares Susan. “His friends even put up an event called ‘Sundays for Spanky,’ which raised funds for him.”

Spanky was also fortunate enough to pass the clinical trial and was able to receive two free infusions of immunotherapy, touted as “a new and better way to treat cancer.”

“Immunotherapy has revolutionized the way we manage cancer,” notes Dr. Gerry Cornelio, director of the Cancer Institute, St. Luke’s Medical Center, Global City. “Immunotherapy not only improves survival but also the quality of life of the patient.”

Unfortunately, not all patients have access to this innovative treatment. 

“To be diagnosed with cancer could be devastating,” adds Dr. Buenaventura “Billy” Ramos Jr., president of the Philippine Society of Medical Oncology. “Adding insult to injury is knowing that there’s a better treatment available — that promises a better quality of life for cancer patients — but you can’t afford it.”

A study by the Philippine Cancer Society estimates that over 80 percent of Filipino families cannot afford to fund basic medical care from out of their own pockets.

The Philippine National Health Accounts (PNHA), along with the National Statistical Coordination Board (NSCB), revealed that in 2007, patients’ cancer-related out-of-pocket expenditures amounted to 54.3 percent of the total health bill, while government contributions and local government unit (LGU) contributions amounted to around 13 percent of the total health bill each, and social insurance contributions amounted to just over eight percent.

CANCER GAME PLAN

The alarming statistics raised concerns around the country’s cancer care and control programs, which prompted the government’s issuance of the implementing rules and regulations of the National Integrated Cancer Control Act (NICCA) in 2019 to help create statutory requirements to address and prioritize gaps in the current continuum of cancer care. It also hopes to integrate policies and programs for cancer prevention, detection, management, and survivorship or palliative care.

This Act, along with the Universal Health Care (UHC) legislation, helps further increase access to much-needed health services, while helping increase funding for national healthcare and cushioning the financial impact on the individual patient.

“We hope that NICCA will be implemented soon. We have the implementing rules already, and it’s also important that we have the money or budget to implement the needed resources and programs,” adds Dr. Valera. “The NICCA and UHC are steps in the right direction and we can only hope to move forward from here on.”