COVID and Cancer: Mercy Prepared to Continue Treating Patients

A cancer diagnosis can bring a lot of uncertainty for a patient, and that’s especially true during a global pandemic.

Doctors at Mercy agree, however, that when it comes to treating cancer, there’s no time to hit the pause button.

“If you have cancer, you have to be treated,” said Dr. Runa Shrestha, oncologist at Mercy Fort Smith. “Treatment should not be delayed just because of the COVID-19 pandemic.”

Like other health care systems across the country, Mercy adopted and continues to maintain safety protocols for patients and staff during the pandemic. These protocols include masking requirements and screening questions for anyone coming inside Mercy’s locations, as well as limits on visitation. (Learn more here.)

The use of telemedicine has also increased, but for cancer patients, most need to be seen in person for scans, lab work or even an initial diagnosis.

“Initially, patients are a little bit apprehensive about coming to the hospital and clinic because of the risk of exposure, but at the same time, we have established the protocols that we follow to keep everyone safe,” Dr. Shrestha said.

Patients should feel safe to visit their doctors as long as he or she has no symptoms of COVID-19, she added.

“If you follow the standard guidelines of safety precautions, I think it is possible to get all the screening colonoscopies or mammograms done so that there’s no delay in cancer diagnoses and treatment,” Dr. Shrestha said.

Julie Scott of Fort Smith was diagnosed with Stage 2 breast cancer in February and was scheduled to begin treatments a few weeks later – just as shutdowns due to COVID-19 began. She credits going in for a mammogram for her early diagnosis.

“I went in for a routine mammogram, didn’t think anything about it,” Scott said. “I was two years out from my last mammogram and thought everything was going to be fine. Well, it wasn’t.”

The mammogram showed a suspicious spot, and Scott came in the next week for a follow-up.

“I could tell when they were reading the ultrasound that it was not good news, and it wasn’t,” she said. “They told me it looked like invasive ductal carcinoma. They didn’t know what stage yet. And I remember just feeling very numb, because I was sitting there wondering, ‘Does that mean cancer? Is invasive ductal carcinoma cancer?’ Turns out, it was.”

Further tests showed the cancer had spread to a lymph node, and Scott began chemotherapy a few weeks later. Surgery followed, as did radiation therapy, which Scott continues to undergo. She’s currently cancer-free.

“I was scared to death to start chemotherapy,” Scott said. “I wanted to go ahead and do surgery, and they said, ‘This is going to be the right way to do this.’ They were very good at taking care of me. I followed my doctor’s advice and did all my treatments to help get rid of the cancer.”

Scott said she was not concerned about continuing her cancer treatment, even as Mercy began postponing some surgeries and temporarily shutting down some services.

“I think there’s a general fear of COVID-19, especially coming into a hospital, knowing that there are going to be patients treated there. There is that general fear, but cancer is a bigger fear,” she said.

“The staff here are amazing,” Scott continued. “They did everything that they could to keep us safe as patients and to keep themselves safe. I’ve felt very safe during treatment.” 

For Carlas Good, masks provide an opportunity to show the world that despite cancer, things are “good.”

For Carlas, it’s more than just a last name. The Fort Smith resident was diagnosed with cancer more than six years ago and has continued to receive treatment at Mercy. Good currently is under the care of Mercy Oncologist Dr. Aswanth Reddy, who joined Mercy this year, as well as nurse practitioner Kathleen Milam.

Diagnosed in 2014 with skin cancer, Good was soon afterward diagnosed with both breast cancer and bone cancer. Good is continuing a routine of doctor’s appointments every other month and lab work once a month.

Taking extra precautions was part of Good’s routine from the beginning, so as checkups continue during the pandemic, it all seems relatively normal.

“What’s crazy is when I was diagnosed with cancer, they said, ‘Make sure you wear a mask when you go to the hospital,’ and I never did, because I trusted everything,” Good said. “All the cleaning – we were doing that anyway, but I had to learn and remind everyone else that my immune system is nonexistent. So, all the cleaning and stuff we were already doing. The only difference is adding the mask.”

Good calls that initial cancer diagnosis a life-saving event, because it led to the other diagnoses.

“The reasons God has for doing things, it allows our eyes to be open to so many other things,” Good said.

Dr. Reddy reiterated the importance of a diagnosis, even during the pandemic.

“Hospital infections of COVID-19 are extremely, extremely low because of the protocols we follow,” he said, adding that now is a great time to go in for diagnostic tests because visitor restrictions mean there are fewer people coming into Mercy facilities.

But what if a cancer patient tests positive for COVID-19?

“Our patients, if they are in chemotherapy, we try not to delay the treatment as much as possible,” Dr. Shrestha said. “However, if they do test positive for COVID-19, or if they have any symptoms suggestive of COVID-19, then we postpone the treatment and resume it once they have cleared the infection.”

Although cancer patients have a compromised immune system because of cancer treatments, and therefore are more vulnerable to complications if they are infected with COVID-19, Dr. Shrestha said it’s essential that treatments continue.

“Even though there might be a lot of changes that we have implemented in the clinic in order to keep everybody safe from this virus, we are all here to help you out,” she said. “Please reach out for help. Even though there are lots of changes, the thing that has not changed is our commitment to provide the best possible care, even in this pandemic, in the safest possible environment. If you have cancer, then you have to seek care.”

Dr. Reddy said communication with patients about their treatment options and care plan is an important part of the process, and this is especially true amid the ever-changing world of COVID-19.

“That’s one of the things I tell my patients is that they need to understand about their diagnosis and their care,” he said. “I actually sit with my patients and draw out the plans word-for-word, which I write for them. I encourage them to ask a lot of questions. That way, when a patient understands what they’re going through with their treatment, it actually lessens the anxiety and makes the process easier. Communication is the biggest part of my patient care.”

For patients like Scott and Good, an early diagnosis proved vital in their battles against cancer. Dr. Shrestha said it’s important for patients to continue to seek out a diagnosis when something’s wrong, even as the pandemic continues.

“Cancer at an early stage can be cured,” she said. “That’s the importance of doing cancer screenings like mammograms. Even during this pandemic, once you’ve not delayed these screenings … the screening techniques will help to detect cancer at an early stage so that we can treat it and possibly cure it.”

Dr. Shrestha said there has not been a significant difference in the way Mercy treats cancer patients during the pandemic.

“We try to get all the scans done as soon as possible, because we know cancer does not wait,” she said. “Without treatment, that cancer will progress. So, we try our best to get the patient into the office, get all the testing that is needed and start treatment as soon as possible.”

Cancer, Good said, has been a tremendous journey, one that requires a great deal of faith.

“God has had a hand in this from the beginning,” Good said. “I can’t tell people how much it means to never doubt and to have faith, because only God knows our tomorrow. We don’t know if we’re going to have the next moment, but our Heavenly Father does.

“I don’t know what else to say other than I’m thankful, and I praise these people that God put in my path to help keep me alive,” Good continued. “We gave it to God and never looked back. God has been truckin’ forward with us ever since.”

Scott said that despite the pandemic, she is eager to spread an important message – that a cancer diagnosis can’t wait. She encouraged others to go in for mammograms, treatments and regular checkups, because “you’re safe.”

“I understand the fear of COVID, but you don’t want to put off checkups or treatment,” she said. “Had it not been for that mammogram, and waiting another year, I would probably be at Stage 4. You want to keep up with your checkups because early detection is the key.

 “The big picture is to treat the disease.”