Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 114
Filter
Add filters

Document Type
Year range
1.
Nat Rev Clin Oncol ; 18(11): 675, 2021 11.
Article in English | MEDLINE | ID: covidwho-1488032
2.
Oncology (Williston Park) ; 35(1): 26-28, 2021 Jan 11.
Article in English | MEDLINE | ID: covidwho-1485807

ABSTRACT

Against the difficult and trying backdrop of the pandemic, cancer investigators persisted, and for patients with lung cancer, that persistence paid off in spectacular ways. With several new FDA approved treatments, as well as 2 new targetable mutations in non-small cell lung cancer (NSCLC), 2020 was a banner year in the overall lung cancer space. ONCOLOGY® recently sat down with Jennifer W. Carlisle, MD, of Emory University's Winship Cancer Institute, to discuss the many advances made during the last year for patients with lung cancer along with her hopes for further significant milestones in the year to come.


Subject(s)
COVID-19/epidemiology , Lung Neoplasms/drug therapy , Medical Oncology/organization & administration , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/genetics , Humans , Lung Neoplasms/genetics , Precision Medicine , SARS-CoV-2
5.
Cancer Med ; 10(20): 7144-7151, 2021 10.
Article in English | MEDLINE | ID: covidwho-1380370

ABSTRACT

OBJECTIVES: Little is known about the impact of coronavirus disease 2019 (COVID-19) on healthcare professional emotional health in pediatric hematology/oncology. Primary objective was to describe anxiety, depression, positive affect, and perceived stress among pediatric hematology/oncology healthcare professionals following a COVID-19 outbreak. Secondary objectives were to compare these outcomes based on contact with a positive person, and to identify risk factors for worse outcomes. MATERIALS AND METHODS: We included 272 healthcare professionals working with pediatric hematology/oncology patients. We determined whether respondents had direct or indirect contact with a COVID-19-positive individual and then measured outcomes using the Patient-Reported Outcomes Measurement Information System (PROMIS) depression, anxiety, and positive affect measures, and the Perceived Stress Scale. RESULTS: Among eligible respondents, 205 agreed to participate (response rate 75%). Sixty-nine (33.7%) had contact with a COVID-19-positive person. PROMIS anxiety, depression, and positive affect scores were similar to the general United States population. Those who had contact with a COVID-19-positive individual did not have significantly different outcomes. In multiple regression, non-physicians had significantly increased anxiety (nurses: p = 0.013), depression (nurses: p = 0.002, pharmacists: p = 0.038, and other profession: p = 0.021), and perceived stress (nurses: p = 0.002 and other profession: p = 0.011) when compared to physicians. CONCLUSIONS: Pediatric hematology/oncology healthcare professionals had similar levels of anxiety, depression, and positive affect as the general population. Contact with a COVID-19-positive individual was not significantly associated with outcomes. Non-physician healthcare professionals had more anxiety, depression, and perceived stress when compared to physicians. These findings may help to develop programs to support healthcare professional resilience.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Hematology/organization & administration , Medical Oncology/organization & administration , Occupational Stress , Pediatrics/organization & administration , Anxiety , Child , Depression , Female , Health Personnel/psychology , Humans , Male , Mental Health , Nurses , Pharmacists , Physicians , Regression Analysis , Resilience, Psychological , Risk Factors , Stress, Psychological , Surveys and Questionnaires , Treatment Outcome
6.
J Cancer Res Ther ; 17(2): 547-550, 2021.
Article in English | MEDLINE | ID: covidwho-1268381

