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Caring for Cancer Patients During a Pandemic

By Dr. Santanu Samanta

“Doc, which C is worse for me… cancer or coronavirus?” Many patients asked this question. The anxiety of a new cancer diagnosis, waiting to start treatment, and then suddenly news of a pandemic changed everything for all cancer patients. Bewildered, some patients would hesitate to come to the hospital while others would try to hide their viral symptoms to prevent interruption of treatment. COVID-19 has presented varying challenges to all health care professionals, and being a resident physician involved in caring for cancer patients has its own unique difficulties.

Graduation day, 2019

I was born and raised in the eastern part of India and was always passionate about becoming a doctor. After completing medical school at the University of Calcutta, I completed residency training in radiation oncology at Christian Medical College, Vellore, one of the premier medical institutions in my home country. My keen interest to pursue cancer research and work with the latest technology for cancer treatment brought me to the USA. At first, I joined as a post-doctoral research fellow in the translational research lab, where I had the opportunity to work on cancer cell lines, animal models, and cutting-edge technology utilizing proton therapy. Thereafter, I joined the radiation oncology residency at the University of Maryland Medical Center and my focus shifted to caring for cancer patients.

Resident room pre-covid times

Moving from India to a new country was a big change. However, what did not change was the fear and uncertainty that I witnessed in the eyes of cancer patients. With the best available therapies and technology in this country, cancer treatment has been very promising, yet has a long way to go. As the COVID-19 pandemic started, it was a huge change for cancer patients. Radiation therapy is usually done with once-daily treatment for a few days or weeks. With the pandemic, there was every effort to minimize their duration of treatments to reduce chances of both contracting and spreading infection, but without also compromising on the treatment efficacy and quality. Most cancer patients are immunocompromised and would need to take extra precautions. With the rapid surge in COVID-19 patients and operating theatres closed, ICU patient numbers soared, and oncology care continued with maximum possible precautions. It was during this time that one of our lung cancer patients started hemoptysis and was transferred from a community center to our medical center with the hope of being intervened by an intervention pulmonologist. However, the OR room being closed for safety-related issues, the patient was unable to get any bronchoscopy intervention and was then referred to us. Using very high dose of radiation treatment in few sessions, also known as “palliative regimen,” we were able to stop the hemoptysis and later get him through chemotherapy treatment. There were many similar instances where cancer would respond to prompt radiation treatment and that would bring about a great sense of joy. While to our dismay, we also saw patients who unfortunately progressed with their cancer while waiting to get their biopsy or who delayed their treatment because of the pandemic.

Fun time with Dr. Miller, our MPTC Director

Our hospital, as well as the department, started functioning with several changes to provide maximum safety to the staff. All tumor board meetings, daily academic sessions, and grand rounds became virtual. We adjusted ourselves to get used to this new electronic platform, and soon realized how much we missed those happy hour dinners or noon conference lunches together. But it was very encouraging to see that both hospital and department leadership ensured we had enough PPE, emotional support and supervision to navigate through this challenging time. We worked well as a large team and took the best possible care of the patients who needed us.

Personal life was no less different during the pandemic. My wife who works as bioinformatician at the School of Medicine, had to manage her entire series of prenatal visits alone, as visitors were not allowed in the hospital. In September 2020, we welcomed our first baby girl, with masks on and no friends being able to visit us. But we are blessed to have my sister’s family close to us where we live, and we have received their wholehearted support during this time. Life comes with struggles. As we hold our hands together to fight through this time, we are humbled by how much we learn from these challenges.