After the measureless loss to millions of people in the first two waves, now the mention of the forthcoming third wave is nothing more than a curse to human life. 

Covid has largely infected the older age group in the last year but in the second wave, the adults and children also got infected due to the mutant variant. Although problems can occur in any case, patients with the immune-compromised state are more likely to get infected as compared to others. 

Cancer is a known immunocompromised condition and it is a known risk factor. Furthermore, cancer has become one of the most feared diseases due to its lack of knowledge, and lack of timely treatment. With the fear of Covid, limitations set by the government as per the preventive protocols, all of this turned out as a serious hurdle in the active management of needy cancer patients. We can not marginalized cancer because whether it is a pandemic or no pandemic, the growth of tumors will not stop in cancer patients. Early detection of symptoms and consultation with healthcare experts, whether in a physical setting with all Covid precautions or in a virtual setting, can at least assist determine the urgency, stage, and prioritize treatment to see if it can be postponed or needs to begin immediately.

Cancer patients fall into the following risk categories:-

• Patients who are undergoing chemotherapy or who have received chemotherapy within the last 3 months.

• Patients with some type of blood or lymphatic system cancer that weaken the immune system. 

• People who are receiving immunosuppressive medications.

• Patients who are undergoing extensive radiotherapy.

Cancer patients with a weak immune system are at higher risk such as, those who have:-

• Immunoglobulin deficiency

• Leukocytopenia

• Immunosuppression that lasts a long time (steroids, antibodies)

Here are some of the recommendations that may be helpful for both healthcare professionals and patients in such situations:

• Before each treatment/cycle, RT-PCR SARS-CoV-2 testing should be offered to all patients undergoing surgery, radiotherapy, chemotherapy, or immunotherapy.

• It is strongly recommended that you communicate with other professionals and patients over the phone rather than face-to-face.

• Adjuvant therapies should be prioritized in patients with resected high-risk cancer who are expected to benefit from a significant absolute survival benefit.

• Discuss the possible benefits and risks of palliative therapies and, if available, switch to oral medications during the pandemic.

• Consider alternative regimens and schedules to cut down on hospital visits.

• Prefer telephone or web-based consultations and prescription renewals for patients receiving oral therapies.

If we simply divide cancer patients into two categories, one would be patients who are “off therapy” have finished treatment or have the disease under control (off therapy), and patients who are “under-treatment” (neoadjuvant or adjuvant curative treatment or treatment for metastatic illness) have been identified as the second one. Patients with "active disease" may be considered for surgery, chemotherapy, radiation therapy, biological therapy, endocrine therapy, and other treatments.

For the patients who are receiving active treatment, outpatient visits for cancer patients should be reduced to the lowest possible level that does not jeopardize patient care. As a patient, one can also follow some preventive techniques that will eventually provide protection. Preventive actions for cancer patients and the general public are the same. The following are the most fundamental precautions to take in order to protect yourself from this virus:

• Make sure your home has enough ventilation.

• Ensure that all surfaces, doorknobs, and bathroom fixtures are disinfected regularly.

• On a regular basis wash your hands with soap and water. If you are unable to do so, use a hand sanitizer frequently.

• Educate yourself on the Covid-19 symptoms to look out for.

• Check with your treating physician or oncologist (who provides medical care for cancer patients) to see if the Covid-19 vaccination is safe for you.

• Use two well-fitted masks to cover your nose and mouth at all times when double masking.

• Avoid going outside and stay at home. Allow no visitors inside your home.

Large drops have been witnessed in cancer screenings and diagnosis, during the pandemic. The majority of cancer patients have seen interruptions in their clinical care because of lockdown. Clearly, these kinds of situations are not acceptable, lessons are learned, and now it’s time to take precautions for the future. 

More attention should be placed on preparing the patient for treatment with proper diet, timely immunization prevention, and preventative medications to avoid serious treatment-related problems and hospitalization. With the limited resources available, particularly in this second wave, it will be advisable to choose options where medical emergencies and the need for specialized care should be available. The Healthcare department and other authorities need to understand the significance of this, so in the future, nobody should suffer due to the lack of healthcare facilities.