Concerns related to the interactions between COVID-19 vaccination and cancer/cancer treatment were barriers to complete primary vaccination series among Chinese cancer patients: A multicentre cross-sectional survey.

COVID-19 vaccination is effective for cancer patients without safety concerns. However, COVID-19 vaccination hesitancy is common among cancer patients. This study investigated factors affecting primary COVID-19 vaccination series completion rate among cancer patients in China. A multicentre cross-sectional study was conducted in four Chinese cities in different geographic regions between May and June 2022. A total of 893 cancer inpatients provided written informed consent and completed the study. Logistic regression models were fitted. Among the participants, 58.8% completed the primary COVID-19 vaccination series. After adjusting for background characteristics, concerns about interactions between COVID-19 vaccination and cancers/cancer treatment (adjusted odds ratios [AOR]: 0.97, 95%CI: 0.94, 0.99) were associated with lower completion of primary vaccination series. In addition, perceived higher risk of COVID-19 infection comparing to people without cancers (AOR: 0.46, 95%CI: 0.24, 0.88), perceived a high chance of having severe consequences of COVID-19 infection (AOR: 0.68, 95%CI: 0.51, 0.91) were also associated with lower completion rate. Being suggested by significant others (AOR: 1.32, 95%CI: 1.23, 1.41) and perceived higher self-efficacy to receive COVID-19 vaccination (AOR: 1.48, 95%CI: 1.31, 1.67) were positively associated with the dependent variable. Completion rate of primary COVID-19 vaccination series was low among Chinese cancer patients. Given the large population size and their vulnerability, this group urgently needs to increase COVID-19 vaccination coverage. Removing concerns about interactions between COVID-19 vaccination and cancers, using fear appeal approach, involving significant others, and facilitating patients to make a plan to receive COVID-19 vaccination might be useful strategies.

Reducedhumoral response against variants of concern in childhood solid cancer patients compared to adult patients and healthy children after SARS-CoV-2 vaccination.

Introduction: Although there is extended research on the response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in adult cancer patients (ACP), the immunogenicity to the variants of concern (VOCs) in childhood cancer patients (CCP) and safety profiles are now little known. Methods: A prospective, multi-center cohort study was performed by recruiting children with a solid cancer diagnosis and childhood healthy control (CHC) to receive standard two-dose SARS-CoV-2 vaccines. An independent ACP group was included to match CCP in treatment history. Humoral response to six variants was performed and adverse events were followed up 3 months after vaccination. Responses to variants were compared with ACP and CHC by means of propensity score-matched (PSM) analysis. Results: The analysis included 111 CCP (27.2%, median age of 8, quartile 5.5-15 years), 134 CHC (32.8%), and 163 ACP (40.0%), for a total 408 patients. Pathology included carcinoma, neural tumors, sarcoma, and germ cell tumors. Median chemotherapy time was 7 (quartile, 5-11) months. In PSM sample pairs, the humoral response of CCP against variants was significantly decreased, and serology titers (281.8 ± 315.5 U/ml) were reduced, as compared to ACP (p< 0.01 for the rate of neutralization rate against each variant) and CHC (p< 0.01 for the rate of neutralization against each variant) groups. Chemotherapy time and age (Pearson r ≥ 0.8 for all variants) were associated with the humoral response against VOCs of the CHC group. In the CCP group, less than grade II adverse events were observed, including 32 patients with local reactions, and 29 patients had systemic adverse events, including fever (n = 9), rash (n = 20), headache (n = 3), fatigue (n = 11), and myalgia (n = 15). All reactions were well-managed medically. Conclusions: The humoral response against VOCs after the CoronaVac vaccination in CCP was moderately impaired although the vaccine was safe. Age and chemotherapy time seem to be the primary reason for poor response and low serology levels.

