Q&A: CRH oncologist talks about COVID-19 and cancer care

Dr. Nadeem Ikhlaque

Health officials across the country say that COVID-19 and cancer can be a dangerous combination, as many cancer patients have a suppressed immune system and tend to be older — both of which are risk factors for severe illness.

Dr. Nadeem Ikhlaque, a medical oncologist and hematologist at Columbus Regional Health’s Cancer Center, spoke with The Republic about how the pandemic has impacted cancer care, the dangers that the latest surge in coronavirus cases poses for cancer patients and why he is encouraging his patients to get vaccinated.

The interview has been edited for length and clarity.

Q: In what ways has the COVID-19 pandemic impacted cancer care?

A: “Cancer care focuses on the early diagnosis of cancer, even at a stage where there are no symptoms. And that leads us to offer patients a curative treatment. …In order to achieve that target, the general population is encouraged to undergo some standard preventive (screenings) like an annual mammography, like colonoscopies, women with their annual pap smears. All these things were sort of delayed just because of inevitable reasons, which the pandemic caused. And what we saw afterwards, as dust settled a little bit, is more patients in advanced stages (of cancer), which could have detected if they had routine care. …In normal circumstances, those cancers could have been detected at an early stage. So the biggest impact of the pandemic on cancer care was losing that opportunity, to some extent, to diagnose cancer at an early stage and offer curative treatment.”

Q: Should people still get screened for cancer during the pandemic?

A: “Yes, it is important (to get screened.) Now, there are situations which may become inevitable as hospitals are getting very overwhelmed with COVID-19 patients and resources are getting more focused on the treatment of … patients with life-threatening illness. …But certainly, whenever there is a chance or a window to get routine preventive care done, I would strongly recommend that all my patients and the general population to get it and do not delay it.”

Q: Is it safe for cancer patients and cancer survivors to get vaccinated against COVID-19?

A: “The clear-cut answer is that, absolutely yes, it is very safe … for patients with a cancer diagnosis and those who are going through (cancer) treatment (to get vaccinated). Over the last eight to nine months, we have very clearly learned the fact that vaccines make a great difference in terms of getting severe illness. Patients who are unvaccinated, regardless of cancer or not, they are right now facing a lot more serious illness, including life-threatening problems, as compared to those who are vaccinated. (Vaccinated people) can still get it, but the disease has a much, much milder course and long-term consequences are much rarer in those situations. On top of that, when someone has a diagnosis of cancer, or going through the treatment, they already have a (weaker) immune system and more risk of having life-threatening problems. …Right now, it is voluntary. It is everyone’s decision whether you want to get it or not, but the truth of the matter is that the facts very clearly indicate that vaccines are making a difference and we all should get vaccinated, including, obviously, patients with a cancer diagnosis.”

Q: How dangerous is the current COVID-19 surge for cancer patients?

A: “Unfortunately, it is very dangerous. Unfortunately, we see are in a sort of a dark spot right now nationwide with infections … including cancer patients, where the chances of getting severe sickness is much higher. …Last year, we were seeing an increasing number of deaths in elderly patients, 80s and 90s and over 75. It’s not that is good but … this year the heartbreaking part is that we are seeing younger people between ages 30 to 60 getting severe illness because of COVID-19, and unfortunately, passing away with respiratory failure, which is heartbreaking to see when younger people start resisting getting the vaccine.”

Q: What should cancer patients do if they start experiencing symptoms of a COVID-19 infection?

A: “(COVID-19) is actually something that is time-sensitive. So anyone who has symptoms, even milder symptoms suggestive of COVID-19, I would strongly suggest (that they) call their oncologist or their primary-care physician immediately and get tested. Do not wait because now there are multiple new drugs available which can be very effective if we diagnose it at an early stage and able to reverse it or at least reduce the consequences.”

Q: What else do you think cancer patients need to know about COVID-19?

A: “I would strongly suggest that you base your opinion on scientific facts. Follow the science. Follow with scientists who deal with it day in and day out … rather than people who have nothing to do with the research and science. This is not in any way a political or racial or ethical issue. This is a purely scientific issue which we all need to base our opinions on the scientific data. …If you follow that, and I would strongly suggest that we should, then there will be less and less resistance against vaccination.”