The world has been living, for some years with a deadly monster. Faced with this filthy beast, man has become a vulnerable and powerless being. He is unable to fight against which easily infiltrates the body by spreading quickly to destroy cells, tissues and organs. This cruel monster called «cancer» will not stop until death ensues.
This is why this disease is considered today the most dangerous and feared pathology that man has ever known as it wreaks havoc every day in the four corners of the planet.
With the spread of the coronavirus (Covid-19) pandemic these days, which has caused a real damage in the world, it was necessary to look into the impact of this devastating virus on patients already suffering from cancer. on those who work in the field of treatment and monitoring this disease.
This interest is all more important since cancer patients are the most vulnerable patients, they undergo all kinds of treatments: chemotherapy, immunotherapy and the consumption of quite powerful drugs. Some even go so far as to submit to unbearable sessions of radiotherapy or bone marrow transplants. All these treatments mean that the cancer patient at risk of contracting this infectious virus. This is mainly due to the weakness of the immune system.
But does this mean that cancer patients with this virus are all irreversibly doomed? What would be the condition of patients who underwent chemotherapy or radiotherapy and who ended up catching the nasty virus? Will they suffer serious health consequences? Are patients recovering from cancer more likely to have health complications if infected with the coronavirus?
These are all questions we are asking ourselves today and which require urgent answers from doctors, specialists and other health practitioners around the world.
To find out more about the subject, we contacted Pr. Sana Abdel-Qader Al-Sukhun, chair of the global affairs committee at the American Association of Oncology. This great specialist in this pathology who agreed to respond to our requests is also a consultant on issues related to hematological and cancerous tumours.
SANA ABDEL-QADER AL-SUKHUN
G.F.B : Given that you are a doctor who has treated different cases of people with leukemia and cancer during this unprecedented Covid-19 crisis, how do you assess the immune system of your patients in the context of this global pandemic?
Pr. S. A : It must be said that the state of a patient’s immune system varies from one person to another, regardless of the disease from which he/ she is suffering. For cancer, it must first be specified that this serious pathology attacks the most vulnerable point of the human immune system.
It is obvious that the global Covid-19 pandemic will have complications on the state of health of cancer patients, It should also be remembered that this type of patient has an organic failure through which this malignant disease infiltrates to attack the human body by forming cancerous cells which spread or stabilize in a very specific organ, this leads to a worsening of the failure of the immune system especially in patients with blood cancer known as (leukemia, lymphoma and myeloma).
Therefore, the complications of infection with the virus will be more accentuated on people with cancer. This is why the medical care of this type of patient, in the context of this viral pandemic, is a challenge, especially since the figures show the death of around four million people with cancer worldwide during the year 2020, according to the WHO report published on the occasion of World Cancer Day.
This figure is staggering compared to half a million people who have disappeared following their infection with the coronavirus. This is why we say that the main pandemic that threatens humanity today is indeed «cancer».
G.F.B : Cancer, which is nicknamed «malignant tumor», is different from Covid-19, when we know that the human body can develop an immune shield to protect itself against the risk of infection by this virus, can we then say that cancer patients are more exposed to coronavirus than other patients?
Pr. S. A : Unfortunately, Covid-19 accentuates complications in cancer patients. This virus constitutes a risk or even a danger more than the other risks to which the cancer patient is exposed. This is why it is established that those who have had to undergo chemotherapy often end up with a weak immune system.
One would then ask the nagging question: «Why do we continue, in this pandemic context, to prescribe this kind of treatment when it is harmful to the immune system? «. It must be said that chemotherapy is a treatment that has proven effective in many cases. It can even cure many people or if necessary, reduce the spread of cancer, its effects on the immune system for a limited period.
Additionally, we have the ability to protect these patients by urging them to wear a mask and observe social distancing. We have reached a scientific conviction: these two simple procedures have shown their effectiveness in preventing infection with this virus.
However, I would like to emphasize that, contrary to popular belief, the biological or immunological treatments followed by cancer patients are not without consequences for the immune system. The exception is hormone therapy, a treatment given to patients with prostate and breast cancer which does not weaken the immune system.
G.F.B : Does the response to treatment given to cancer patients vary from person to person?
diagnosis are based on the type of genes their body has as these play an important role throughout treatment. The weight of the patient must also be taken into account when prescribing the chemical or immune dose.
Still, biological and hormonal treatments are the subject of studies carried out on patients of average weight, but doctors of course take into account deviations from normal weight. This is why reactions to treatment differ from one patient to another, even if it is the same diagnosis and the same stage of evolution of the pathology. In addition, genes play a role in the patient’s resistance to infection, since they are formed and differentiated according to environmental factors and lifestyles.
When we look at our Arab societies in the Mediterranean basin, we see that breast cancer is the most common, followed by lung cancer and the digestive system, more specifically the colon. This health situation differs from that of populations in Southeast Asia or the Western world because it is bladder cancer that is the most common there. It must also equal in statistics the lung cancer recorded in our region.
But let’s say that the health situation in our Arab countries is not so alarming. The number of people affected here by cancer does not exceed half or even one third compared to the figures recorded elsewhere.
However, we have recently noticed that the scourge of smoking is becoming more and more widespread in our region. Which can probably change the statistics since cigarette smoking is known to be the main cause of cancer.
G.F.B : Why has breast cancer become the most common and deadliest today?
Pr. S. A : There is no scientific or rational explanation for this finding. But I think that in our societies – this is of course a personal opinion – the dissemination of awareness programs and the increase in requests for screening have revealed the increase in the number of women affected by this type of cancer. . But we cannot say that this type of cancer is more (or less) frequent compared to previous years in the absence of these two factors in the past.
