Impact of Covid19 on Lung Cancer Diagnosis, Treatment and Outcomes

The outbreak of SARS-CoV-2 (COVID-19) is one of the greatest public health crises facing our society which is even more worrisome in patients with lung cancer.

Multiple factors impact the outcomes of patients with lung cancer include increasing age, smoking status, infections affecting lung which include covid 19. 

Lung cancer patients represent a central challenge in clinical diagnosis and treatment decision-making in the context of the COVID-19 infection.

During pandemic, there is raised apprehension within the oncology community, in which physicians are being forced to select which patients should receive anticancer therapy on the basis of who is most likely to have a positive outcome.

Radiological findings of covid 19 infection overlaps with CT findings that are often found in patients with lung cancer upon disease progression.

Due to increase in CT scans in people with covid 19 symptoms, the early lung cancer detection rates increased which resulted in curing them completely with one modality of treatment like Radiotherapy (SBRT or Radiosurgery) or surgery instead of multidisciplinary approach. Contrary to that, patients with advanced lung cancer are severely affected by covid 19.

Adding further complexity to this, pneumonitis can also be induced by immunotherapy and radiation therapy, which are effective and widely used standard treatment for lung cancer in various treatment settings. 

Pneumonitis causes cough, chest pain, fever and difficulty in breathing which overlaps with the symptoms of covid 19 infection.

Chemotherapy administration for lung cancer is often associated with immunosuppression which further increases the risk of protracting covid 19.

In lung cancer patients with covid infection, it is difficult to administer complete treatment due to the risk of flaring up the covid infection which results in decreasing cure rates for lung cancer.

But now with a wide range of vaccination programs, covid 19 cases have drastically come down and diagnostic and treatment approaches for lung cancer patients are resumed to pre covid era.

By Dr. V.Rama Krishna. The author is Consultant Radiation Oncologist, Manipal Hospitals, Vijayawada