TOGETHER Against Cancer Malaysia (TAC) would like to urge Malaysia’s government to prioritise cancer patients.
We want to congratulate the Health Ministry and the Malaysian government for the national Covid-19 vaccination programme aiming for 80% coverage involving 25.6 million people commencing Feb 26.
Equally encouraging, the government has committed to initiating Phase Two in April 2021 covering 9.4 million senior citizens (above 60 years old) and those with chronic conditions like heart disease, obesity, diabetes and persons with disabilities. However, no mention was made about this phase covering cancer survivors.
This miscommunication is worrying cancer patients.
We want to bring to the government’s attention that cancer spares no one in any age group. The latest national cancer registry published in 2019 recorded 1.15 million new cases over five years, of which 55% were women. The highest age at diagnosis was 55-59 years in females and 60-64 years age group in males. Diagnosis of cancer for those below 60 years of age was 61% for female and 46% for male cancer survivors.
Notably, cancer patients are not a homogeneous group, and Covid-19 risk depends on the disease’s trajectory and whether patients are on active immune-suppressive treatments.
We want to bring attention to the detailed information available in other countries: The Joint Committee on Vaccination and Immunisation in Britain, for example, has prioritised the following groups (in order of priority) for vaccination:
> Residents in a care home for older adults and their carers.
> All those 80 years of age and over and frontline health and social care workers.
> Those 75 years of age and over.
> Those 70 years of age and over and clinically extremely vulnerable individuals.
> Those 65 years of age and over.
> Individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality.
> Those 60 years of age and over.
> Those 55 years of age and over.
> Those 50 years of age and over.
Public Health England has published guidance on shielding and protecting people who are clinically extremely vulnerable from Covid-19 (updated on Jan 22,2021) that categorises people with specific cancers to fall under the clinically extremely vulnerable:
> People with cancer who are undergoing active chemotherapy.
> People with lung cancer who are undergoing radical radiotherapy.
> People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.
> People having immunotherapy or other continuing antibody treatments for cancer.
> People having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP (poly ADP ribose polymerase) inhibitors.
> People who have had bone marrow or stem cell transplants in the last six months or who are still taking immunosuppression drugs.
> Other people who have also been classed as clinically extremely vulnerable based on clinical judgment and assessing their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.
Other cancer patients such as those treated a long time ago and those surgically treated are placed in the priority group of individuals aged 16 years to 64 years with underlying health conditions mentioned. Their clinician can also recommend cancer patients about to have major surgery to get the vaccine before treatment.
Information on the contact tracing MySejahtera app only records the age group and no details about cancer, thus making cancer patients feel vulnerable and anxious during this pressing time.
Hence, TAC urges Malaysia’s government to prioritise this vulnerable group and reach out to professional bodies and civil society groups to assist in the prioritising exercise and communicating the rollout plan more effectively.
WONG KUAN SING
Against Cancer Malaysia (TAC)
PROF NUR AISHAH MOHD TAIB
Vice President, TAC, and Head, Cancer Research Institute, Faculty of Medicine, Universiti Malaya
Note: TAC is a multidisciplinary group of cancer advocates and can be reached at email@example.com.