It should be noted here that science has not yet managed to explain the real causes of this disease which mainly affects women. The important thing is that it is now possible to guard against this cancer thanks to examinations for early detection of the disease and certain practices such as breastfeeding, pregnancy at a reasonable age, following a healthy diet , make sure to maintain an ideal weight, practice sports…
SANA ABDEL-QADER AL-SUKHUN
G.F.B : There is a controversy today about the negative impact of the coronavirus on the treatment of cancerous diseases. How does the spread of this virus affect the medical care of patients with this kind of pathology?
Pr. S. A : The studies revealed two important points: firstly, there was a delay in detecting the cancerous tumor, and this was due to apprehensions related to the fear of catching the virus if one went to the hospitals or medical laboratories to perform such tests.
As for the second point, it is the inability of hospitals and other health structures to take care of cancer
by the growing number of victims of Covid-19. It is now difficult to make an appointment or find a bed given the scale of this pandemic.
G.F.B : There is a feeling of apprehension among people with cancer today about getting vaccinated against Civid-19. What is your comment on that?
Pr. S. A : far, there is no study indicating that cancer patients are advised against getting vaccinated to protect themselves against the risk of infection with the Covid-19 virus. According to the report of the American Association of Oncology, the anti-Covid vaccine does not pose any risk to the health of cancer patients.
G.F.B : What do you think of telemedicine and can you really get treatment remotely through the virtual world?
Pr. S. A : I think telemedicine is a qualitative step in the world of medicine today. This system will certainly develop more and more and spread to all the countries of the planet. But in our Arab societies, it seems quite difficult to apply this kind of system in the absence of any legislation and laws to explain the functioning of this modern device. Although we have sometimes dealt with our patients via the web and social networks, communication is still quite difficult. Telemedicine requires, in addition to a societal culture, laws to control it before resorting to it, particularly in our societies.
SANA ABDEL-QADER AL-SUKHUN
G.F.B : Do you have any indications of deaths among cancer patients due to the Covid-19 vaccine?
Pr. S. A : It has not been proven so far that there have been deaths of patients with cancer or other diseases as a result of vaccination against the coronavirus, nor complications on their health . The human immune system is like an army comprising different forces (air, land and sea). The degree of complication of each type of treatment on these defense forces varies from patient to patient. We have found, for example, that the complications due to chemotherapy are simple and very limited in time. But for biological treatment, there are types of complications whose effect extends over a period of six months because they act on the strongest defense force of the immune system.
G.F.B : Are cancer patients considered contagious?
Pr. S. A : There is no possibility of transmitting the infection from the affected person to the unaffected person, since cancer is, so to speak, a cell that has deserted from a patient’s immune system. It is therefore not a foreign body transmitted from an infected person to a healthy person. On the contrary, it is rather feared that cancer patients receive viruses and bacteria from those around them.
G.F.B : What is the differentiating between a benign tumor and a malignant colon or breast tumor?
Pr. S. A : I come back once again to remind you that early detection and prevention are the best ways to guard against the disease. This is why it is advisable to perform colonoscopy, especially for men over 45 years old. This will allow the attending oncologist to eradicate benign adenomatosis which requires a period ranging from (5 to 10) years before turning into cancerous tumors.
Since there are not 100% benign protrusions in the colon, it is best to get rid of them. Contrary to those of the breast since their presence here does not represent any danger for woman.
G.F.B : Has the Covid-19 pandemic affected studies and research devoted to treatments for cancer patients?
Pr. S. A : Unfortunately yes! There has been, for example, a delay in the publication of the results of studies on the effectiveness of new drugs intended for cancer patients, given that all efforts have been focused at this time on the coronavirus pandemic.
G.F.B : Pr. Sana Al-Sukhun, despite the alarming situation induced by Covid-19, you still managed to publish many studies and research on the net.
Pr. S. A : The virtual world remains a wonderful space, although of course it cannot compensate for the direct contact and the warmth of being together.
My research published on the web was conducted in partnership with doctors from five continents. Each participant describes their own experience and presents their research in order to get to a consensual results. I can cite here as an example the recommendations that we have made for the treatment of breast cancer in the Middle East region, taking into account this new context characterized by the pandemic.
G.F.B : To what extent is the origin of drugs a priority in the care of cancer patients?
Pr. S. A : This is a long topic to discuss, but I will say briefly that most anti-cancer drugs, especially newer ones, have not expired. But I believe it is more correct that they are made by the company that owns the patent.
It’s not because the drug is of American, Swiss or British origin, it’s mainly because there are drugs whose patent period has expired but are still authorized to be manufactured by companies in several countries of the world.
We all know that there are countries where control is as high as it is strict in the pharmaceutical industry, which is able to reassure us
about the reliability and effectiveness of the product.
G.F.B : In view of what is happening today to fight against Covid-19, don’t you think that a certain societal culture is an obstacle to our lifestyle and our behavior in dealing with epidemics and other serious diseases ?
Pr. S. A : I always say that we are fine, but we lack that awakening and deep reflection to overcome this epidemic. We must realize that there is no magic cure for Covid-19. Our salvation then lies in the cooperation of all humans with health institutions to make medicine and vaccines available to all in an equitable manner.
At the level of society, we very much regret these scenes where we see people walking around in closed places without wearing protective masks. This is a recklessness to stay upright since we do not yet realize that the coronavirus is, like cancer, a multi-tentacled monster that can grab you,reach you at any time and in any place.
Also, is it time for us to give up these annoying habits which unfortunately inform about a culture where much remains to be done to overcome this health crisis and regain health and well-being.