ABSTRACT

Purpose: Health emergency due to COVID-19 started in Uruguay on March 13, 2020; our mastology unit tried to ensure adequate oncological care, and protect patients from the virus infection and complications. Objective: To assess the health care activities in the "peak" of the pandemic during 3 months. Materials and Methods: we collected data from the electronic health record. Results: There were a total of 293 medical appointments from 131 patients (221 face-to-face), that decreased by 16.7% compared to the same period in 2019 (352 appointments). The medical appointments were scheduled to evaluate the continuity of systemic treatment or modifications (95 patients; 72.5%), follow-up (17; 12.9%), first-time consultation (12; 9.1%), and assess paraclinical studies (7; 5.3%). The patients were on hormone therapy (81 patients; 74%), chemotherapy (CT) (21; 19%), and anti-HER2 therapies (9; 8%). New twenty treatments were initiated. Of the 14 patients that were on adjuvant/neoadjuvant CT, 9 (64.3%) continued with the same regimen with the addition of prophylactic granulocyte-colony-stimulating factors (G-CSF), and 5 (35.7%), who were receiving weekly paclitaxel, continued the treatment with no changes. Of the seven patients that were on palliative CT, 2 (28.5%) continued the treatment with the addition of G-CSF, 3 (42.8%) continued with weekly capecitabine or paclitaxel with no treatment changes, and 2 (28.5%) changed their treatment regimen (a less myelosuppressive regimen was selected for one and due to progression of the disease in the other patient). The ninety patients who were receiving adjuvant, neoadjuvant, or palliative criteria hormone therapy and/or anti-HER2 therapies, continued the treatment with no changes. Conclusions: The evidence suggests that, although medical appointments decreased by approximately 17%, we could maintain healthcare activities, continued most of the treatments while the most modified was CT with G-CSF to avoid myelosuppression.


Subject(s)
Breast Neoplasms/drug therapy , COVID-19/epidemiology , Continuity of Patient Care/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Medical Oncology/statistics & numerical data , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bone Marrow/drug effects , Breast Neoplasms/complications , Breast Neoplasms/diagnosis , Breast Neoplasms/immunology , COVID-19/immunology , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control/standards , Continuity of Patient Care/organization & administration , Delivery of Health Care/organization & administration , Delivery of Health Care/standards , Electronic Health Records/statistics & numerical data , Female , Granulocyte Colony-Stimulating Factor/administration & dosage , Hematopoiesis/drug effects , Hematopoiesis/immunology , Humans , Medical Oncology/organization & administration , Medical Oncology/standards , Middle Aged , Pandemics/prevention & control , Referral and Consultation/standards , Referral and Consultation/statistics & numerical data , Retrospective Studies , Telemedicine/organization & administration , Telemedicine/standards , Telemedicine/statistics & numerical data , Triage/organization & administration , Triage/standards , Uruguay/epidemiology
7.
Am Soc Clin Oncol Educ Book ; 41: e339-e353, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1249568

ABSTRACT

Optimizing the well-being of the oncology clinician has never been more important. Well-being is a critical priority for the cancer organization because burnout adversely impacts the quality of care, patient satisfaction, the workforce, and overall practice success. To date, 45% of U.S. ASCO member medical oncologists report experiencing burnout symptoms of emotional exhaustion and depersonalization. As the COVID-19 pandemic remains widespread with periods of outbreaks, recovery, and response with substantial personal and professional consequences for the clinician, it is imperative that the oncologist, team, and organization gain direct access to resources addressing burnout. In response, the Clinician Well-Being Task Force was created to improve the quality, safety, and value of cancer care by enhancing oncology clinician well-being and practice sustainability. Well-being is an integrative concept that characterizes quality of life and encompasses an individual's work- and personal health-related environmental, organizational, and psychosocial factors. These resources can be useful for the cancer organization to develop a well-being blueprint: a detailed start plan with recognized strategies and interventions targeting all oncology stakeholders to support a culture of community in oncology.


Subject(s)
Burnout, Professional/psychology , Medical Oncology/methods , Neoplasms/therapy , Oncologists/psychology , Stress, Psychological/prevention & control , Burnout, Psychological/prevention & control , Burnout, Psychological/psychology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , Humans , Internet , Job Satisfaction , Medical Oncology/organization & administration , Neoplasms/diagnosis , Pandemics , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , Social Support , United States
8.
Am Soc Clin Oncol Educ Book ; 41: e13-e19, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1249567

ABSTRACT

The COVID-19 pandemic and the simultaneous increased focus on structural racism and racial/ethnic disparities across the United States have shed light on glaring inequities in U.S. health care, both in oncology and more generally. In this article, we describe how, through the lens of fundamental ethical principles, an ethical imperative exists for the oncology community to overcome these inequities in cancer care, research, and the oncology workforce. We first explain why this is an ethical imperative, centering the discussion on lessons learned during 2020. We continue by describing ongoing equity-focused efforts by ASCO and other related professional medical organizations. We end with a call to action-all members of the oncology community have an ethical responsibility to take steps to address inequities in their clinical and academic work-and with guidance to practicing oncologists looking to optimize equity in their research and clinical practice.