Mental Wellbeing among Children with Cancer during COVID-19 Pandemic in Indonesia: A Cross-sectional Study

Introduction Coronavirus disease 2019 (COVID-19) has affected both physical and mental aspect of people worldwide, especially the high-risk group such as pediatric cancer patients. Children with cancer were considered both clinically and mentally vulnerable during this pandemic. They were also affected by the self- isolation, quarantine, and social distancing policy taken as a respond to public threat. Objectives To evaluate the impact of social distancing and health protocol during COVID-19 on the mental health profile of children with cancer in Indonesia. Methods A cross-sectional study evaluating the mental health of children with cancer during COVID-19 pandemic was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September 2020. An online questionnaire was used to collect demographics of parents and children, children's Strength and Difficulties Questionnaire ( SDQ) score, and parents' Self-Reporting Questionnaire (SRQ). SDQ score consists of five subscales, including the emotional symptoms, conduct problems, hyperactivity, peer relationships problems and prosocial behavior. Cancer types were grouped into retinoblastoma, nonretinoblastoma (other solid tumors), and leukemia. Results There were 156 valid responses, consisting of 42 patients with retinoblastoma, 34 patients with nonretinoblastoma ( other solid tumors), and 80 patients with leukemia. Pandemic-related lifestyle changes did not significantly impact emotional or behavioral problems. Children with normal total SDQ (odds ratio [OR]: 473, p = 0.001) and emotional scores (OR: 3.19, p = 0.07) had parents with normal SRQ scores (<6). Leukemia patients with shorter diagnosis period had worse hyperactivity score ( p = 0.01). On the contrary, leukemia inpatients had better prosocial scores than outpatients (p = 0.03). More bilateral retinoblastoma patients (p = 0.04) with longer duration of cancer diagnosis (p = 0.03) faced peer problems.

Impact of Cancerous Pulmonary Involvement on Outcomes in COVID-19 Patients.

BACKGROUND: SARS-CoV2 is a highly contagious virus causing COVID-19 (Corona virus disease 2019), which has resulted in more than 6 million deaths worldwide as of June 2022. Mortality in COVID-19 has mainly been attributed to respiratory failure. Previous studies showed that the presence of cancer did not adversely affect the outcome of COVID-19. However, in our clinical practice, it was noted that in cancer patients with pulmonary involvement, COVID-19-related morbidity, and morbidity were high. Therefore, this study was designed to assess the impact of cancerous pulmonary involvement on COVID-19 outcomes and to compare clinical outcomes of COVID-19 in cancer and non-cancer population, with further discretion between cancers with and without pulmonary involvement. METHODS: We performed a retrospective study from April 2020 until June 2020 with a sample size of 117 patients with a confirmed diagnosis of SARS-CoV2 on nasal swab PCR. Data was extracted from HIS (Hospital Information System). Hospitalization, supplemental oxygen, ventilatory support, and death were compared between non-cancer and cancer patients with a particular focus on pulmonary involvement. RESULTS: Admissions, supplemental oxygen requirement, and mortality were significantly higher in cancer patients with pulmonary involvement (63.3%, 36.4%, and 45%, respectively) compared to cancer patients without pulmonary involvement (22.1%, 14.7%, and 8.8% respectively) (p-values: 0.00003, 0.003, and 0.00003 respectively). In the non-cancer group, there was no mortality, only 2% required admission, and none needed supplemental oxygen. CONCLUSION: We conclude that the cancer patient with pulmonary involvement was significantly at higher risk of complications and death from COVID when compared with the non-pulmonary cancer group and the general population.

Impact of the COVID-19 pandemic on the main indicators of cancer service.

