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1.
Curr Treat Options Oncol ; 22(10): 95, 2021 09 13.
Article in English | MEDLINE | ID: covidwho-1404665

ABSTRACT

OPINION STATEMENT: While emergency use is authorized for numerous COVID-19 vaccines and the high-risk population including cancer patients or those with immunosuppression due to disease or therapy is prioritized, data on this group's specific safety and efficacy of these vaccines remains limited. Safety data from clinical trials and population data may be extrapolated, and these vaccines may be used for cancer patients. However, concerns of efficacy due to the variable immune response in patients with active cancers undergoing active therapy and cancer survivors with chronic immunosuppression remain. The authors aim to discuss the current recommendations for use of COVID-19 vaccination in patients with cancer.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Neoplasms/immunology , Vaccination/adverse effects , COVID-19/complications , Humans , Immune System , Immunization , Immunocompromised Host , Medical Oncology/standards , Neoplasms/complications , Patient Safety , Practice Guidelines as Topic , SARS-CoV-2 , Treatment Outcome
2.
Oncology (Williston Park) ; 35(8): 459, 2021 08 09.
Article in English | MEDLINE | ID: covidwho-1359547

ABSTRACT

ONCOLOGY® co-editor-in-chief Howard S. Hochster, MD, reviews research on delays in oncology care as a results of the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Delayed Diagnosis/trends , Early Detection of Cancer/trends , Neoplasms/diagnosis , Time-to-Treatment/trends , Humans , Medical Oncology/standards , Outcome and Process Assessment, Health Care , Risk Factors , Time-to-Treatment/statistics & numerical data
3.
Klin Onkol ; 34(3): 211-219, 2021.
Article in English | MEDLINE | ID: covidwho-1346925

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19), a respiratory tract infection caused by the severe acute respiratory syndrome coronavirus named SARS-CoV-2, initially emerged in China in late 2019. The rapid global spread of this novel virus led the World Health Organization declare a pandemic with > 30,000,000 confirmed cases, 946,000 deaths and > 21,000,000 recoveries reported as of 18 September 2020, according to the Johns Hopkins Coronavirus Resource Center. Initial reports from Asia suggested that elderly patients with multiple comorbidities, specifically diabetes, hypertension, and obesity were at an increased risk of developing severe COVID-19 following a SARS-CoV-2 infection. As data on these risks have evolved, evidence has increasingly shown that patients with cancer are indeed a particularly vulnerable group. However, the effects of various confounding factors, including an older than average patient population who often have underlying comorbidities including a suppressed immune system and/ or a hypercoagulable state, have been difficult to separate from the effects of having cancer. Common presenting symptoms of SARS-CoV-2 including dyspnoea, cough, fever, fatigue, dysgeusia and, less commonly, diarrhoea and/ or a hyperinflammatory syndrome are equally confusing to clinicians as they all are common symptoms of both cancer and toxicity from anti-cancer therapy. Furthermore, the radiographic dilemma of distinguishing between immune-checkpoint inhibitor-induced pneumonitis from that caused by SARS-CoV-2 infection and conflicting data on the effects of certain therapies on patient outcomes has left clinicians with considerable angst on how to help patients with acute or worsening symptoms in an optimal way. Predicted increase in mortality follows not only from the delay in discovery and progress resulting from temporary closing of research laboratories at cancer centers but also from diversion of resources to patient care and temporary suspension of clinical trial enrolment both by companies and local institutions. The possibilities of travelling to specialized medical centers whose activities are essential for the delivery and improvement of patient care were reduced, too. Viral mutations might also occur during transmission and spread; this leads to a statement that SARS-CoV-2 will forever remain a looming threat to the oncological community. What is crucial to remember is that cancer itself is a pandemic with > 18,000,000 people dia-gnosed worldwide every year. Many societies, including the European Society for Medical Oncology and the American Society of Clinical Oncology, are providing clinical recommendations for the management of patients with cancer during this challenging time, recognizing that continuation in the precise treatment of our patients is critical for our role of physicians. PURPOSE: The aim of the presentation is to point out the contact or overlapping areas of both mentioned disease entities for the purpose of possible simplification of dia-gnostic and therapeutic management of a cancer patient with suspected or already proven  COVID-19 disease.