Subject(s)
Health Equity/statistics & numerical data , Health Status Disparities , Healthcare Disparities/statistics & numerical data , Medical Oncology/methods , Neoplasms/therapy , Racism/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , Health Equity/ethics , Healthcare Disparities/ethics , Humans , Medical Oncology/ethics , Medical Oncology/organization & administration , Neoplasms/diagnosis , Pandemics , Public Health/ethics , Public Health/methods , Public Health/statistics & numerical data , Racism/ethics , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , United States
9.
Gynecol Oncol ; 162(1): 4-11, 2021 07.
Article in English | MEDLINE | ID: covidwho-1225432

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has quickly transformed healthcare systems with expansion of telemedicine. The past year has highlighted risks to immunosuppressed cancer patients and shown the need for health equity among vulnerable groups. In this study, we describe the utilization of virtual visits by patients with gynecologic malignancies and assess their social vulnerability. METHODS: Virtual visit data of 270 gynecology oncology patients at a single institution from March 1, 2020 to August 31, 2020 was obtained by querying a cohort discovery tool. Through geocoding, the CDC Social Vulnerability Index (SVI) was utilized to assign social vulnerability indices to each patient and the results were analyzed for trends and statistical significance. RESULTS: African American patients were the most vulnerable with a median SVI of 0.71, Asian 0.60, Hispanic 0.41, and Caucasian 0.21. Eighty-seven percent of patients in this study were Caucasian, 8.9% African American, 3.3% Hispanic, and 1.1% Asian, which is comparable to the baseline institutional gynecologic cancer population. The mean census tract SVI variable when comparing patients to all census tracts in the United States was 0.31 (range 0.00 least vulnerable to 0.98 most vulnerable). CONCLUSIONS: Virtual visits were utilized by patients of all ages and gynecologic cancer types. African Americans were the most socially vulnerable patients of the cohort. Telemedicine is a useful platform for cancer care across the social vulnerability spectrum during the pandemic and beyond. To ensure continued access, further research and outreach efforts are needed.


Subject(s)
COVID-19/prevention & control , Genital Neoplasms, Female/therapy , Patient Acceptance of Health Care/statistics & numerical data , Telemedicine/statistics & numerical data , Vulnerable Populations/statistics & numerical data , African Americans/statistics & numerical data , Aged , Asian Americans/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Cohort Studies , Communicable Disease Control/standards , Female , Genital Neoplasms, Female/diagnosis , Gynecology/organization & administration , Gynecology/standards , Gynecology/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Humans , Medical Oncology/organization & administration , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Middle Aged , Pandemics/prevention & control , Socioeconomic Factors , Telemedicine/organization & administration , Telemedicine/standards , United States/epidemiology , /statistics & numerical data
10.
Gynecol Oncol ; 162(1): 12-17, 2021 07.
Article in English | MEDLINE | ID: covidwho-1213578

ABSTRACT

OBJECTIVE: To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS: This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS: A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION: During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.


Subject(s)
Elective Surgical Procedures/statistics & numerical data , Genital Neoplasms, Female/surgery , Hospitals, Private/statistics & numerical data , Hospitals, Public/statistics & numerical data , Time-to-Treatment/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Canada/epidemiology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/statistics & numerical data , Communicable Disease Control/standards , Female , Genital Neoplasms, Female/diagnosis , Gynecologic Surgical Procedures/statistics & numerical data , Gynecology/economics , Gynecology/organization & administration , Gynecology/standards , Gynecology/statistics & numerical data , Hospitals, Private/economics , Hospitals, Private/organization & administration , Hospitals, Private/standards , Hospitals, Public/economics , Hospitals, Public/organization & administration , Hospitals, Public/standards , Humans , Medical Oncology/economics , Medical Oncology/organization & administration , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Middle Aged , Pandemics/prevention & control , Retrospective Studies , Tertiary Care Centers/economics , Tertiary Care Centers/organization & administration , Tertiary Care Centers/standards , Tertiary Care Centers/statistics & numerical data , Time Factors , Triage/statistics & numerical data , United States/epidemiology , Young Adult
11.
Sci Prog ; 104(2): 36850421998487, 2021.
Article in English | MEDLINE | ID: covidwho-1207543