Objective. To evaluate the impact of the COVID-19 pandemic on the course of cancers and to estimate the achievement of the main indicators of a cancer service in case of the Nizhny Novgorod Region. Subjects and methods. In the Nizhny Novgorod Region, data on the detection and registration of COVID-19 in patients with malignant neoplasms (MNs) were analyzed on the basis of data of the information and analytical system (IAS) <<Cancer Registry 6S>>. Results. As of December 31, 2020, there were a total of 99.477 cancer patients, including 1.470 confirmed COVID-19 cases, accounting for 1.5% of all the registered patients with MNs. Among the cancer patients with COVID-19, the females were 1.6 times more likely to be ill than the males. Analyzing the age structure of cancer patients with COVID-19 revealed that the older ablebodied persons (61.6%) were more likely to get sick than younger ones (38.0%). Cancer concurrent with COVID-19 led to a severe course of COVID-19 in 15.9% of cases and resulted in death of cancer patients in 17.8% of cases. The older able-bodied patients were more likely to die, which accounted for 89.3% of the total number of died cancer patients with COVID-19. In the structure of the causes of death of cancer patients with COVID-19, the latter comes first (51.3%), MNs ranked next (33.0%), circulatory system diseases occupied the third place (13.0%), and other causes ranked fourth (2.7%). According to the 2020 results, the Nizhny Novgorod Region during the COVID-19 pandemic displayed a 0.4% increase in the mortality rate from neoplasms, including that from malignant ones, a 5.0% decrease in the proportion of MNs detected at Stages 1-2, a 22.0% reduction in active detection rates, and a 21.0% rise in neglect rates. Conclusion. Thus, the COVID-19 pandemic negatively affects the course of cancers, by aggravating the condition of cancer patients, which results in a fatal outcome in 17.8% of cases.Copyright © 2022, Media Sphera Publishing Group. All rights reserved.

The Effectiveness of Bevacizumab in COVID-19 Pneumonia Among Critically Ill Patients

Background:Bevacizumab, an antiangiogenic drug, is being evaluated for the management of novel coronavirus disease (COVID-19) pneumonia among critically ill patients. The objective of this study was to assess the effectiveness of bevacizumab in severe COVID-19 pneumonia. Methods:This was a retrospective, observational study performed in 111 patients diagnosed with COVID-19 pneumonia. Bevacizumab was administered intravenously at 7.5 mg/kg along with standard care in a non-randomly selected subset of patients (n = 29) with evidence of acute respiratory distress syndrome (ARDS) within 72 hours of worsening of oxygenation. The primary outcome measure was intensive care unit (ICU)-related mortality. Results:Bevacizumab was administered for a median of 9.4 (4-24) days from the onset of symptoms and 2.2 (1-3) days from the day of ICU admission. Bevacizumab-treated patients showed a statistically significant improvement in PF ratio and reduction in radiological severity score. In the bevacizumab group, 13 (44.8%) of 29 patients died in ICU, and in the standard-of-care group, 37 (45.1%) of 82 patients died. The difference in clinical status assessed using the World Health Organization 7-category Ordinary Scale at 28 days between the bevacizumab group and the standard-of-care group was not statistically significant (odds ratio 1.02, 95% confidence interval 0.44-2.4, P = .94). Conclusion:Bevacizumab plus standard care was not superior to standard care alone in reducing mortality and improving clinical outcomes at day 28.

Stakeholders' Perceptions of Home-based Palliative Care for Cancer Patients During the COVID-19 Pandemic: A Qualitative Study

Background: During the COVID-19 pandemic, care for cancer patients may be disrupted for several reasons, leading to disease progression. Home-Based palliative care, if properly managed, can provide easy and safe access to care services for these patients. This study aimed to explore stakeholders' perceptions of home-based palliative care for cancer patients during the pandemic. Methods: This qualitative study was conducted using conventional content analysis in Tehran, Iran, in 2021. By purposeful sampling, 19 participants, including cancer patients receiving home-based care services from the Iranian Cancer Control Center (MACSA) and their families, as well as the homecare providers, were recruited. The study data were generated by conducting 19 semi-structured interviews and a focus group session and analyzed based on the method proposed by Lundman and Graneheim. Results: Qualitative analysis of the data revealed 5 main categories: "need for remote services”, "disease transmission reduction”, "management requirements”, "burnout”, and "reducing hospital workload.” Conclusion: The use of telemedicine, the existence of call centers, and the designing of appropriate guidelines, along with the help of qualified personnel, prevent the transmission of COVID-19 to cancer patients in-home palliative care and lead to the provision of comprehensive care to these patients. This approach to care helps avert staff burnout and reduces the number of occupied beds in hospitals. © The Author(s), 2023.

Antigen rapid diagnostic test monitoring for SARS-CoV-2 in asymptomatic and fully vaccinated cancer patients: Is it cost-effective?

