Nepalese Journal of Cancer

Impact of COVID-19 Pandemic on Cancer Screening Services

Gambhir Shrestha — 2020-09-28

Not available

Detection of Circulating Tumor Cells and Its Application in Prostate Cancer

Jin-Qi Song — 2020-09-28

In recent years, circulating tumor cells have become the focus of tumor research. In-depth study of the role
of circulating tumor cells in the genesis, development, and evolution of tumors will be of great significance
for the early detection, early diagnosis, early treatment, and prognosis of tumors. Prostate cancer is one of
the common male malignant tumors, and the role of circulating tumor cells in prostate cancer has been
increasing year by year. This article will focus on the progress of circulating tumor cells detection and its
application in prostate cancer.

Importance of Circumferential Resection Margin in Management of Esophageal Cancer

Binay Thakur — 2020-09-28

Esophagectomy (R0) remains the gold standard for the management of esophageal cancer. But due to close
vicinity of esophagus with the major structures like heart, aorta, vertebral column, tracheobronchial tree and
lungs, a wider circumferential resection is generally not possible and a R1/ R2 resection might occur. Therefore,
locoregional recurrence rates of esophageal cancer are reported to be as high as 52%. The Royal College of
Pathologists (RCP) and The College of American Pathologists (CAP) define circumferential resection margin (CRM)
differently. A mean overall CRM involvement was found to be 40.7% (RCP criteria) and 11.8% (CAP criteria). Two
meta-analyses have shown poor survival in CRM positive cases. CRM positivity in T1/ T2 lesions should not occur
unless there is a surgical fault. For T3 lesions, a higher rate of CRM positivity has been documented. Therefore, a
wider CRM using transthoracic approach appears mandatory, especially for T3 lesions.

Observation on the Effect of Local Flap Transfer and Sclera Transplantation in Repairing Skin Defect after Eyelid Tumor Operation

Ying-Hui Ma — 2020-09-28

Introduction: Eyelid tumor refers to the primary eyelid skin and accessory tumors, which not only affects the
appearance and vision, and even local infiltration and distant metastasis, thereby threatening life. Surgical
resection is the most important and effective treatment, but tumor resection often leads to a wide range of eyelid
defects, significantly affecting the shape and function of the eyelid. Therefore, the eyelid defect must be repaired
after resection to achieve the purpose of aesthetic appearance and protection of the eyeball.
The objective of the study was to analyze the clinical results of local flap transfer and scleral transplantation in
repairing skin defect after eyelid tumor operation.
Methods: Forty patients with postoperative skin defects of eyelid tumors admitted from December 2008 to
December 2018 were taken for analysis and divided into two groups, 20 cases in each group. The control group
underwent autologous lip mucous membrane transfer and nearby skin flap, while the experimental group received
local skin flap rotation and scleral allograft repair. The clinical effect of repair of the two groups were compared.
Results: In the experimental group, the effect of clinical repairs were better, the difference of height of palpebral
fissure and the length of palpebral fissure were compared with the control group, which showed statistical
significance favoring the experimental group.
Conclusion: Local flap transfer and scleral transplantation has better clinical outcome to repair the skin defect
after operation of eyelid tumor.

Awareness regarding Cervical Cancer among Women Residing in Bharatpur, Chitwan

Laxmi Shrestha — 2020-09-28

Introduction: Cervical cancer is one of the most prevalent cancer affecting women globally. It is the fourth most
common cancer in women and the seventh overall. Cervical cancer can be cured and prevented by regular pelvic
check-up, screening test and vaccination against human papilloma virus. The objective of this study was to find
out awareness regarding cervical cancer among women aged 18-49 years residing in Bharatpur Metropolitan
City-5, Chitwan.
Methods: A community based descriptive cross-sectional research design was used, 186 women were selected
using simple random sampling method. Structured interview schedule was used to collect the data within 2
weeks. The collected data was entered in Epi data 3.1 and exported into IBM SPSS version 20. Data was analysed
in terms of descriptive and inferential statistics.
Results: The study revealed that 72.6% of the women were >30 years and 93% of women were literate, among
them 35.2% had completed secondary level of education. It was found that only 28.0% of women had good level
of awareness and 43.5% of them had poor level of awareness regarding cervical cancer. There was statistically
significant relationship between level of awareness with age (p=0.029), ethnicity (p=0.013), marital status
(p=0.018) and heard about organism that causes cervical cancer (p=<0.001).
Conclusions: Based on the findings of the study, it is concluded that, almost half of the women have poor level of
awareness regarding cervical cancer. Hence, there is need for community awareness program on cervical cancer,
its screening and preventive measures through the medium of health personnel, friends and mass media.

