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Int J Radiat Oncol Biol Phys ; 113(3): 513-517, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1828628


PURPOSE: To survey Canadian radiation oncology (RO) practice leaders to determine the effect of the COVID-19 pandemic on radiation services and patient and staff issues in the early phase of the pandemic and 1 year later. METHODS AND MATERIALS: The RO leader (department or division head) from every Canadian cancer center with radiation services was identified. Two surveys were circulated to the identified leader via email from the Canadian Association of Radiation Oncology central office, using the SurveyMonkey survey tool: the first closed in June 2020 and the second (expanded) survey in June 2021, representing 2 points in time of the COVID-19 pandemic. Questions included patient volume, service interruptions and delays, and changes in scheduling and telemedicine use. Additional questions were included in the follow-up survey to determine further effects on disease presentation, volume, vaccination and access, and personnel issues. RESULTS: Telemedicine was widely adopted early in the pandemic and continued to be a common technique to communicate and connect with patients. Although many centers were deferring or delaying certain disease sites early in the pandemic, this was not as prevalent 1 year later. Reduced cancer screening and patients presenting with more advanced disease were concerns documented in the 2021 survey. A high level of concern regarding stress among health care professionals was identified. CONCLUSIONS: Canadian RO centers have faced numerous challenges during the COVID-19 pandemic but continued to provide timely and essential cancer care for patients with cancer. Future evaluation of RO center practices will be important to continue to document and address the effect of the COVID-19 pandemic on issues relevant to RO leaders, patients, and staff.

COVID-19 , Radiation Oncology , Telemedicine , COVID-19/epidemiology , Canada/epidemiology , Humans , Pandemics
Lancet Gastroenterol Hepatol ; 5(8): 765-775, 2020 08.
Article in English | MEDLINE | ID: covidwho-692971


Around the world, recommendations for cancer treatment are being adapted in real time in response to the pandemic of COVID-19. We, as a multidisciplinary team, reviewed the standard management options, according to the Barcelona Clinic Liver Cancer classification system, for hepatocellular carcinoma. We propose treatment recommendations related to COVID-19 for the different stages of hepatocellular carcinoma (ie, 0, A, B, and C), specifically in relation to surgery, locoregional therapies, and systemic therapy. We suggest potential strategies to modify risk during the pandemic and aid multidisciplinary treatment decision making. We also review the multidisciplinary management of intrahepatic cholangiocarcinoma as a potentially curable and incurable diagnosis in the setting of COVID-19.

Carcinoma, Hepatocellular/therapy , Coronavirus Infections/epidemiology , Liver Neoplasms/therapy , Pandemics , Pneumonia, Viral/epidemiology , Betacoronavirus , Bile Duct Neoplasms/therapy , COVID-19 , Carcinoma, Hepatocellular/pathology , Cholangiocarcinoma/therapy , Clinical Decision-Making , Humans , Liver Neoplasms/pathology , Neoplasm Staging , Patient Care Team , Risk Factors , SARS-CoV-2
Radiother Oncol ; 148: 194-200, 2020 07.
Article in English | MEDLINE | ID: covidwho-258496


As of April 6, 2020, there are over 1,200,000 reported cases and 70,000 deaths worldwide due to COVID-19, the disease caused by the SARS-CoV-2 virus, and these numbers rise exponentially by the day [1]. According to the Centers for Disease Control (CDC), the most effective means of minimizing the spread of the virus is through reducing interactions between individuals [2]. We performed a review of the literature, as well as national and international treatment guidelines, seeking data in support of the RADS principle (Remote visits, Avoid radiation, Defer radiation, Shorten radiation) [3] as it applies to gastrointestinal cancers. The purpose of the present work is to guide radiation oncologists managing patients with gastrointestinal cancers during the COVID-19 crisis in order to maintain the safety of our patients, while minimizing the impact of the pandemic on cancer outcomes.

Betacoronavirus , Coronavirus Infections , Gastrointestinal Neoplasms/radiotherapy , Pandemics , Pneumonia, Viral , COVID-19 , Guidelines as Topic , Humans , SARS-CoV-2