Arushi Bidhuri
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Written By: Arushi Bidhuri | Published : February 4, 2021 3:21 PM IST
Here's how COVID-19 is affecting liver cancer patients and treatment
The COVID-19 pandemic has rightfully occupied in the minds and efforts of almost everyone, but people with comorbidities have it worse. Media reports have suggested that more than 95 per cent deaths of COVID-19 positive patients have occurred due to comorbidities. A study published in the journal PLOS ONE found that conditions like heart disease, hypertension, diabetes, chronic kidney disease and cancer can increase a patient's risk of dying with the virus.
It is no different for patients suffering from cancer like liver cancer. Dr Santosh B. Patil, consultant Neuro and Vascular Interventional Radiologist, of The Vein Center, says, "Liver cancer is the fourth leading cause of cancer-related death, with three times increase in the occurrence of new cases during the past 40 years."
Liver cancer is a type of cancer that starts in the liver. There are two types of liver cancer: primary and secondary liver cancer. Primary liver cancer typically affects individuals who have already advanced liver disease or cirrhosis (usually as a result of hepatitis B or C virus infection), alcoholic liver disease or fatty liver disease. Secondary liver cancer develops as a result of other cancers attacking other parts of the body such as bowel, lungs, breasts, etc.
There is so much left unknown, particularly with regard to the treatment and recovery of liver cancer who are at risk of coronavirus. Research on immunization, transmission and links with other existing conditions is fairly new, which is why TheHealthSite reached out to Dr Santosh B. Patil to address all your queries.
Dr Patil explains, "Patients who are on long term surveillance for the liver tumour are at risk of landing into advanced stages of cancer undetected without widespread availability of proper surveillance. Due to the ongoing pandemic, patients are finding it difficult to consult their medical professionals. The surgeries too are being deferred due to shortage of healthcare personnel, unavailability of OTs and risk of spreading coronavirus during general anaesthesia procedures."
If you are someone receiving treatment for cancer, you should follow your doctor's guidance. Dr Patil suggests that telemedicine using video consultation is one platform where the patients can now seek medical advice. While some treatment for cancer patients can be delayed, others cannot. "Newer interventional radiology treatments can be safely offered in eligible patients since these are minimally invasive day-to-day procedures which do not require anaesthesia. Shorter hospital stay will also reduce exposure to the coronavirus."
Now that vaccines are available, the question of "to get vaccinated or not get vaccinated" lingers in the mind of people, especially for someone suffering from an underlying disease. "People, including those with underlying medical conditions such as cancer, may get vaccinated if they have no contradictions that is, no history of a severe allergic reaction to any component of the vaccine," elaborates the expert.
Even though the clinical trials have shown that the vaccines are safe to use for cancer patients, the radiologist says that more research is needed on the subject.
"More data is needed on the safety and efficacy of COVID-19 vaccines in people with a compromised immune system due to an underlying medical condition or immunosuppressive therapies. It is even possible that these individuals may have a weaker response to the vaccine. Meanwhile, people who have received the vaccine should continue to follow all current guidance to protect themselves against COVID-19 exposure."
For patients with solitary tumours and preserved liver function, surgical resection remains the first-line treatment for them. Liver transplantation is the treatment recommended to those with tumour characteristics within transplant criteria. The expert further explained that only 10-20 per cent of patients are candidates for resection/transplant due to tumour burden, the presence of extrahepatic spread or the extent of underlying liver disease. Novel non-invasive interventional radiology treatment methods provide a ray of hope to the rest of the patients of liver cancer.
Here are the newer minimally invasive treatment options available for liver cancer:
Ablative anti-cancer therapies: include radiofrequency ablation, microwave ablation, cryotherapy and irreversible electroporation therapy. With ablative therapies, interventional radiologists insert a small, needle-like probe directly into the tumour using live image guidance to identify its precise location. Depending on the type of therapy, monitored heat, cold, or electrical energies are then passed through the probe to destroy the liver tumour.
Trans-arterial anti-cancer therapies: With these, interventional radiologists or oncologists employ live image guidance to advance a small tube, called a micro-catheter, through a tiny hole in the patient's groin or wrist until it reaches the blood vessel that supplies the liver tumour. Once in place, the micro-catheter is used to deliver high doses of either chemotherapy or radiation to the exact location. When delivering microspheres with chemotherapeutic drugs, this therapy is called transarterial chemoembolization (TACE). When delivering microspheres that contain a radiation source, the therapy is called transarterial radioembolization (TARE) or Y90 radiotherapy.
These therapies can be performed in isolation or as a combination to derive the best result.
One of the enormous benefits of image-guided therapy is its reduction in side effects, compared to systemic chemotherapy or conventional radiation. Because tumour ablative therapy targets tumours precisely, healthy organs will be relatively unaffected, and patients will be protected from more serious and uncomfortable side effects.
These precision interventional treatments are so well-tolerated that they are mostly outpatient procedures without the need for general anaesthesia. For interventional treatments, occasional side effects might include fatigue, flu-like symptoms, and inflammation due to a rise in liver enzymes. But those side effects tend to pass quickly, within one to two weeks after treatment. A patient can quickly return to normal daily life.
Patients suffering from comorbidities like cancer are at a higher risk of getting infected with COVID-19. It can lead to severe consequences in people suffering from liver cancer, which is the fourth leading cause of cancer-related death in the world. With the ongoing pandemic and lockdown, it has become difficult for cancer patients to get proper treatment, which is necessary for them to keep their health in check. Expert recommends following your doctor's guidance, and there are multiple treatments available to treat patients suffering from liver cancer. Even new interventional radiology treatments can be safely offered to patients after a thorough analysis of their condition.