Palliative Hypofractionated Radiotherapy in Advanced Squamous Cell Carcinoma of Head and Neck

Deepa Gautam — 2020-09-28

Introduction: A significant proportion of patients with advanced squamous cell carcinoma of head and neck
(HNSCC) are unsuitable for radical treatment and we aim to evaluate the acute toxicity, symptom relief and disease
response after palliative hypofractionated radiotherapy in such patients.
Methods: A prospective observational study was conducted from November 2014 to November 2015 at the
Department of Radiation Oncology, B.P. Koirala Memorial Cancer Hospital, Bharatpur in 30 patients with stage III
or stage IV HNSCC who received radiotherapy of 30 Gy in 10 fractions over two weeks. Pain, dysphagia, insomnia
and dyspnoea at presentation were assessed using 11 point numerical scale. Acute treatment toxicities were
assessed using Common Terminology Criteria for Adverse Events (CTCAE) at the end of two weeks. After six weeks
of completion of radiotherapy, percentage of symptom relief and disease response based on Response Evaluation
Criteria in Solid Tumors (RECIST) were recorded. A few patients were selected for further curative radiotherapy.
Results: Common symptoms were pain (86.7%) and dysphagia (50%). Two-third of patients with pain and
dysphagia, and about 90% patients with dyspnoea and insomnia had more than 75% symptom relief. An objective
response rate of 70% and disease progression of 13.3% were observed. Acute radiation toxicities were acceptable
with no grade 3 or 4 toxicities. It was observed that 46.3% of patients had mucositis, 13.3% had dysphagia, and
6.7 % had hoarseness and dermatitis each.
Conclusion: Palliative radiotherapy is a suitable modality of treatment for patients with advanced HNSCC for
symptom relief and tumour control, with acceptable toxicity.

Effects of Concentrated Growth Factor and Cervical Lymph Node Metastasis on the Prognosis of Mucoepidermoid Carcinoma of the Parotid Gland

Shang-Zhi Han — 2020-09-28

Introduction: Mucoepidermoid carcinoma (MEC) is a common salivary gland malignancy. As studies reported on
large cases of mucoepidermoid carcinoma of the parotid glands are few, this paper aims to research the effects
of clinical and pathological factors, such as applying concentrated growth factor (CGF) on repairing and cervical
lymph node metastasis, on the prognosis of mucoepidermoid carcinoma of the parotid gland.
Methods: The retrospective analysis of prognostic factors was conducted based on 176 cases with mucoepidermoid
carcinoma of the parotid gland, who received treatment at the Affiliated Hospital of Chengde Medical College
during the period of March 2000 to March 2012.
Results: The Five-year overall survival rate was 75.57%, while the Five-year tumor-free survival rate was 64.77%.
Univariate analysis showed that the influential factors for the prognosis of mucoepidermoid carcinoma of the
parotid gland included surgical approach, tumor size, clinical stage, pathological grade, lymph node metastasis,
and distant metastasis, etc; among which pathological grade, lymph node metastasis, and distant metastasis
were indicated by multivariate analysis to be the independent risk factors.
Conclusion: The survival rate of mucoepidermoid carcinoma of the parotid gland is relatively high. Lymph node
metastasis, pathological grade, and distant metastasis are the independent risk factors that affect the prognosis
of patients with mucous epidermoid carcinoma of the parotid gland.

The Prognostic Ability of Staging System in Men with Penile Cancer: An Analysis of SEER Database

