The opportunities in COVID-19 for the cancer patient

Scene: Miss Made-up-name in her taxi-ride, returning home to Made-up-place in rural St Elizabeth.

Miss Made-up-name: (Tearfully thinking out loud) “But no sah! There must be someone, somewhere I can call to talk to bout this … .”

THE COVID-19 pandemic has been the harbinger of greater personal health uncertainty for the cancer patient. Unprecedented new norms of physical separation have impacted all aspects of healthcare delivery globally, from screening through to survivorship. As Jamaican health professionals revise how to safely facilitate the many cancer patients on waiting lists or seated in waiting areas of health centres, I am certain that this adversity can be the first ‘dutty wata hog ketch to wash himself’.

The awakening comes through multitasking as we: look to clinicians’ critical skills and life-saving resources like adequate ventilators, personal protective equipment and staffing; see so many around the world having hard conversations about dying and death; give psychological support to overstrained hard-working colleagues; see many of our Jamaican brothers at home and returning across the high seas face the dehumanising effects of isolation and care through masks and face shields.

The COVID-19 pandemic is a catalyst for reviving wide-scale rudimentary skills of communication and compassion. It is also a segue that challenges our creativity to cost-effectively fill the information gaps in cancer care as we: see the global activation of information using easy-to-read pamphlets like those from our Ministry of Health and Wellness; become more aware of the accessibility of information from trusted websites; engage and are updated through virtual town hall meetings; harness technology creatively to continue our productivity while we work from home.

The COVID-19 pandemic is possibly most instrumental in highlighting the apathy existing in cancer care as we: see the mobilisation of help through private companies and concerned individuals to buttress the COVID-19 public-health response; listen daily to news media for announcements of newer drugs that have the promise of greater help for COVID-19 complications; adjust to the new experiences that the loneliness and confinement of being safer at our homes bring; despair the loss of job and economic uncertainty.

Lastly, this COVID-19 pandemic should be the light-bulb moment where we all become empathetic to the challenges of the cancer patient and be spurred into action.

A Look Back to Look Forward

“But the story of cancer … is the story of patients who struggle survive and move from one embankment of illness to another. Resilience, inventiveness and survivorship are reflected qualities, emanating first from those who struggle with illness and only then mirrored by those who treat them. If the history of medicine is told through the stories of doctors, it is because their contributions stand in place of the more substantive heroism of their patients.”

Dr Siddhartha Mukherjee in The Emperor of All Maladies.

The supportive cancer care works of laymen and health professionals globally culminated in the landmark 2007 publication of the American National Academy of Medicine. Laymen like Douglas Macmillan, who was impassioned by his father’s poor cancer experience, founded a charity organisation in 1911, The Society for the Prevention and Relief of Cancer. His ambition was to provide information and social relief to those affected by cancer in the United Kingdom. His single humanitarian vision has flourished into the now most impactful Macmillan Cancer Support. Health professionals like one of our own paediatricians, Dr Denise Thwaites, who through her own experience with breast cancer founded the 1977 breast cancer support community, Jamaica Reach to Recovery. This Kingston-based community was instrumental in obtaining the first mammography machine for the Jamaica Cancer Society and continues to be a welcoming and impactful support.

Thereafter, the meeting of international bodies at the 2014 World Health Assembly, through the World Health Organization, cemented supportive cancer care as integral for the standard of quality cancer care. They recommended that this aspect of care be integrated into public healthcare because it significantly improves cancer survival and its experience. Supportive cancer care needs to be a prioritisation of total cancer care in Jamaica and across the Caribbean.

To embolden the cry for a new era of heightened supportive cancer care we now have: the wheels of mental health optimisation, anaemic targets of Jamaican and regional National Cancer Control Plans and the upside of the COVID-19 crisis. We say bye-bye to its relegation and dereliction. We look forward to care that is equitably integrated to support the distresses of all cancer patients across the nation. I am heartened to say that Jamaica Reach to Recovery has begun meeting online, a more far-reaching platform than its Kingston constraints. People living with cancer need our attention now more than ever.

Dr Tamara Green is a family physician, committee member of International Psycho-Oncology Society and member of the Jamaica Cancer Society. Email feedback to maragreen.ta@gmail.com.