BACKGROUND: Routine testing for cancer patients not presenting COVID-19-related symptoms and fully vaccinated for SARS-CoV-2 prior to cancer treatment is controversial. METHODS: In this retrospective study we evaluated whether antigen-rapid-diagnostic-test (Ag-RDT) monitoring for SARS-CoV-2 in a large cohort of consecutive asymptomatic (absence of SARS-CoV-2-related symptoms such as fever, cough, sore throat or nasal congestion) and fully vaccinated cancer patients enrolled in a short period during cancer treatment has an impact on the therapeutic path of cancer patients. RESULTS: From December 27, 2021, to February 11, 2022, 2439 cancer patients were screened through Ag-RDT for SARS-CoV-2 before entering the hospital for systemic treatment. Fifty-three patients (2.17%) tested positive, of whom 7 (13.2%) subsequently developed COVID-related symptoms, generally mild. Cancer treatment was discontinued, as a precaution, in 49 patients (92.5%) due to the test positivity. CONCLUSION: SARS-CoV-2 screening in asymptomatic and fully vaccinated cancer patients during systemic treatment appeared to be not cost-effective: the low rate of SARS-CoV-2 positive patients and the low percentage of overt associated infection do not seem proportional to the direct costs (nursing work for swabs, costs of materials and patient monitoring) and indirect costs (dedicated rooms, extension of waiting times for patients and oncologists in delivering therapy as well as its discontinuation in the positive ones). It can, on the other hand, be detrimental when systemic cancer treatment is suspended as a precaution. Given the small number of patients testing positive and the rapid and favorable trend of the infection, it is recommended to always consider continuing systemic oncological treatment, especially when this impacts patient survival as in the adjuvant or neoadjuvant setting.

The Effect of CoViD-19 Pandemic on the Hospitalization of a Department of Oncology of an Italian Hospital

In the last years, the entire world has been affected by the SARS-COV-2 pandemic, that represents the etiologic agent of Coronavirus disease 2019 (CoViD-19), which degenerated into a global pandemic in 2020. CoViD-19 has also had a strong impact on cancer patients. Our analysis has been performed at the Department of Oncology of the AORN "Cardarelli” in Naples, collecting data from all patients who had access in 2019–2020. We aim to understand how CoViD-19 affected hospital admissions. The statistical analysis showed that between 2019 and 2020 there was an increase in urgent hospitalizations and a decrease in scheduled hospitalization, probably to decrease the risk of infection, particularly in this category of susceptible patients. Indeed, as recommended by the European Society of Medical Oncology, during the pandemic, it was necessary to reorganize healthcare activities, ensure adequate care for patients infected with CoViD-19. Therefore telemedicine services were implemented and clinic visits were reduced. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Safety of Extending Implanted Vascular Access Device Maintenance Flush Frequency

The study reviewed current standards of care for IVAD flush maintenance frequency, examined the characteristics of blood from IVADs by aspirating and observing contents prior to flushing when maintenance care is delayed beyond four weeks, and identified whether more research is required to determine optimal IVAD maintenance flush frequency methods: KEYWORDS port maintenance;guideline variations;flushing;oncology;standards of care;biofilm more than two billion intravascular devices, which are widely used in critical patients and patients with cancer, are inserted globally each year (He et al., 2019). Project Procedures A literature review included a search from January 2016 through April 2022 and encompassed current INS, Oncology Nursing Society, National Comprehensive Cancer Network, and Centers for Disease Control and Prevention guidelines and recommendations for practice, and manufacturer guidance. [...]once the Huber needle was inserted, aspiration was attempted to observe for a brisk blood return.