Aditya Jalan — 2020-09-28

Background: Penile cancer is now a rare condition. The low incidence of the disease makes a valid estimation of
its prognosis difficult. In this study, we made an attempt and propose a nomogram to develop a prognostic rule
that could predict the Cancer-Specific Mortality (CSM) free rates in patients with primary penile squamous cell
carcinoma of the penis (PPSCC).
Methods: This study included 1304 patients diagnosed with PPSCC between the years 2004 & 2011 and treated
with penile tumor excision. Subjects were staged as per Surveillance, Epidemiology & End Results stage (SEER),
American Joint Committee on Cancer (AJCC), TNM classification and tumor grade (TG). CSM free rates were
determined. Univariate and multivariate Cox regression model was used to test the prediction of the CSM free
rate. The predictive rule accuracy was created using the receiver operating characteristic curve.
Results: The clinico-pathological profile depicts a mean age of 64.66 ± 14.38 yrs. The most common primary site
involved was glans penis (n= 483, 37%) and the disease was most commonly diagnosed at AJCC stage I (n= 670,
51.4%) disease. The cumulative 5-year CSM free rates according to Fine & Gray, & Kaplan-Meier methods were
81.8% and 79.8%, respectively. The predictive accuracy as per SEER stage, AJCC stage, TNM stage alone were
68.8%, 70.3%, 72.3%, respectively. When TG was combined, the predictive accuracy increased to 72.8%, 73.1%,
and 75.0%, respectively. TNM stage with TG was most accurate in predicting CSM free rate compared to other
models.
Conclusions: TNM stage with TG and AJCC stage with TG appear to have comparable accuracy to predict the CSM
free rate in patients with PPSCC, the TNM stage with TG is the most accurate (75%) method to predict the CSM
free rates. The addition of the TG variable improved the accuracy of these prognostic models.

Institutional Audit of Pediatric and Adolescent Malignancy in Nepal

Krishna Sagar Sharma — 2020-09-28

Background: There have been no records of the incidence of pediatric malignancy recorded in Nepal until recently.
The aim of this study is to analyze the cases of pediatric malignancy reported in 2006 in order to find out the
relative frequency and geographical distribution of childhood malignancy throughout Nepal.
Methods: All the data for 2006 were collected from the Hospital-based Cancer Registry of Nepal (B P Koirala
Memorial Cancer Hospital Registry Programme). All the cases included in the report were analyzed for geographical
distribution, age, sex and relative frequency of the various types of childhood malignancies. The cancers were all
classified according to the International Classification of Childhood Cancer (ICCC) and separated into 12 major
groupings.
Result: A total 343 children and adolescents from seven tertiary care hospitals located in the western, middle
and eastern regions of Nepal were registered in the Hospital-based Cancer Registry Program of Nepal. A majority
of the patients were from the eastern and mid-eastern regions. The others were from the western, far-western
and mid-western regions. Very few of them were from the far-western and mid-western regions. The males had a
higher reported rate of malignancies than the females, 60% vs. 40%. The adolescent population (13-19 years old)
had 43% of the malignancies: a significant number. Leukemia (33%), lymphoma (18%) and bone tumors (13%)
were the first, second and third most common cancers among the 12 groups. The number of reported cases has
increased each year from 2003 to 2006.
Discussion: The Hospital-based Cancer Registry was started in 2003. At that time not much attention was given
during the collection of data to making note of the different variables. The incidence of pediatric malignancies has
not been known till now. This study shows that the relative frequencies of pediatric malignancies and leukemia
are the same as in western countries. Knowledge of the national incidence is necessary in order to make proper
policies for the treatment of children with cancer and for research in the field of pediatric oncology. Brain tumors are
the second most common cancer in developed countries but in our study it is the fifth most common malignancy:
20% Vs 5%. We have a higher percentage of bone tumors 10% vs. 5% unlike other developed countries where
population based registry data are available.

The Value of P504s, 34βE12, Ki-67 and PSA in Diagnosis and Prognosis of Prostate Cancer

Jin-Qi Song — 2020-09-28

Background: In recent years, the incidence of prostate cancer(PCa) is increasing. Advanced PCa has a poor
prognosis and high cost, which seriously affects the quality of life of patients. Therefore, how to improve the
diagnosis rate and prognosis of early PCa is the focus of clinical research. This paper aims to investigate the value
of P504s, 34βE12, Ki-67 and prostate-specific antigen (PSA) in the diagnosis and prognosis of PCa.
Objective: To investigate the expression of P504s, 34βE12, Ki67 and PSA in prostate tissues and their clinical
significance.
Methods: Twenty four cases in the study group were selected from PCa confirmed by pathology in the urology
department of Chengde Affiliated Hospital from October 2018 to August 2020, and 33 cases of Benign Prostate
Hyperplasia (BPH) confirmed by pathology in the same period were selected as the control group.The expression
of P504s, 34βE12 and Ki-67 in prostate tissues were determined by immunohistochemistry.
Results: The positive expression rates of P504s, 34βE12 and TPSA or F/TPSA in PCa patients were 95.8%, 12.5%
and 87.5%, respectively. The positive rates in BPH patients were 9.1%, 93.9% and 27.3%,The difference between
the two groups was statistically significant (p<0.05). PCa bone or lymph node metastasis was positively correlated
with Ki-67 (r=0.423, p<0.05) and Gleason score (r=0.446, p<0.05), indicating a stronger correlation with Gleason
score.
Conclusion: The combined detection of P504s, 34βE12 and PSA is helpful for the diagnosis and differential
diagnosis of PCa.High Gleason score and ki-67 expression may indicate high risk of PCa metastasis and poor
prognosis.