ABSTRACT

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic had a significant impact on the Italian healthcare system, although geographical differences were present; regions in northern Italy have been the most severely affected while regions in the south of the country were relatively spared. Otolaryngologists were actively involved in the management of the pandemic. In this work, we analyzed and compared the otolaryngology surgical activity performed during the pandemic in two large public hospitals located in different Italian regions. In northern Italy, otolaryngologists were mainly involved in performing surgical tracheotomies in COVID-19 positive patients and contributed to the management of these patients in intensive care units. In central Italy, where the burden of the infection was significantly lower, otolaryngologists focused on diagnosis and treatment of emergency and oncology patients. This analysis confirms the important role of the otolaryngology specialists during the pandemic, but also highlights specific differences between two large hospitals in different Italian regions.


Subject(s)
COVID-19/epidemiology , Medical Oncology/organization & administration , Otolaryngology/organization & administration , Pandemics , SARS-CoV-2/pathogenicity , COVID-19/pathology , COVID-19/surgery , COVID-19/virology , Geography , Hospitals , Humans , Intensive Care Units , Italy/epidemiology , Patient Admission/statistics & numerical data , Surveys and Questionnaires , Tracheotomy
13.
Int J Health Plann Manage ; 36(4): 1030-1037, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1198379

ABSTRACT

Italy was the first western country to be hit by the initial wave of severe adult respiratory syndrome coronavirus 2 pandemic, which has been more widespread in the country's northern regions. Early reports showing that cancer patients are more susceptible to the infection posed a particular challenge that has guided our Breast Unit at Hub Hospital in Trento to making a number of stepwise operational changes. New internal guidelines and treatment selection criteria were drawn up by a virtual multidisciplinary tumour board that took into account the risks and benefits of treatment, and distinguished the patients requiring immediate treatment from those whose treatment could be delayed. A second wave of the pandemic is expected in the autumn as gatherings in closed places increase. We will take advantage of the gained experience and organisational changes implemented during the first wave in order to improve further, and continue to offer breast cancer management and treatment to our vulnerable patient population.


Subject(s)
Breast Neoplasms/therapy , COVID-19/epidemiology , Medical Oncology/organization & administration , Organizational Innovation , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Female , Humans , Italy/epidemiology , Risk Assessment
16.
Clin Exp Metastasis ; 38(3): 257-261, 2021 06.
Article in English | MEDLINE | ID: covidwho-1147602

ABSTRACT

Cancer patients represent a vulnerable cohort during the Sars-CoV-2 pandemic. Oncological societies have generated a plethora of recommendations, but precise instructions about routine oncological procedures remain scarce. Here, we report on local COVID-19 protection measures established in an interdisciplinary approach at a tertiary care center during the first wave of the pandemia in Germany. Following these measures, no additional morbidity or mortality during oncological procedures was observed, and no nosocomial infections were registered. However, Validation of our measures is outstanding and regional SARS-CoV-2 prevalence was low. However, specific oncological measures might be important to ensure optimal oncological results, especially for advanced cancer stages during this and future pandemia. In the future, communication about these measures might be crucial to a cancer patient´s assigned network to reduce the danger of excess mortality within the second wave of the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Infection Control/methods , Medical Oncology/methods , Neoplasms/immunology , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Germany/epidemiology , Humans , Infection Control/organization & administration , Infection Control/standards , Medical Oncology/organization & administration , Medical Oncology/standards , Neoplasms/complications , Pandemics/statistics & numerical data , Prevalence , SARS-CoV-2/immunology , SARS-CoV-2/pathogenicity , Tertiary Care Centers/organization & administration
17.
Am J Hosp Palliat Care ; 38(7): 842-844, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1116166

ABSTRACT

The current COVID-19 pandemic has impacted the way outpatient palliative care providers deliver care for patients and their families. Operational changes such as the reduction of in-person care to minimize the risk of exposure is a way healthcare has adjusted to the pandemic. Our New York City-based outpatient palliative care practice is embedded in oncology. Adopting telemedicine was an essential tool to continue providing comprehensive palliative care to vulnerable oncology patients during the COVID-19 pandemic. We describe a case illustrating the benefits and barriers of telemedicine in the care of an oncology patient in the outpatient palliative care setting.


