ABSTRACT
Purpose: Inmate oncologic patients' rates increased drastically worldwide. Elderly, limited exercise, unhealthy diet, hepatitis, HIV + status, tobacco and alcohol use, constitute the main cancer risk factors. We present an outline of practical oncological management and ethical thinking, in the specific environment of a detention facility. Methods: PubMed, Cochrane Database of Controlled Trials, SCOPUS and grey literature were extensively searched up to October 2021. Incarcerated oncologic patients experience various everyday challenges:their confinement in high security facilities, the lack of access to critical care and related ethical dilemmas inherent to the context of a correctional facility. Results: The detention facilities may be inadequate in providing early cancer diagnosis and appropriate care mainly due to a lack of specialized personnel, b) in-house or in external specialized cancer hospitals, care variability (e.g. admissions in small local or regional hospitals), c) delays in providing access and d) gatekeeper systems. There is a paucity of administration of a)systemic therapy (chemotherapy, targeted drug therapy etc),b)radiotherapy, c) palliative care, and d)enrollment in clinical trials. Conclusions: Correctional facilities must encourage teamwork between healthcare and correctional professionals in order to improve the provided anticancer care.
ABSTRACT
To protect cancer patients from COVID-19exposure, prioritization strategies are being implemented at global level. Measures include use of tele-health services, deferring elective surgeries, delaying non life-saving therapies, interrupting maintenance and supportive care regimens and suspending screening and regular follow-up visits. Nonetheless, the risk of infection may not always outweigh oncology treatment benefit. Lives of most oncology patients depend on their ability to receive medical, surgical and radiotherapy care. Postponing screening, follow-up and radical surgeriesincreasepatients’riskofdevelopingmetastaticdisease. Aviral pandemic lasts long time andexhibits seasonal and geographical variations. Though vaccines will be available only in the 2021, a global, aggressive, all-embracing and protracted slowdown of oncologic activities will severely jeopardize patients’ outcomes. A present international oncologists’ panel, ECPC and FAVO, strongly suggest that Hospital measures in a specific geographical area/Nation should be in line with the local epidemic, and restrictions adopted should be adapted and stratified over time.