A Retrospective Analysis of Breast Cancer at BPKMCH, Nepal

Chin Bahadur Pun — 2020-09-28

Introduction: Breast cancer is the most common cancer and also the leading cause of cancer related mortality in
women worldwide which impact 2.1 million women each year. Breast cancer rates are increasing in nearly every
region globally.
Methods: This was retrospective study at Department of Pathology in B P Koirala Memorial Cancer Hospital
effective from 15 April 2018 to 14 April 2019. All the data were retrieved and analyzed.
Results: Total 205 breast cancer cases were analyzed, among them 198 cases were females accounting 96.5 %
and 7 cases were males accounting 3.5 %.
Among 205 cases, 181 ( 88.6% ) cases were invasive ductal Carcinoma No Special Type. Majority of cases 111
(54%) were diagnosed with Nottingham grading system grade II of breast cancer.
According to our study breast cancer was most common in the age group 41-50 years ( 32.2% ).
Conclusion: Breast cancer is more common in females than in males. Most common affected age group was 41-
50 years. Most common histological type was invasive ductal carcinoma NST. Similarly, left sided breast cancer
was more common than right.

Pediatrics Germ Cell Tumors: A Ten Year Audit in a Cancer Center of Nepal

Krishna Sagar Sharma — 2020-09-28

Introduction: Pediatric Germ cell tumors are rare disease in pediatric and adolescent age group. Germ cell tumors
are the most frequently found malignancies which are highly chemosensitive. GCTs are curable if diagnosed and
treated adequately even in resources poor setting in resource constraints countries like Nepal.
Objective: To study the clinicopathological profile and treatment outcome of Pediatrics Germ cell tumors (GCTs)
among children and adolescent group seeking treatment at B.P. Koirala Memorial Cancer Hospital (BPKMCH),
Nepal.
Methodology: Descriptive study was done at BPKMCH Nepal. All available case records of pediatric and adolescent
girls diagnosed to have GCTs from 2002 to 2011 were collected and analyzed in terms of age, clinical features,
malignancy types, treatment modalities and outcome.
Results: Total 70 girls were with female gynecological malignancy. There are 46 (76.66%) with ovarian
malignancies. Among the ovarian cancers, 42 had malignant germ cell cancer (91.3%) among all ovarian
malignancies which are enrolled in the study. The commonest presentation was abdominal distension and pain in
70%. Onset of symptoms ranged from three days to 730 days (mean 95 days). Disease stage at presentation was
early stage 18 (30%) and advanced disseminated disease 42 (70%). In treatment modality, 8 (13.33%) underwent
fertility sparing surgery only, 21(35%) underwent chemotherapy only and 31(51.66%) underwent multimodality
treatment. 82.5% patients who were completed recommended treatment were cured.
Conclusion: Malignant germ cell cancer is the commonest ovarian malignancies among pediatric and adolescent
girls. Early presentation and prompt appropriate treatment would offer chances of cure even with preservation of
fertility.

Peri-Operative Morbidity and Outcomes of Radical Cystectomy- Institutional Experience of Single Center

Amit Mani Upadhyay — 2020-09-28

Introduction: The incidence of urinary bladder carcinoma increases distinctly with increasing age. Radical
cystectomy has been the gold standard for the treatment of patients with muscle-invasive bladder cancer or
recurrent high-grade non-muscle invasive bladder cancer. Our study aimed to see the peri-operative morbidity and
surgical outcomes of the patient who had undergone radical cystectomy in our low volume center.
Methods: We retrospectively reviewed the inpatient charts as well as the outpatient records of 10 patients who
had undergone radical cystectomy performed in our center for 9 years. A review of the literature on perioperative
morbidity of radical cystectomy was also done using the combination of keywords like mortality, complications,
and outcomes of surgery.
Results: Age of the patients ranged from 40-80 years. Eight of them were male and two were female. Painless
hematuria (70%) was the commonest presenting symptom, 80% of them were smokers. Three patients received
neoadjuvant chemotherapy. Nine patients had radical cystectomy with an ileal conduit, whereas one patient had
radical cystectomy with orthotopic neo-bladder.In postoperative complications, five patients had Clavien-Dindo
grade I, three patients had grade II, one patient had grade IIIB and one patient had grade V complications. Two
years of cancer-free survival was 90% and five years of cancer-free survival was 50%.
Conclusions: Radical cystectomy with ileal conduit was still the choice of surgery in muscle-invasive and recurrent
high-grade non-muscle invasive bladder cancer.