COVID-19 Pandemic: Care for Indian Cancer Patients

Background: Current COVID-19 pandemic poses a significant health crisis caused by SARSCoV-2 coronavirus around the globe, including India. Patients with cancer, especially those who underwent treatment, may have a higher risk of getting sicker with COVID-19 disease. Medical care facilities aim to provide proper treatment to cancer patients while minimizing the possibilities of COVID-19 transmission. Objective(s): The perspective article summarizes practical recommendations and perspective answers to all difficulties so that we can better treat and care for cancer patients. Method(s): The literature search includes recent publications and guidelines/recommendations of the central institutes of India. Result(s): Social distancing, guidelines, rescheduling the treatment of stable patients, nutritional care and telecommunication are some of the containment measures that can be applied in clinical practice in cancer management in COVID-19 pandemic. Conclusion(s): With these interventions discussed above, we can reduce the impact of this pandemic and deliver the best care to cancer patients.Copyright © 2021 Bentham Science Publishers.

Safe provision of elective endocrine surgery operations amid the COVID-19 crisis

IntroductionThe aim of this study was to determine the impact of the COVID-19 pandemic on the provision of clinical services (perioperative clinical outcomes and productivity) of the department of endocrine and general surgery at a teaching hospital in the UK.MethodsA retrospective chart review was conducted of all patients who were operated in our department during two periods: 1 April to 31 October 2019 (pre-COVID-19 period) and 1 April to 31 October 2020 (COVID-19 period). The perioperative clinical outcomes and productivity of our department for the two time periods were compared.ResultsIn the pre-COVID-19 period, 130 operations were carried out, whereas in the COVID-19 group, this reduced to 89. The baseline characteristics between the two groups did not significantly differ. Parathyroid operations decreased significantly by 68% between the two study periods. Overall, during the COVID-19 phase, the department maintained 68% of its operating workload compared with the respective 2019 time period. The clinical outcomes for the patients who had a thyroid/parathyroid/adrenal operation were not statistically different for the two study periods. There were no COVID-19 related perioperative complications for any of the operated patients and no patient tested positive for COVID-19 while an inpatient. For the COVID-19 group, the department maintained 67% of its outpatient appointments for endocrine surgery and 26% for general surgery pathologies.ConclusionsThe COVID-19 pandemic significantly reduced the clinical activity of our department. However, it is possible to continue providing clinical services for urgent/cancer cases with the appropriate safety measures in place.

LIVE MUSIC AT THE ONCOLOGY BEDSIDE

Psychosocial Dimensions of Care Cancer diagnosis and treatment is one of the most complex and traumatizing life events. Cancer impedes physical, social, and emotional well-being and often generates a range of emotions including anxiety, depression, fear, sadness, anger, guilt and even shame. Studies have shown that during and after treatment patients suffer from elevated emotional distress and physical and psychological disorders. These undesirable side effects from cancer related treatment and therapy amplifies the overall stress. According to the American Music Therapy Association Music Therapy uses music to address physical, emotional, cognitive, and social needs of patients. The purpose of his project was to use music at the bedside to increase the overall quality of life and soothe the undesirable emotions associated with cancer. On our inpatient Blood and Marrow transplant unit, music at the bedside is designed to promote wellness, relaxation and to provide a sense of normalcy and a distraction with individualized, interactive and personal experience through live, virtual musical performances. In 2019 live music began with a trained artist from the Eastman Performing Art Medicine performing in-person on the unit. Schedule, budget, patient population, infection control protocols and expectations were discussed, reviewed and established. Despite the COVID-19 Pandemic, music therapy continued virtually through the use of iPads donated by a former patient with funding and provided through a grant. Informal patient and staff feedback has been positive. Qualitatively, many patients have expressed the music therapy sessions as uplifting, amazing, honorable, and unforgettable. And staff have expressed the joy of seeing patients smile from their interaction with the musician. The program has since been adopted on two other units and early anecdotal evidence show is it positive. Music at the bedside is a non-pharmacological intervention for our cancer patients. The power of music is an unrealized effective and supportive tool that affects and benefits patients emotionally, physically and spiritually. Through enhanced relaxation and interactive listening, our patients are able to experience and have shared a sense of joy, uplifting and improved mood, decreased anxiety and emotional distress and a feeling that aids them to cope with loneliness and fear.