Subject(s)
COVID-19 , Neoplasms , Palliative Care , Telemedicine , Humans , Medical Oncology/organization & administration , Neoplasms/therapy , New York City , Outpatients , Pandemics
18.
Curr Oncol ; 28(2): 1056-1066, 2021 02 26.
Article in English | MEDLINE | ID: covidwho-1115412

ABSTRACT

The COVID-19 pandemic has a significant impact on cancer patients and the delivery of cancer care. To allow clinicians to adapt treatment plans for patients, Ontario Health (Cancer Care Ontario) issued a series of interim funding measures for the province's New Drug Funding Program (NDFP), which covers the cost of most hospital-delivered cancer drugs. To assess the utility of the measures and the need for their continuation, we conducted an online survey of Ontario oncology clinicians. The survey was open 3-25 September 2020 and generated 105 responses. Between April and June 2020, 46% of respondents changed treatment plans for more than 25% of their cancer patients due to the pandemic. Clinicians report broad use of interim funding measures. The most frequently reported strategies used were treatment breaks for stable patients (62%), extending dosing intervals (59%), and deferring routine imaging (56%). Most clinicians anticipate continuing to use these interim funding measures in the coming months. The survey showed that adapting cancer drug funding policies has supported clinical care in Ontario during the pandemic.


Subject(s)
Antineoplastic Agents/economics , COVID-19/epidemiology , Drug Costs , Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Attitude of Health Personnel , Data Collection , Health Policy , Health Services Accessibility , Humans , Medical Oncology/economics , Medical Oncology/organization & administration , Neoplasms/epidemiology , Ontario/epidemiology , Pandemics , Quality of Health Care , Surveys and Questionnaires
19.
JCO Glob Oncol ; 7: 342-352, 2021 02.
Article in English | MEDLINE | ID: covidwho-1115261

ABSTRACT

PURPOSE: Delays and disruptions in health systems because of the COVID-19 pandemic were identified by a previous systematic review from our group. For improving the knowledge about the pandemic consequences for cancer care, this article aims to identify the effects of mitigation strategies developed to reduce the impact of such delays and disruptions. METHODS: Systematic review with a comprehensive search including formal databases, cancer and COVID-19 data sources, gray literature, and manual search. We considered clinical trials, observational longitudinal studies, cross-sectional studies, before-and-after studies, case series, and case studies. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the included studies was assessed by specific tools. The mitigation strategies identified were described in detail and their effects were summarized narratively. RESULTS: Of 6,692 references reviewed, 28 were deemed eligible, and 9 studies with low to moderate methodological quality were included. Five multiple strategies and four single strategies were reported, and the possible effects of mitigating delays and disruptions in cancer care because of COVID-19 are inconsistent. The only comparative study reported a 48.7% reduction observed in the number of outpatient visits to the hospital accompanied by a small reduction in imaging and an improvement in radiation treatments after the implementation of a multiple organizational strategy. CONCLUSION: The findings emphasize the infrequency of measuring and reporting mitigation strategies that specifically address patients' outcomes and thus a scarcity of high-quality evidence to inform program development. This review reinforces the need of adopting standardized measurement methods to monitor the impact of the mitigation strategies proposed to reduce the effects of delays and disruptions in cancer health care because of COVID-19.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities , Health Status Disparities , Healthcare Disparities , Medical Oncology/trends , Neoplasms/therapy , Cross-Sectional Studies , Decision Making , Humans , Medical Oncology/organization & administration , Models, Organizational , Outcome Assessment, Health Care , Pandemics , Time-to-Treatment
SELECTION OF CITATIONS
SEARCH DETAIL
...