Impact of COVID-19 on cancer care in India: a cohort study.

BACKGROUND: The COVID-19 pandemic has disrupted health-care systems, leading to concerns about its subsequent impact on non-COVID disease conditions. The diagnosis and management of cancer is time sensitive and is likely to be substantially affected by these disruptions. We aimed to assess the impact of the COVID-19 pandemic on cancer care in India. METHODS: We did an ambidirectional cohort study at 41 cancer centres across India that were members of the National Cancer Grid of India to compare provision of oncology services between March 1 and May 31, 2020, with the same time period in 2019. We collected data on new patient registrations, number of patients visiting outpatient clinics, hospital admissions, day care admissions for chemotherapy, minor and major surgeries, patients accessing radiotherapy, diagnostic tests done (pathology reports, CT scans, MRI scans), and palliative care referrals. We also obtained estimates from participating centres on cancer screening, research, and educational activities (teaching of postgraduate students and trainees). We calculated proportional reductions in the provision of oncology services in 2020, compared with 2019. FINDINGS: Between March 1 and May 31, 2020, the number of new patients registered decreased from 112 270 to 51 760 (54% reduction), patients who had follow-up visits decreased from 634 745 to 340 984 (46% reduction), hospital admissions decreased from 88 801 to 56 885 (36% reduction), outpatient chemotherapy decreased from 173634 to 109 107 (37% reduction), the number of major surgeries decreased from 17 120 to 8677 (49% reduction), minor surgeries from 18 004 to 8630 (52% reduction), patients accessing radiotherapy from 51 142 to 39 365 (23% reduction), pathological diagnostic tests from 398 373 to 246 616 (38% reduction), number of radiological diagnostic tests from 93 449 to 53 560 (43% reduction), and palliative care referrals from 19 474 to 13 890 (29% reduction). These reductions were even more marked between April and May, 2020. Cancer screening was stopped completely or was functioning at less than 25% of usual capacity at more than 70% of centres during these months. Reductions in the provision of oncology services were higher for centres in tier 1 cities (larger cities) than tier 2 and 3 cities (smaller cities). INTERPRETATION: The COVID-19 pandemic has had considerable impact on the delivery of oncology services in India. The long-term impact of cessation of cancer screening and delayed hospital visits on cancer stage migration and outcomes are likely to be substantial. FUNDING: None. TRANSLATION: For the Hindi translation of the abstract see Supplementary Materials section.

Optimizing e-learning in oncology during the COVID-19 pandemic and beyond.

The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted cancer care, research and residency training in oncology worldwide. Many countries canceled exams, shortened their residency program and medical school tenure. Traditional teaching and learning method has faced significant disruption during this time and the situation has pushed us to adapt to e-learning. Most national and international cancer meetings were converted into a virtual platform during this time. E-learning ensures a safe environment to maintain education during a pandemic. Digital technology-based learning is likely to be used effectively in oncology training even after the pandemic ends. Stakeholders should work towards standardizing e-learning into routine educational modules and create a system of credibility and accountability.

Challenges and perceptions of cancer patients attending a tertiary care center during COVID 19 Pandemic Era: Patient's Perspective

Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to their immunocompromised state related to the disease and anticancer treatment. There is a lack of literature assessing the patient's perspective of the present crisis and its impact on their treatment. Aims and Objective: The present study aimed to address the challenges and sufferings faced by patients with cancer during their treatment in the current COVID-19 pandemic era. Materials and Methods: A single-institute, cross-sectional questionnaire-based observational study was conducted in a tertiary care teaching hospital. Patients attending the Oncology outpatient department were enrolled in the study. Results: One hundred patients (64 males, 36 females) with a mean age of 47.17 years (range-24-71) participated in the study. The majority of patients (89%) were aware of the COVID 19 symptoms and did not confuse them with cancer symptoms. Most of them were aware of preventive measures like frequent hand washing, sanitizer usage, and face masks to reduce the risk of infection. Almost half of them encountered difficulties in commuting to the Hospital. Most (83%) of them were worried about treatment delay and disease progression due to the COVID-19 pandemic. Almost half of the patients (54%) were fearful of acquiring the infection from the radiotherapy machine and immobilizing devices. Two-third of the patients (64%) were afraid to carry the virus back to their homes. Awareness regarding our Hospital's teleconsultation facility was limited among patients. Conclusion: The present study underscores the success of ongoing COVID-19 awareness programs run by the government. However, there is an urgent need to address the various challenges encountered by patients with cancer. The strengthening of telemedicine facilities may reduce the in-person visits made by the patients. [ABSTRACT FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Running of high patient volume radiation oncology department during COVID-19 crisis in India: our institutional strategy.

PURPOSE: Due to COVID 19 pandemic, the treatment of cancer patients has become a dilemma for every oncologist. Cancer patients are at an increased risk of immunosuppression and have a higher risk to acquire any infection. There are individual experiences from some centers regarding the management of cancer patients during such a crisis. So we have developed our institutional strategy to balance between COVID and cancer management. MATERIALS AND METHODS: Radiation Oncology departmental meeting was held to prepare a consensus document on Radiotherapy schedules and department functioning during this pandemic. RESULTS: Strategies were taken in form of following areas were steps need to be taken to decrease risk of infection, categorise treatment on the basis of priority, radiotherapy schedules modification, academic meetings and management of COVID positive patient/personnel in Radiation Oncology department. CONCLUSION: We hope to strike the balance in overcoming both the battles and emerge as winners. Stringent long term follow up will be done for assessing the response or any unforeseen treatment related sequelae.