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Dear Cancer Patient,

I hope you are well and keeping safe during this pandemic. Most of you are very anxious and feel stuck because having cancer is sometimes scary and hospitals are becoming more stringent with coronavirus matters. Many people are going to be visiting hospitals for fear of corona making hospitals are a good site for transmission to take place.

Cancer patients tend to be at higher risk of developing complications of COVID-19 especially those undergoing strong chemotherapy, the elderly, those with blood cancers as well as those with other diseases like heart failure, kidney failure or lung disease. I thought I’d come up with a list of recommendations to guide you as you make some decisions so please read carefully because coronavirus is real and spreading fast. These views are my own and do not represent the views of my affiliations.

  1. Follow all the hygiene recommendations by the MOH just like any other Kenyan including frequent handwashing with soap and running water, not shaking hands and adhering to social distancing.
  2. If you are currently undergoing chemotherapy please adhere to the following
    1. Stay at home in between chemo sessions. Don't leave the house unless you have to. If you do. Wear a mask and enforce 2m rule
    2. Social distancing is a must
    3. Don’t touch anything, object, a surface that you don't need to.
    4. Don’t go to hospital randomly in between chemos – call your oncologist first
    5. Ask a family member to collect your meds from a pharmacy
    6. Avoid crowded places - public transport, malls, salons, spas etc
    7. When you visit the chemo centre for your treatment, don’t touch anything, especially surfaces, doorknobs, lift buttons toilet seats etc. Sanitize & wash hands frequently, carry packed lunch, and wear a mask. Don’t even touch NHIF forms ovyo ovyo. You family member can fill them for you and sign
    8. If you can self-inject your immune booster or family member to inject at home, it is better than coming back to the hospital for several days. Alternatively, you may carry them home on ice and have an arrangement for a home nurse to inject you
    9. Preferably eat clean home-cooked meals.
    10. Keep a thermometer at home. If you get a fever above 38 call your oncologist, don't come to casualty.
    11. While at home ensure all surfaces and utensils are kept clean.
    12. If you get flu-like symptoms and suspect you may have contacted a COVID-19 patient please call 719 for advice. Please alert your oncologist too.
  3. If you are taking tablet chemo or non-chemotherapy anticancer drugs like tamoxifen, letrozole, Zoladex, zoledronic, zytiga, gefitinib or Xeloda etc
    1. Please arrange to collect 2-3 months’ supply and stay at home. You can send for it via courier and stay at home
    2. Cancel all non-urgent doctor visits or arrange video consults with your oncologist
    3. For those on Zoladex due 2 weeks from now, you can arrange to have it earlier then go back home
    4. For those on zoledronate, you can skip 2 months and come back in June
  4. Talk to your oncologist about tablet chemo options to avoid coming to the chemo centre especially for those on palliative/non-curative chemotherapy
  5. If you are currently undergoing radiotherapy
    1. discuss with you radiation oncologist about hypofractionation or rescheduling
    2. discuss alternative options or delaying if it’s for palliative/non-curative purposes
    3. observe strict hand hygiene and do not touch any doorknobs, handles surfaces etc.
  6. For survivors/those on long term surveillance please reschedule your routine appointments and stock up on all routine medications you can utilize courier services without going to the hospital.
  7. Stock up on your pain meds and other support meds like morphine, patches, nutrishakes DF118 etc.
  8. If you are using a shared wheelchair insist that it is sanitized before use
  9. If you have just been diagnosed to have cancer, you must seek consultation promptly and formulate a plan.
  10. If you have recently had cancer surgery in the last 2-4 weeks
    1. I recommend you to adhere to social distancing.
    2. Talk to your surgeon/oncologist about future treatments
    3. Incase chemo centres are forced to shut down discus non-chemo options too.
  11. If you are being planned for curative surgery at this moment please expedite and proceed with caution. If elective theatre spaces are adversely limited consider chemotherapy before surgery to buy time.
  12. If you get signs or symptoms of the flu and suspect you may have gotten into contact with a proven or suspected case CALL 719
  13. If you are diagnosed with COVID-19 make sure you inform public health doctors about your cancer history and treatment and immediately alert your oncologist

I hope this helps. This isn’t supposed to make you panic. I just want you to be safe until the pandemic is contained. If you have any other specific questions or clarification please feel free to contact me.

Yours truly,

Dr Andrew
Twitter: @odhis1
FB Page: Dr. Andrew Odhiambo

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