Subject(s)
COVID-19/complications , Medical Oncology/standards , Neoplasms/therapy , Practice Guidelines as Topic/standards , SARS-CoV-2/isolation & purification , COVID-19/virology , Humans , Neoplasms/epidemiology , Neoplasms/virology
4.
Clin J Oncol Nurs ; 25(4): 361-362, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1315866

ABSTRACT

Now that the SARS-CoV-2 virus and its variants have altered clinical oncology practice as we know it, let's return to a familiar focus from the Core Curriculum for Oncology Nursing-pain management. Much has happened during the past two years that influences the effective management of pain in patients with cancer-not the least of which is a clinical environment that has been changed by the COVID-19 pandemic.


Subject(s)
Analgesics, Opioid/adverse effects , Analgesics, Opioid/therapeutic use , COVID-19/epidemiology , Cancer Pain/drug therapy , Medical Oncology/standards , Oncology Nursing/standards , Opioid-Related Disorders/epidemiology , Pain Management/standards , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pandemics , Practice Guidelines as Topic , SARS-CoV-2 , United States/epidemiology
5.
Ann R Coll Surg Engl ; 103(7): 520-523, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1288675

ABSTRACT

INTRODUCTION: In light of the COVID-19 recommendations from the Association of Coloproctology of Great Britain and Ireland, we aimed to study patient and clinician satisfaction with a newly established telephone (TP) colorectal clinic service in lieu of traditional face-to-face (FTF) appointments. Comparative outcomes included patient versus clinician satisfaction; patient versus clinician desire to continue TP clinics postpandemic; and views of Specialty Trainee 3+ (ST3+)/Specialty Associate Specialist (SAS) doctors versus consultants on TP compared with FTF appointments. METHODS: We conducted a prospective service evaluation of patient and clinician satisfaction with colorectal surgery TP clinics between 1 June 2020 and 30 June 2020 in a British District General Hospital. RESULTS: Patients had higher satisfaction than clinicians with TP clinics: 91.5% versus 66.6% reported above-average experience [odds ratio (OR) = 5.35, 95% confidence interval (CI) 1.53 to 18.75, p = 0.01]. Clinicians had lower demand to continue TP clinics post-COVID-19 versus patients, with a trend towards significance (60% versus 82.9%, OR = 0.31, 95% CI 0.10 to 0.97, p = 0.08). ST3+/SAS doctors were more likely than consultants to find TP clinics inferior to FTF consultation for patient assessment (48.3% versus 23.7%, OR = 3.00, 95% CI 1.17 to 7.71, p = 0.03). CONCLUSIONS: While clinicians may be concerned that patient assessment suffers, patient satisfaction with TP clinics is high. There should be a place for TP clinics post-COVID-19 but there must be a robust process for patient selection as well as adequate training for current and future generations of clinicians.


Subject(s)
COVID-19/prevention & control , Colorectal Neoplasms/diagnosis , Medical Oncology/methods , Remote Consultation/methods , Telephone , Aftercare/methods , Aftercare/standards , Aftercare/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Colorectal Neoplasms/therapy , Humans , Infection Control/standards , Job Satisfaction , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Prospective Studies , Remote Consultation/standards , Remote Consultation/statistics & numerical data , Surgeons/psychology , Surgeons/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , United Kingdom/epidemiology
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.
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
8.
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
9.
Oncol Res Treat ; 44(6): 354-359, 2021.
Article in English | MEDLINE | ID: covidwho-1211630

