High-level screening must for new cancer patients

Hyderabad: It is important to screen newly diagnosed cancer patients for Hepatitis B, Hepatitis C and HIV, as cancer treatments like chemotherapy and radiotherapy tend to aggravate the virus if patients are not given anti-viral treatment, doctors have said.

Cancer patients require blood transfusion if platelet levels go down during treatment. There are chances of getting Hepatitis virus during blood transfusion. To avoid this, doctors prefer to give injections that stimulate blood formation in patients.

But most cancer patients undergo blood transfusion. It is not possible to detect virus in blood during window period, which is the time between potential exposure to HIV infection and the point when the test will give an accurate result. During window period, a person can be infected with HIV and still test HIV negative.

Infections pass on easily during transfusion, say experts. So, a lot of patients are vaccinated before getting treated for cancer as a precautionary measure to prevent these transmission-related diseases/infections.

 “Chemotherapy or radiotherapy aggravates the virus if a cancer patient Hepatitis B or Hepatitis C virus,” said Dr Sai Ram, clinical oncologist at MNJ Cancer Hospital. “Screening is therefore a must for a newly-diagnosed cancer patient. If doctors get to know about Hepatitis virus in a cancer patient, anti-viral treatment must be given to keep the virus under control. They will be able to tolerate radiotherapy and chemotherapy. If patients undergo chemotherapy and radiotherapy without getting anti-viral treatment, there are more chances of patients dying from these diseases rather than cancer.”

Experts say that instead of blood transfusion, doctors must give injections like Erythropoietin, which stimulates blood formation in cancer patients, and Eltrombopag, which stimulates blood-platelet formation, and other injections.

Hepatitis B and C affect functioning of the liver and there are severe jaundices that lead to dysfunction in other parts of the body. Those who have a good immunity system and are undergoing cancer treatment will pass it on to other people.

“It is not possible to completely sterilise instruments during proctoscopy, sigmoidoscopy and colonoscopy,” said Dr Sai Ram, explaining how it spreads. “We can’t boil them for long periods. We try to sterilise them with hydrophilic and other agents, which are supposed to kill these viruses completely. But they are not 100 per cent safe. There is still possibility of infection.”

Dr Padmaja Lokireddy, consultant haemato-oncologist at Apollo Hospitals said safety of blood transfusion is compromised by low-level testing. “Someone who is having recurrent blood transfusions, should have a Nucleic Acid Amplification testing of blood,” Dr Lokireddy said. “We should take utmost care of needle usage, single usage. People with Hepatitis B can also develop liver cancer. Equipment used on patients should be sterilized with utmost care.”

NAT is a highly sensitive method of testing blood for Hepatitis C virus, Human Immunodeficiency Virus and West Nile Virus.