BENEFITS AND FEASIBILITY OF A DEDICATED HEAD AND NECK CANCER PROGRAM AT A COMMUNITY CANCER CENTER

With patients seeking care closer to home, community cancer centers must meet the demands of caring for complex cancer patients with limited resources. A need was identified within the Radiation Oncology Center at our Community Cancer Center to provide comprehensive care for Head and Neck Cancer patients. This initiative required buy-in and devoted time from Hospital teams (Registered Dietitian (RD), Inpatient Speech Pathologists (SP)) for implementation. Full multidisciplinary support services were implemented in September 2019. A retrospective review of Head and Neck patients referred to Radiation Oncology, Stage 1 & 2, receiving concurrent chemoradiation from March 2019 to August 2021 was performed to evaluate patient outcomes prior to and after implementation (N=18). Processes implemented included dedicated education sessions provided by the Radiation Oncology RN at time of consultation regarding the importance and benefit of SP and RD services during their cancer treatment. Referrals were then placed to each specialty. Patient education continued at each weekly Radiation visit to aid in overall compliance. Multidisciplinary communication took place via EMR communication, as well as during newly initiated Head and Neck Chart Rounds. Of the 18 patients, four patients were treated prior to implementation (January to August 2019). 3 of the 4 (75%) patients required a Radiation treatment break related to unmet nutrition needs, zero (0%) patients met with a RD and 2 (50%) patients underwent SP Evaluation. Two (50%) patients required PEG tube placement. Nine patients were treated after initiative implementation. Zero patients required a Radiation treatment break related to unmet nutrition needs, 4 (44%) patients met with a RD and 8 patients (89%) underwent SP Evaluation. Three (33%) patients required PEG tube placement. Not only did we see a significant decrease in treatment breaks due to unmet nutritional needs, but with the incorporation of this initiative, our team was able to streamline ambulatory PEG tube placement to avoid unnecessary hospitalizations, with 50% admitted for PEG placement prior to initiative and 0% requiring a hospital stay following implementation. In conclusion, the implementation of a dedicated head and neck program is feasible at a community hospital when appropriate resources are available to ensure positive patient outcomes and preserve hospital resources. Barriers identified during our initiative included availability of hospital team members (RD services during COVID-19 peaks) and patients opting to forgo additional visits with multidisciplinary team members.

Hesitancy to Receive the Booster Doses of COVID-19 Vaccine Among Cancer Patients in China: A Multicenter Cross-Sectional Survey - Four PLADs, China, 2022.

What is already known about this topic?: Cancer patients are more vulnerable and have higher mortality rates from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population; however, coverage for booster doses of the coronavirus disease 2019 (COVID-19) vaccine was low among cancer patients in China. What is added by this report?: Overall, 32.0% and 56.4% of cancer patients from four Provincial Level Administrative Divisions (PLADs) expressed hesitancy toward the first and second booster doses, respectively. Factors negatively associated with hesitancy to receive booster doses included positive attitudes, perceived support, and higher exposure to COVID-19 vaccination information. Conversely, postvaccination fatigue was positively associated with vaccine hesitancy. What are the implications for public health practice?: Improved COVID-19 vaccination coverage is needed to promote health for cancer patients.

"I Had to Do It All Alone": Hispanic Perspectives on Navigating Breast Cancer Treatment.

Cancer patients are at a high risk for COVID infection and its corresponding impacts on treatment delay, social isolation, and psychological distress. Hispanic breast cancer patients may be more vulnerable due to a lack of resources and language barriers, widening disparities in cancer care. This qualitative study explored the challenges and obstacles to cancer care during the COVID pandemic among 27 Hispanic females from a United States-Mexico border region. Data were collected via individual in-depth interviews and analyzed using thematic analysis. The majority of the participants were interviewed in Spanish. More than half (55.6%, n = 15) were diagnosed with breast cancer within the prior year to the interview. One-third of the participants (33.3%, n = 9) reported that COVID somewhat to greatly impacted their cancer care. Study findings revealed potential barriers and challenges for cancer care at multiple levels (e.g., medical, psychosocial, financial level) during the COVID pandemic. Five major themes reported include: (1) delays in testing and access to care; (2) fear of COVID infection; (3) social isolation and reduced social support; (4) challenges in navigating treatments alone; and (5) financial hardships. Our findings highlight the importance for health care practitioners to understand various challenges encountered by underserved Hispanic breast cancer patients due to COVID. Screening for psychological distress and exploring approaches to expand social support to address these challenges are discussed.

