As the war rages around them, Ukraine’s oncologists are scrambling to get cancer patients the treatment they need.
“Quite a lot of oncological centers have been attacked—I have no words about it,” said Tetiana Skrypets, a Crimean-born oncologist-hematologist who has previously worked for Ukraine’s National Cancer Institute in Kyiv and is now a PhD candidate in Italy, at Università degli Studi di Modena e Reggio Emilia.
Scheduled treatment sessions, surgeries, and diagnostic procedures for cancer patients are among the casualties of this war. At some locations, drugs are in short supply.
“Basically, we are not able to give them any care,” Oleksandr Stakhovskyi, a urologist and oncological surgeon at Ukraine’s National Cancer Institute in Kyiv, said to The Cancer Letter. “We discharge almost everybody. We still have two or three patients, maybe up to 10, who are not able to leave [for] home because their home is destroyed.”
A conversation with Stakhovskyi appears here.
Cancer patients have been forced into underground bomb shelters, with pediatric cancer patients at centers like Ohmatdyt Children’s Hospital receiving treatment in the facility basement.
“There are children who have, for example, acute leukemia, or other types of cancer where they need urgent treatment,” Darya Kizub, a Ukrainian-born oncology fellow at MD Anderson, said to The Cancer Letter. “They are giving them chemotherapy right now, even though there is war, and whenever there’s an air alert, everybody goes down to the basement, which serves as a bomb shelter. Whenever the kids have a continuous infusion of chemotherapy, they have to be very careful to bring all of that to the basement so that the treatment can continue.”
Kizub received this information from the head of the pediatric oncology section at a hospital in the city of Ivano-Frankivsk. This source told Kizub that, at least at her hospital in western Ukraine, physicians are still able to get to work and offer treatment.
In other parts of the country, even getting to the hospital presents a challenge.
“There are quite a lot of difficulties. I’m not even talking about how to provide therapies,” Skrypets said to The Cancer Letter. “Quite a lot of people haven’t got the possibility even to reach hospitals. Quite a lot of doctors are staying in clinics and can’t go home because it’s dangerous, and some of them can’t reach hospitals to help because it’s dangerous.”
In eastern Ukraine, where the fighting is at this time more intense, cancer care is far more limited than in cities further West.
“You go to the eastern parts, where all these affected cities, like Kharkiv, for example, which is bombed for the last three days, and we have all these awful videos from that city—I’m sure that nobody’s caring about oncology at all,” Stakhovskyi said. “I don’t know the status of our oncological colleagues from there, but I believe they are trying to escape Kharkiv, to move to Kyiv or to other western cities.”
Hospitals are trying to coordinate the transportation of cancer patients from eastern Ukraine to western Ukraine.
“There has been a mobilization where everybody’s trying to help with medical supplies and humanitarian aid,” Kizub said. “In western Ukraine, things are actually safer than the rest of the country. What they’re doing is they’re accepting cancer patients from other areas in the country, which are, you know, less safe because of the bombs and artillery fire—including on the civilian infrastructure in the hospitals.”
Facing limited resources, hospitals in western Ukraine are also pushing to get patients across the border.
“In Western Ukraine, they’re also working on moving patients from oncology centers there to other places in Europe,” Kizub said. “That’s something that they’re working on right now—to transfer them across the border, because they are accepting patients from all over the country and they have limited capacity.”
Skrypets said she is working with colleagues in Ukraine to assist cancer patients.
“We are trying our best just to save one life, one life,” Skrypets said. “We are trying to organize some networks with our European colleagues all over Europe to provide health care for patients who will be able to reach Ukrainian borders to go, I don’t know, in Poland, in Hungary, in Czech Republic, wherever, in Germany, in Italy.”
Reaching these countries can be difficult, because the political situation and refugee crisis have made travel treacherous, and not all patients are healthy enough to relocate.
“The main problem is to reach these places, when some patients have more difficult situations and need more advanced treatment,” Skrypets said. “I know that now in Poland, in Germany, also in Italy, they will receive all these therapies for free, because these people haven’t got anything anymore. Here in Europe, we could organize everything. The more difficult thing is to reach these countries where they can have therapy.”
