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Jocelyn Harding talks about her book collaboration that is raising the bar in oral cancer care - and the need for open conversations with patients.
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Background/Aims: Remote service delivery became a key method of providing therapy for psychological oncology services during the COVID-19 pandemic and beyond. This study aimed to understand the experiences and preferences of both patients and therapists who undertook remote psychological therapy in a cancer support service, with a view to informing ongoing service provision. Methods: A total of 99 out of 152 invited patients completed an online mixed-methods (quantitative and qualitative) audit survey. All patient participants had accessed therapy with the psycho-oncology support team at Guy's Cancer Centre in London. Of the 12 therapists and four trainee therapists working in this service, 11 and two from each group (respectively) completed a corresponding survey about their experiences as therapists. For quantitative data, descriptive statistics were collated. Results: Patients rated their experience of remote therapy as positive, reporting that they felt respected, understood and confident during therapy, and acknowledged the associated advantages of increased accessibility and infection control. Despite this, 87% of patients and 100% of therapists expressed a preference to access or deliver therapy in person, with patients identifying human connection and relationship building as key reasons for choosing in-person delivery. Therapists valued the relational aspects of in-person psychological support and reported that remote delivery had negatively affected the quality of therapy delivered. Conclusions: Understanding the needs and preferences of patients and therapists is important in informing ongoing psychological service delivery. The results highlight the importance of retaining provision for in-person service delivery and offering choice to patients in how they access psychological support, in line with personalised care recommendations made by the NHS Long Term Plan.
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AUTH Why you should read this article: • To understand the clinical reasons for pre-treatment assessment of patients undergoing systemic anticancer therapy (SACT) • To appreciate the benefits of a digital SACT pre-assessment pathway for cancer patients • To familiarise yourself with the challenges of providing a digital service During the coronavirus disease 2019 (COVID-19) pandemic measures have been implemented in healthcare systems to reduce transmission of the infection. People with cancer are immunocompromised and at higher risk of contracting infections, therefore many cancer services have been conducting routine reviews and pre-treatment assessments remotely through telephone and video consultations during the pandemic. Patients who are to receive systemic anticancer therapy (SACT) should have an additional consultation to provide them with specific information about the therapy, including side effects and who to contact for advice if they develop these at home. This article describes the development and implementation of a digital SACT pre-assessment pathway in a large university hospital during the COVID-19 pandemic, which aimed to deliver information to groups of patients remotely. The article explores the challenges to implementation and discusses some of the findings of a patient feedback survey, which suggest that the digital SACT pre-assessment sessions have been successful overall.
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Background cancer patients are at higher risk of COVID-19 infection and more likely to have higher morbidity and mortality than the general population, While cancer it self is still the main cause of death in children around the world, In countries with limited health facilities, that might cause delayed of seeking treatment, cancer death rate in children could reach 90%, this condition would become bigger in the pandemic condition expecially in hospital that appointed as a referral hospital for COVID-19 but also tertiary hospital for hematology and oncology cases. The aim of the study was to describe is there any differences mortality profile of pediatric oncology patient before and during COVID-19 pandemic. Method : we collected data pediatric oncology patient aged 1 to 18 years that admitted to Hasan Sadikin General Hospital from Hospital Information Systems, IP-CAR, and Waiting List of Oncology Ward Hospital Admission, data conducted to differentiate between Admission Rate, New case Diagnosis and abandonment rate before and during COVID-19 pandemic. Mortality data and what might caused it also collected after audited by experts from Hasan Sadikin General Hospital. Results There were 87 death cases from January to Desember 2021 when pandemi has already happened, Acute lymphoblastic leukemia still the main oncology diagnosis for those cases (33%), most of the death cases was caused by septic Shock ((24%), the second leading caused was covid 19 (8%). We also found in our research there was a significantly increased rate of treatment abandonment from 1.1% before to 17% during COVID-19 pandemic. This may pose risk for the patients involved, not only cause treatment failure, increased toxicity or complications. Conclusion Pandemic COVID-19 increased abandonment rate that could impact the general condition of oncology patient, that might indirectly related to mortality rate. While infection as the leading causes of death before and after pandemic remain the same but the distinction was the COVID-19 as a second most caused of death. Optimal efforts should be made to avoid abandonment and prevent the occurrence of infection
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Background/Aim: Multidisciplinary team meetings have been an integral part of comprehensive cancer services in the UK for over 20 years. The COVID-19 pandemic led to the adoption of virtual platforms to allow these meetings to continue with minimal in-person contact. This study assessed multidisciplinary team members' perspectives regarding the efficacy of the virtual platform, with the view of continuing this mode of delivery in the post-pandemic world. Methods: A two-phased survey study was conducted among all members of the cancer multidisciplinary team in one UK hospital. Respondents completed a four-part questionnaire 6 months (n=108) and 1 year (n=120) after the implementation of the virtual platform in March 2020 to determine their perceptions of its effectiveness and safety. Results: There was a statistically significant (P<0.05) improvement between the 6-month and 1-year survey responses in terms of overall satisfaction with the virtual platform, ease of use and efficiency of collective decision making using the virtual format. After 1 year, 80.5% of respondents preferred either continuing to use the virtual platform exclusively or switching to a hybrid model. Conclusions: Staff experiences of using a virtual platform for cancer multidisciplinary team meetings may improve over time, with many respondents preferring this mode of delivery. Virtual meetings can provide greater flexibility and allow wider participation, potentially including specialists from across the globe.
