ABSTRACT
Background: Cancer patients (Pts) present an increased risk of a severe form of SARS-cov-2 disease because of immunodepression status induced by treatments and cancer. National and international organizations recommend vaccination against SARS-cov-2 in this specific population. An efficient vaccination procedure in oncologic Pts is particularly relevant. ASLVC Oncology spoke (North West Piedmont, Italy) includes two hospitals: one in Vercelli and one in Borgosesia. We report here our real life experience about SARS-Cov-2 vaccination in cancer patients, in both hospitals. Material and methods: Hospital Administration approved a local vaccination procedure for cancer pts on April 2021. Medical, nursing and administrative staff of Oncology Unit were trained for the vaccination of their Pts and worked out a specific disclosure. A member of a Voluntary Association welcomed and helped Pts. Each patient benefited from an individual medical examination with an oncologist before the first administration of the vaccine. Medical history, allergy and ongoing treatments were reviewed before administration. Blood tests were performed to every patient treated by chemotherapy. A consent form was signed. Information about Covid-19 status and vaccination were reported in the oncologic medical record. Results: Vaccines used for vaccination were Pfizer- BioNTech according to current guidelines. Two doses were scheduled three to four weeks apart. Since April 26th to May 19th in Vercelli there were 9 injection sessions;115 Pts.were vaccinated: 91 (79%) had first dose and 24 (21%) second;while in Borgosesia 45 Pts were vaccinated, 32 (73%) had first dose and 12 (27%) second. Nobody had acute reaction or serious adverse event, 20 (12.5%) Pts had late and mild adverse events. Most frequently reported adverse event were arm pain, arthralgia, muscle weakness, headache. Only one patient (0.6%) with a history of severe allergic reaction was vaccinated in intensive care. Conclusions: Vaccination against Sars-Cov-2 in cancer Pts is safe and is still ongoing in our hospitals. An appropriate and specific procedure permitted to manage and efficient vaccination in cancer Pts even through chemotherapy.
ABSTRACT
Background: Teenagers are at age when they start making decisive choices. Without adequate information on correct lifestyles they run health risks, particularly with regard to future cancers. However, they have curiosity, interest and strong desire to learn in medical issues. This trial was developed to promote knowledge of cancer development and prevention program by informing students about correct lifestyles by teaching, playing an educational game, involving them interactively both in presence and on digital platform. Methods: Since September 2019, medical oncologists with teachers from 2 first grade classes in two schools started a shared teaching path. Educational meetings were held for class presenting slides on neoplasms development and wrong lifestyles causing their onset. Slides were illustrated with comics. Students built with comics some of 90 boxes of a pathway similar to game of goose, set in their country in Middle Age. Players were two classes competing throwing dices to reach box number 90,equal to the years of cancer-free life expectancy conquered with correct lifestyle. Each box corresponded to a card like “tarot cards”, prepared to slow down the path, if it represented a wrong conduct or event, and to speed up otherwise. During the second year of class, lessons illustrated H&N with gastrointestinal cancers. Impact of course was evaluated through a questionnaire prepared by a dental hygienist and proposing a healthy snack at least once a week at school. Results: We performed 40 educational meetings of 30 minutes, followed by 20 minutes of play. Six medical oncologists, 1 psychologist, 1 dietician, 1 dental hygienist, 4 teachers actively contributed;4 classes joined the initiative, 92 teenagers participated in 15 in-presence meetings and 25 on online platform during COVID19. All contributed to build and enjoyed the game. They wanted to start following course directions by bringing to school a snack proposed by dietician once a week. Ten of them offered to participate in the peer education course in other classes. Fifty-two questionnaires were completed at the beginning of the course and re-proposed at the conclusion. Students answered: 52/52(100%) knew tumors of oral cavity, 37/52(71%) knew color of precancerous lesions, 42/52(79%) knew risk factors, 48/52(92%) replied they would never start to smoke. Conclusions: Teaching teenagers correct lifestyle preventing cancer by innovative method playing an educational game is achievable and can give results.
ABSTRACT
Background: Rapid outbreak of SARS Covid-2 Pandemia required emergency action by health services. Since March 1st 2020 Vercelli Sant'Andrea Hospital was appointed COVID19 referral center. Infection is associated with worse survival in pts with cancer so we developed a structured guidance and education program for disease prevention and containment. Implemented procedure concerns pts, health care professionals and all those involved in care and management of diagnostic therapeutic pathway. Methods: Since March 1st pts were divided in 2 groups: 1st off therapy for which access to clinics was postponed;2nd receiving treatment (chemotherapy, immunotherapy or radiotherapy). To everyone COVID19 WHO hygien standards were recommended. Other directions were: to use leukocyte growth factors also in subjects with risk <10%;to assess opportunity to undertake neo-adjuvant treatment in case of excessive delay of surgery;to transfer as many activities as possible in smart mode (eg.email, phone contacts);to informs pts that the use of internet means does not guarantee privacy;to identify and share path, lifts and spaces (eg. waiting rooms)creating an explanatory and educational brochure with a map of covid free path;to reshape waiting lists for outpatient and day hospital activities both in terms of timing and booking;to recommend attention to subjects undergoing surgical treatment for lung localized tumors, with treatment that has involved a partial or total sacrifice of the pulmonary parenchyma, and in all patients undergoing immunotherapy;to perform pretriage before going into oncology unit;to suspend all activities not strictly necessary for therapeutic purposes such as those managed by Voluntary Associations;to examine information from the General Management (GM), providing for implement them promptly. Results: Guideline has been laid and immediately applied, then it was formally notified with a flow chart of activity and an explanatory brochure for pts to GM and it was approved on 31th march. Since March 1st to May 4th we performed 520 visits and 760 therapies, and since April 1st to May 4th explanatory brochure was given to 203/258 (78%) pts;all pts (100%) had pretriage . No pts was affected by COVID-19 and all therapies were administered and were given without delay. Conclusions: Our experience shows that a structured program of pts information and effective interventions can offer opportunity of safe care in COVID19 referral hospital.
ABSTRACT
Background: In Vercelli there is a Spoke Hospital and in Borgosesia there is a little Proximity Hospital: both are in the same district. Since March the 1st 2020, only Vercelli's Hospital has been appointed as COVID19 referral center. Pts with cancer have less chances of survival this infection, so a structured guidance and an educational program has been created and immediately applied in Vercelli, while in Borgosesia, the General Management (GM) standard hygiene procedures were applied to prevent the SARS CoVID19 infection. Our objective is to highlights outcomes and differences between SGEP and SOP on Pts with cancer in these two different cancer wards. Methods: Since February the 23rd to May the 4th, during COVID-19 Phase 1, we retrospectively conducted an analysis of all patients who entered in Vercelli 's (with SGEP) and Borgosesia's (with SOP) cancer wards and we compared impact on infection between them. Results: In Vercelli, 433 Pts entered the Oncology unit with SGEP and underwent 796 treatments and 682 nursing services. In Borgosesia, 87 pts entered in Oncology unit with SOP and underwent 220 treatments and 73 nursing services. COVID 19 affected 0/422 (0%) Pts in Vercelli, while 3/87 (3,5.%) Pts in Borgosesia had been infected. These patients have then been hospitalized and 2/3 (66%) of them died (one chemotherapy for colon cancer adjuvant and the other one for advanced lung cancer). Conclusions: Even if in a limited number of cases, our experience seems to demonstrate that standard measures (SOP) are not enough for cancer patients in course of an epidemic and they need a differentiated approach (SGEP).