Online connectivity is crucial for coordinating these efforts—according to Kizub and Stakhovskyi, internet connections have been holding up in Ukraine. The Ukrainian Ministry of Health announced on Telegram that the Kyiv City Clinical Oncology Center has launched a hotline for patients with cancer, aiming to connect city residents to consultations and special and palliative treatments.
Quite a lot of people haven’t got the possibility even to reach hospitals. Quite a lot of doctors are staying in clinics and can’t go home because it’s dangerous, and some of them can’t reach hospitals to help because it’s dangerous.
Tetiana Skrypets
“The connections are very good. Ukraine is a country that is very connected to social media,” Kizub said. “So, people are talking to each other via WhatsApp, via another app called Viber, via Facebook.
“We hope it stays that way, because, I think, now that the Russian military’s advance has stalled and they’re frustrated, they’re trying to decrease morale in the general population by bombing civilian infrastructure, including the power stations. They hit the main telecommunications tower in Kyiv, but so far, the country is holding up.”
Kizub said she is heartened by the channels of communication and the organized humanitarian efforts that have emerged from the conflict in Ukraine.
“The whole country is together, which is really wonderful,” Kizub said. “I think everything is just in very early stages, where unless you’re there, it’s even hard to provide aid. But, thankfully, there are aid networks that are developing where there are clear channels where you can send donations to Poland, then they get them over to Ukraine—and this includes medical supplies.”
Stakhovskyi said he and his colleagues will remain at NCI in Kyiv, helping cancer patients as long as they can and, if needed, deploying their medical skills for front-line care.
“People are putting everything on the table,” Stakhovskyi said. “Whatever they will do, they try to volunteer, they try to help—if not with weapons in their hands, at least with a car, with food, with petroleum, sending money to the army. It’s great to see how the nation united against one opponent, against Russia.”
For many scientists, the Russian invasion of Ukraine has raised questions about scientific collaboration with Russia.
Scientists and research organizations across the globe, including in Russia, have condemned the Russian government’s actions. A letter written by Ukraine’s Council of Young Scientists, addressed to the European Commission and member states of the European Union and signed by over 130 people, pushes for a wide-reaching boycott of the Russian academic community.
“It’s really unfortunate, because we know that there are a lot of Russian people, and especially a lot of Russian physicians and oncologists, who are completely against the war, and who have put out statements to this effect and have even gone to protest—even though in Russia, when you protest, this can carry a heavy prison sentence, you can be assaulted by the police, you can be very heavily fined—it’s a high price to pay, but many people are still doing it,” Kizub said.
Scientists have made it clear that sanctions against Russia extend to the medical and research communities.
“Now Russians are saying that we hate them. No, we don’t,” Skrypets said. “I will not do any violence, nothing, I don’t care—but I will do my best not to cooperate with them.”
On behalf of Ukraine’s National Cancer Institute in Kyiv and Ukrainian physicians working abroad, Skrypets and some of her colleagues tweeted a letter urging prominent medical organizations to cease cooperation with Russia for the time being.
“Please, arrest membership of the Russian Federation and Republic of Belarus or their citizens till the end of the war in Ukraine, change the payment net for them, stop any cooperation, cancel joint events or those planned at the territory of the Russian Federation and Republic of Belarus, exclude [these] states from the list of new clinical trials,” the letter states. “Each step will support the global reaction to the revolting and mad actions of the Russian Federation against [the] people of Ukraine, it will save lives of our patients and ordinary people.”
The letter was tweeted at organizations including the American Society of Hematology, American Society of Clinical Oncology, American Society for Transplantation and Cellular Therapy, European Society for Blood and Marrow Transplantation, European Hematology Association, European Organisation for the Research and Treatment of Cancer, European School of Oncology, and European Society for Medical Oncology.
Skrypets said in her experience, Russia has been hesitant to get involved in nonprofit research projects, meaning that excluding Russian collaborators will not destine these projects to failure.
“We are in quite a lot of nonprofit projects, and also we would like to involve Russia in our projects, but unfortunately for nonprofits, they are quite closed. They didn’t want to share their data. They didn’t want to participate in nonprofits,” Skrypets said. “So, our European research will not fall down without Russia.”