ABSTRACT

Treatment of cancer patients has become challenging when large parts of hospital services need to be shut down as a consequence of a local COVID-19 outbreak that requires rapid containment measures, in conjunction with the shifting of priorities to vital services. Reports providing conceptual frameworks and first experiences on how to maintain a clinical hematology/oncology service during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are scarce. Here, we report our first 8 weeks of experience after implementing a procedural plan at a hematology/oncology unit with its associated cancer center at a large academic teaching hospital in Germany. By strictly separating team workflows and implementing vigorous testing for SARS-CoV-2 infections for all patients and staff members irrespective of clinical symptoms, we were successful in maintaining a comprehensive hematology/oncology service to allow for the continuation of treatment for our patients. Notably, this was achieved without introducing or further transmitting SARS-CoV-2 infections within the unit and the entire center. Although challenging, our approach appears safe and feasible and may help others to set up or optimize their procedures for cancer treatment or for other exceedingly vulnerable patient cohorts.


Subject(s)
COVID-19/prevention & control , Hematology/standards , Medical Oncology/standards , Pandemics/prevention & control , Tertiary Care Centers/standards , Adult , Germany , Humans , Neoplasms/therapy , SARS-CoV-2/pathogenicity
11.
Expert Rev Respir Med ; 15(6): 773-779, 2021 06.
Article in English | MEDLINE | ID: covidwho-1165209

ABSTRACT

Introduction: Bronchoscopy and related procedures have unambiguously been affected during the Corona Virus Disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS COV-2). Ordinary bronchoscopy practices and lung cancer services might have changed over this pandemic and for the years to come.Areas covered: This manuscript summarizes the utility of bronchoscopy in COVID-19 patients, and the impact of the pandemic in lung cancer diagnostic services, in view of possible viral spread during these We conducted a literature review of articles published in PubMed/Medline from inception to November 5th, 2020 using relevant terms.Expert opinion: Without doubt this pandemic has changed the way bronchoscopy and related procedures are being performed. Mandatory universal personal protective equipment, pre-bronchoscopy PCR tests, dedicated protective barriers and disposable bronchoscopes might be the safest and simpler way to perform even the most complicated procedures.


Subject(s)
Bronchoscopy , COVID-19/epidemiology , COVID-19/therapy , Cross Infection/prevention & control , Practice Patterns, Physicians' , Bronchoscopes/microbiology , Bronchoscopes/standards , Bronchoscopes/virology , Bronchoscopy/instrumentation , Bronchoscopy/methods , Bronchoscopy/standards , COVID-19/prevention & control , COVID-19/transmission , Equipment Contamination/prevention & control , History, 21st Century , Humans , Lung Neoplasms/diagnosis , Medical Oncology/instrumentation , Medical Oncology/methods , Medical Oncology/standards , Pandemics , Personal Protective Equipment/virology , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/trends , SARS-CoV-2/physiology
13.
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
14.
Cancer Res Treat ; 53(2): 323-329, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1134332

ABSTRACT

At the end of 2019, the cause of pneumonia outbreaks in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In February 2020, the World Health Organization named the disease cause by SARS-CoV-2 as coronavirus disease 2019 (COVID-19). In response to the pandemic, the Korean Cancer Association formed the COVID-19 task force to develop practice guidelines. This special article introduces the clinical practice guidelines for cancer patients which will help oncologists best manage cancer patients during the COVID-19 pandemic.