Carcinosarcoma of the Uterus: an Elusive Diagnosis

Anupama Bhattarai — 2020-09-28

Introduction: Carcinosarcoma or Malignant Mixed Mullerian Tumor (MMMT) of the uterus is a rare malignant tumor
comprising both carcinomatous and sarcomatous components. Worldwide it accounts for two to five percentages
of all uterine malignancies. However, there is a paucity of reports in Nepalese literature.
Case report: A 62 years postmenopausal woman with diabetes and hypertension presented with urinary
symptoms for two months and passage of fleshy mass per vagina for two days. Ultrasound was inconclusive,
whereas, Magnetic Resonance Imaging (MRI) showed an endo-cervical mass. Pre-operative biopsy of the mass
suggested leiomyosarcoma. Abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic and
para-aortic lymphadenectomy was performed. Per-operatively, an atrophic uterus, a dimple in the fundus, and
ballooning of the lower uterine segment and vagina were noted. The cut section showed an exophytic polypoidal
mass with base in the fundus. Histopathology revealed Stage IA carcinosarcoma with aggressive mitotic figures.
Immunohistochemistry confirmed the diagnosis of carcinosarcoma with a heterologous rhabdomyosarcomatous
component. Adjuvant chemotherapy and radiation therapy was advised.
Conclusion: The preoperative diagnosis of carcinosarcoma or MMMT was difficult and might be missed on biopsy
as well. Owing to its aggressive nature and higher rates of post-surgical recurrence, carcinosarcoma accounts for
around one-fifth of deaths due to uterine malignancies. Surgery is the primary treatment modality, yet much study
is needed before evidence-based adjuvant management for improving its outcome is established.

Squamous Cell Carcinoma in Non-Functioning Kidney Associated with Staghorn Calculi: Uncommon Presentation of Common Malignancy

Shankar Bastakoti — 2020-09-28

Cancers of the kidney account for 2% of all the total human cancer. Squamous cell carcinoma (SCC) of renal
pelvis is a rare neoplasm, accounting for only 0.5 to 0.8% of malignant renal tumors. In most cases, renal SCC is
associated with chronic infections, chronic renal calculi, radiotherapy or any factor that can irritate the urothelium.
We report a female patient aged 60 years diagnosed with Right Non-functioning Kidney with Nephrolithiasis with
Suspicious Mass. Histopathological diagnosis with Squamous Cell Carcinoma in Stage III with Staghorn Calculi. In
long standing urolithiasis, possibility of concomitant harboring of malignancy needs to be taken into consideration.

A Case Report of Giant Cell Tumor of Proximal Fibula in Children

Sushil Adhikari — 2020-09-28

Giant cell tumour (GCT) is histopathologically benign tumor of long bone particularly in distal femur and the
proximal tibia. It commonly occurs in adults of age 20-40 years but rare in children. GCT is considered to be locally
aggressive tumor and tendency of recurrence is higher even after surgery.
The clinical features are nonspecific, the principle symptoms are pain, swelling and limiting adjacent joint
movements. Diagnosis is based on the radiographic appearance and histopathological findings .In our case X-ray
showed ill defined lytic lesion on proximal fibula with cortical thinning and MRI finding revealed expansile lytic
lesion in meta-epiphysis of right fibula 16×16×28mm adjacent to growth plate with fluid level. The sclerotic rim
appears hypointense on T1 & hyperintense on T2. Core needle biopsy showed giant cell tumor on proximal fibula.
Considering the risk of recurrence wide local excision was done. Management of GCT of proximal fibula in young
patient is critical for preventing recurrence and enhancing functional outcomes by saving adjacent anatomical
structure. No evidence of local recurrence and metastasis was found in 24 months of follow up.