Impact of pharmacist-led educational intervention on pneumococcal vaccination rates in cancer patients: a randomized controlled study.

PURPOSE: This study aimed to evaluate clinical pharmacist's contribution to the pneumococcal vaccination rate by providing education to cancer patients in hospital settings. METHODS: This study was conducted in 2 tertiary-care hospitals' medical oncology outpatient clinics. Patients over 18 years of age and diagnosed with cancer for less than 2 years, in remission stage, and have not previously received the pneumococcal vaccine were included. Patients were randomized to intervention and control groups. The intervention group was provided vaccination education and recommended to receive the PCV13 vaccine. The control group received routine care. Patients' knowledge about pneumonia/pneumococcal vaccine, Vaccine Attitude Examination Scale (VAX) score, and vaccination rates were evaluated at baseline and 3 months after the education. RESULTS: A total of 235 patients (intervention: 117, control: 118) were included. The mean age ± SD was 57.86 ± 11.88 years in the control and 60.68 ± 11.18 years in the intervention groups. The numbers of correct answers about pneumonia/pneumococcal vaccine (p = 0.482) and VAX scores (p = 0.244) of the groups were similar at baseline. After the intervention, the median (IQR) number of correct answers in intervention group [10(3)] was higher than control group [8(4)] (p < 0.001). After the education, the total VAX score (mean ± SD) was less in intervention group (33.09 ± 7.018) than the control group (36.07 ± 6.548) (p = 0.007). Three months after the education, 20.2% of the patients in the intervention and 6.1% in the control groups were vaccinated with pneumococcal vaccine (p = 0.003). CONCLUSIONS: The pneumococcal vaccination rate in cancer patients has increased significantly by the education provided by a clinical pharmacist in hospital settings.

Distance Monitoring of Advanced Cancer Patients with Impaired Cardiac and Respiratory Function Assisted at Home: A Study Protocol in Italy.

During the pandemic, telemedicine and telehealth interventions have been leading in maintaining the continuity of care independently of patients' physical location. However, the evidence available about the effectiveness of the telehealth approach for advanced cancer patients with chronic disease is limited. This interventional randomized pilot study aims to evaluate the acceptability of a daily telemonitoring of five vital parameters (heart rate, respiratory rate, blood oxygenation, blood pressure, and body temperature) using a medical device in advanced cancer patients with relevant cardiovascular and respiratory comorbidities assisted at home. The purpose of the current paper is to describe the design of the telemonitoring intervention in a home palliative and supportive care setting with the objective of optimizing the management of patients, improving both their quality of life and psychological status and the caregiver's perceived care burden. This study may improve scientific knowledge regarding the impact of telemonitoring. Moreover, this intervention could foster continuous healthcare delivery and closer communication among the physician, patient and family, enabling the physician to have an updated overview of the clinical trajectory of the disease. Finally, the study may help family caregivers to maintain their habits and professional position and to limit financial consequences.

Impact of COVID-19 pandemic on older cancer patients: Proposed solution by the International Geriatric Radiotherapy Group.

Older cancer patients are disproportionally affected by the Coronavirus 19 (COVID-19) pandemic. A higher rate of death among the elderly and the potential for long-term disability have led to fear of contracting the virus in these patients. This fear can, paradoxically, cause delay in diagnosis and treatment that may lead to a poor outcome that could have been prevented. Thus, physicians should devise a policy that both supports the needs of older patients during cancer treatment, and serves to help them overcome their fear so they seek out to cancer diagnosis and treatment early. A combination of telemedicine and a holistic approach, involving prayers for older cancer patients with a high level of spirituality, may improve vaccination rates as well as quality of life during treatment. Collaboration between health care workers, social workers, faith-based leaders, and cancer survivors may be crucial to achieve this goal. Social media may be an important component, providing a means of sending the positive message to older cancer patients that chronological age is not an impediment to treatment.