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An introduction is presented to a series of articles within the issue focused on the importance of good communication skills and compassion to providing nursing care for cancer patients.
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Happy New Year to you all. In this month's issue, readers will notice a theme: survival and recovery. These words are frequently used, not only because more people with cancer are surviving the disease than ever before, but also because of the complex challenges involved with helping people live well after successful treatment.
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INTRODUCTION: During the COVID-19 pandemic, Lombardy (Northern Italy) Regional Health Council created hubs for cancer care, meant to be SARS-CoV-2-free pathways for cancer patients. The workflow of breast cancer (BC) radiotherapy (RT) in one of the hubs is presented here. METHODS: Candidates to adjuvant RT during the pandemic peak of March-April 2020 were compared to those treated in the same period of 2019, and patient volume, deferral rate, and type of RT were analyzed. Statistics were calculated with χ2 or Fisher exact tests for categorical variables, and the Wilcoxon rank test for continuous variables. RESULTS: In March-April 2020 the BC patient volume increased by 28% compared to the same period in 2019 (scheduled patients: 175 vs. 137) and amid travel restrictions it was kept high (treated patients: 136 vs. 133), mainly due to an influx from across Lombardy. RT schemes basically did not change, being already centered on hypofractionation. The increase of median time (67 vs. 74.5 days in 2019 and 2020, respectively) to the commencement of RT for low-risk patients was clinically negligible yet statistically significant (p = 0.03), and in line with the pertinent recommendations. No significant difference was found in the time interval between treatments and RT for high-risk patients. Concomitant chemoradiotherapy was avoided throughout the pandemic peak. Twenty-one women (13.6%) delayed either computed tomography simulation or RT commencement mainly because of COVID-19-related concerns and mobility restrictions. CONCLUSION: The workload for BC was high during the pandemic peak. Hubs allowed the continuation of oncologic treatments, while mitigating the strain on frontline COVID-19 hospitals.
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Coronavirus disease 2019 (COVID-19) is expected to significantly affect cancer patients due to adverse outcomes with COVID-19 and disruptions in cancer care. Another important point is the stress and anxiety burden of COVID-19, which could affect quality of life. Patient education is vital due to the vulnerability of the topic to disinformation. To determine the areas needing improvements in patient education, and coping with stress, the burden of the problem should be pictured. From this point, we aimed to assess the perspectives and fears of cancer patients about COVID-19 with resources of COVID-19 knowledge with a questionnaire. A total of 250 adult cancer patients applied to the outpatient chemotherapy unit of Hacettepe University Cancer Center between May 27, 2020, and June 9, 2020, invited to answer a questionnaire of 13 multiple-choice questions with a return rate of 78% (195/250). Most patients acquired their knowledge about COVID-19 from television (91.9%). Social media were the second most common source of knowledge (43.8%) with a predilection in younger patients, nonsmokers, targeted therapy- or immunotherapy-treated patients, and breast cancer patients (>65 vs. <65 years of age, p = 0.057; nonsmoker vs. ever-smoker, p = 0.036; targeted therapy and immunotherapy vs. chemotherapy, p = 0.004; breast cancer vs. other cancers, p = 0.019). The percentage of patients seeing the information about COVID-19 as adequate (38.9%) or inadequate (35.1%) was similar. More than 90% of the patients had a moderate to severe degree of COVID-19 fear. In addition, 27.6% of patients had false knowledge of glove using as a protective measure for COVID-19. More than half of the patients had another wrong knowledge as the need for the supplements for COVID-19 protection. A significant percentage of patients (84.7%) expected some level of disruption in oncological care with the expectation of a moderate-to-severe disruption was more common in the advanced-stage patients (p = 0.026). In our experience, most cancer patients had a significant degree of fear about both infecting COVID-19 and the disruption of cancer care by COVID-19. A significant amount of our patients had wrong information about the protection necessities, which denotes the need for better patient education about COVID-19.