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Coronavirus means worrying big changes in the way we treat cancer patients

Photo credit: Pablo_K - Getty Images
Photo credit: Pablo_K - Getty Images

From Harper's BAZAAR

Like many people, my whole world went topsy turvy in March 2020 with the arrival on the UK shores of the new coronavirus – COVID-19. I am a cancer doctor in a central London teaching hospital, but I am also a wife to a consultant surgeon and a mother to two primary school-aged children. Facing COVID-19 has challenged me in every aspect of my life. The usual juggle of being a working mother has magnified: a battle between being a professional, ready to stand up and do what I have been trained to do, against the natural protective urge to shield my loved ones at a time of such insecurity.

People assume oncology is all doom and gloom, but I love my job. Helping people through the most challenging periods of their lives can be so rewarding. The best part of our job is when treatments work well, and the tumour shrinks and people visibly get their lives back. The advances in oncological treatments have given extra years to many and even total cure and a chance at a new life. We cannot cure everyone, but in the majority of cases, we can at least provide pain relief, maintain quality of life and give precious time with relatives.

Delivering bad news to patients and their relatives is the worst part of the job. We build relationships with these patients over time to a depth that I think few other medical specialities achieve; this can make these difficult conversations a little easier. But without doubt, these conversations and losses take an emotional toll on us, as although we are doctors, we are humans too.

The emotional toll on patients and healthcare workers cannot be understated. There is palpable confusion, distress and even anger at how cancer services are changing due to the crisis. Some patients will be having their treatment stopped due to COVID-19 as the risk/benefit evaluation does not fall in favour of treatment. Usually, this discussion would mostly take place over several face to face appointments and with the benefits of years of scientific evidence to guide us. In the COVID era, this is all happening so fast, with so much bad news being delivered all at once, and for many patients over the phone or by doctors with whom they don't have a relationship. The psychological and physical effects of COVID-19 are far-reaching, its ripples will be felt for years to come even for those not infected.

When I started to realise the enormity of the pandemic coming towards us in February, I wanted to shield my family. Like many of you, I haven't seen my parents in weeks. I realised early on that I was a high risk to them, and we cut off physical contact. For some of my patients, their prognosis with their cancer is shorter than the Government’s requested shielding time of 12 weeks. While I am craving a hug from my Mum, I can only begin to imagine what it would be like to spend the last few months of your life in social isolation. And then there’s the awful idea that spending time with the very people that make life worth living also exposes you to the virus and make your life shorter.

I feel guilt at not being on the front line for COVID-19, but in all likelihood, it won't be long till I am. Right now, my skill set is most useful in guiding people who are already dealing with cancer through this particularly difficult challenge. I try not to take my job home with me, but it is hard not to. My children are suddenly at home all the time and need entertaining and schooling. My husband, also a doctor, has similarly had his regular job thrown upside down. We are trying more than ever to juggle work and home life and shield the children from the reality of what we face every day at work. We have taken protective measures to try to physically not bring the virus home in the form of changing clothes, showering when we arrive home. I worry about the psychological burden that all healthcare workers will be bringing home after this crisis.

Without doubt, COVID-19 will cause wide-ranging and long-lasting damage beyond the awful initial death toll. But there are silver linings already appearing. The amount of change the NHS has gone through in the last few weeks is monumental and awe-inspiring. There is no doubt that some of the technology that has been brought in and changes to practice will be here with us forever and a great move forward. I am so proud of my department and the broader hospital for rising to the challenge. I choose to focus on the positive changes I am witnessing, the growing sense of community and the outpourings of love – from the bin men to bus drivers – for all of us.

Follow Ailsa Lumsden’s journey on Instagram @dr_ailsa.

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