Upper Esophageal Schwannoma: Rare Differential Diagnosis of Dysphagia

Bigyan Acharya — 2020-09-28

Esophageal schwannomas are rare primary submucosal tumors, 45 cases have been reported so far. We herein
report the 46th case of an esophageal schwannoma from Nepal. A 60-year-old woman presented with progressive
dysphagia. Oesophago-Gastro-Duodenoscopy (OGD) showed a submucosal mass with mucosal puckering in the
upper esophagus; Computed tomography (CT) of the chest showed an upper esophageal mass of size 8x7x6cm3
compressing the trachea. Bronchoscopy showed external compression of the mid trachea. The patient underwent
three incision VATS esophagectomy. Histopathological examination and immunohistochemical (IHC) staining
confirmed the diagnosis of schwannoma.

Surface brachytherapy in Skin Cancer with High Dose Rate Remote Afterloader: an Experience from Nepal Cancer Hospital and Research Center

Gisupnikha Prasiko — 2020-09-28

High Dose Rate (HDR) brachytherapy for skin cancer, such as basal cell carcinoma and squamous cell carcinoma, provides an alternative treatment option to surgery or, in recurrent cases. This is especially relevant for cancers on the nose, ears, eyelids, or lips. Surface mould brachytherapy is delivering ionizing radiations via a carrier device known as mould. At Nepal Cancer Hospital and Research Center (NCHRC) we have treated 5 patients with skin cancer by surface brachytherapy. We prepared different source carrier of mould (thermoplastic sheets, wax sheets, and both) that is designed to provide constant and reproducible geometry for source positioning. Total volume ranging from 4cc to 10 cc was treated with a total dose of 40.5Gy in 9 Fractions (twice a week) was prescribed at 0.5cm depth. 3 to 5 applicators were used at 0.5 to 1cm distance as required to cover the treatment area. The patient’s treatment was evaluated on routine treatment and follow-up after one-month post-treatment and every 3 months for a year. Skin reactions were found after 2 to 3 fractions of treatment. We followed up the patients after the 1^st and 6^th months of treatment. After treatment, we achieved a complete response without any major complications. Surface mould brachytherapy is a very effective treatment for treating carcinoma of skin where difficult curve surfaces are involved.

Modified Palliation in Cancer Patients during COVID-19 Pandemic

Bhawna Wagle — 2020-09-28

Coronavirus disease 2019 (COVID 19) has put huge challenge to the health delivery system all across the globe.
The risk of mortality due to COVID 19 is highest on critically ill patients and those with preexisting disease.
Palliative and end of life care are no exceptions to the surge in increased demand for health care services. It is
now an essential part of global health care. The benefits of early palliative care are already well established. In
the pandemic like this, we must not pull back the services, particularly in these vulnerable groups. It is important
to determine how best to deliver palliative care during this crisis. It may include preparedness to shift the focus of
resources to community level and the innovative use of telemedicine. Use of telemedicine is to ease patients and
minimize caregiver distress, and to prevent hospitalizations. The fear of contracting COVID-19 and the emotional
burden during diagnosis requires the need of continuous psychosocial support. These challenges should be
handled by specialized and skilled interdisciplinary palliative care team.

Development of Oncology Nursing in Nepal: Historical Perspective

Sarojini Sharma — 2020-09-28

Professional nursing in general and oncology nursing in particular underwent significant changes and a distinct
paradigm shift in oncology nursing education and practice in the 30 year period of time (1991 to 2020), which
promoted the advancement of oncology nursing. This historical review and reflection provides lessons for
contemporary clinical cancer nurses, researchers, policy makers and educators to approach the nursing issues,
necessity of cooperation/ collaboration and maintaining the passion for increasingly complex nursing speciality.

Caring Cancer Patients while Living with COVID-19: An Experience of a Tertiary Cancer Care Center

Murari Man Shrestha — 2020-09-28

COVID-19 has emerged as a serious public health crisis of 21st century affecting millions of people around the
world. First identified in Wuhan China, COVID-19 has spread globally claiming millions of human life and suffering.
The Government of Nepal (GoN) has accelerated control measures through mass media, laboratory testing,
quarantine, isolation and treatment of COVID patients in designated hospitals. With rapid spread of COVID-19, the
government owned as well as the private hospitals and health institutions across the nation face a great challenge
to contain the spread of the novel virus. Nepal Cancer Hospital and Research Center (NCHRC) has been managing
uninterrupted treatment services to cancer patients since the beginning of spread of COVID-19 in Nepal. Early
planning and preparedness has been crucial to ensure patient care in the midst of COVID-19 pandemic.