Subject(s)
COVID-19 , Medical Oncology/standards , Neoplasms/therapy , Practice Guidelines as Topic , Clinical Trials as Topic , Early Detection of Cancer , Humans , Patient Safety , Republic of Korea
15.
Spine (Phila Pa 1976) ; 45(19): 1386-1394, 2020 Oct 01.
Article in English | MEDLINE | ID: covidwho-1109345

ABSTRACT

STUDY DESIGN: Case series. OBJECTIVE: For each of the most frequent clinical scenarios, the authors reached a consensus on how should be timing and indications be optimized to reduce risk while maintaining the expected outcomes under the Covid-19 pandemics. SUMMARY OF BACKGROUND DATA: The organization of health care has been changed by the Covid-19 pandemic with a direct impact on Spine Oncology Surgery. Emergency surgery is still a priority, but in case of spinal tumors it should be better defined which conditions require emergency treatment. METHODS: An expert panel with general spine surgeons, oncological spine surgeons, and radiation oncologists was formed to analyze the most frequent scenarios in spinal musculoskeletal oncology during Covid-19 pandemics. RESULTS: Spine metastases can be found incidentally during follow-up or can clinically occur by increasing pain, pathologic fracture, and/or neurological symptoms. Primary spine tumors are much more rare and very rarely present with acute onset. The first step is to suspect this rare condition, to avoid to treat a primary tumor as it were a metastasis. Most complex surgery, like en bloc resection, associated with high morbidity and mortality rate for the treatment of low grade malignancy like chordoma or chondrosarcomas, if intensive care unit availability is reduced, can be best delayed some weeks, as not impacting on prognosis, due to the slow growth rate of these conditions. The currently accepted protocols for Ewing sarcoma (ES) and osteogenic sarcoma must be performed for local and systemic disease control. For ES, after the first courses of chemotherapy, radiotherapy can be selected instead of surgery, during Covid-19, to the end of the full course of chemotherapy. In immunocompromised patients, (treated by chemotherapy), it is necessary to avoid contact with affected or exposed people. CONCLUSION: Even more than during normal times, a multidisciplinary approach is mandatory to share the decision to modify a treatment strategy. LEVEL OF EVIDENCE: 5.


Subject(s)
Betacoronavirus , Coronavirus Infections/surgery , Medical Oncology/standards , Pandemics , Pneumonia, Viral/surgery , Spinal Neoplasms/surgery , Surgeons/standards , Adult , COVID-19 , Clinical Decision-Making/methods , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/epidemiology , Female , Humans , Male , Medical Oncology/methods , Middle Aged , Pandemics/prevention & control , Patient Care Team/standards , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/epidemiology , Prognosis , Reconstructive Surgical Procedures/methods , Reconstructive Surgical Procedures/standards , SARS-CoV-2 , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/epidemiology , Surgeons/psychology
16.
JCO Glob Oncol ; 6: 1428-1438, 2020 09.
Article in English | MEDLINE | ID: covidwho-1088630

ABSTRACT

PURPOSE: The COVID-19 pandemic affected health care systems globally and resulted in the interruption of usual care in many health care facilities, exposing vulnerable patients with cancer to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. METHODS: We conducted a cross-sectional study using a validated web-based questionnaire of 51 items. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of disruption of care, reasons for disruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. RESULTS: A total of 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve 716,979 new patients with cancer a year. Most of them (88.2%) reported facing challenges in delivering care during the pandemic. Although 55.34% reduced services as part of a preemptive strategy, other common reasons included an overwhelmed system (19.94%), lack of personal protective equipment (19.10%), staff shortage (17.98%), and restricted access to medications (9.83%). Missing at least one cycle of therapy by > 10% of patients was reported in 46.31% of the centers. Participants reported patient exposure to harm from interruption of cancer-specific care (36.52%) and noncancer-related care (39.04%), with some centers estimating that up to 80% of their patients were exposed to harm. CONCLUSION: The detrimental impact of the COVID-19 pandemic on cancer care is widespread, with varying magnitude among centers worldwide. Additional research to assess this impact at the patient level is required.


Subject(s)
Cancer Care Facilities/statistics & numerical data , Coronavirus Infections/prevention & control , Health Services Accessibility/statistics & numerical data , Medical Oncology/statistics & numerical data , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus/pathogenicity , COVID-19 , Cancer Care Facilities/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross-Sectional Studies , Global Burden of Disease , Health Services Accessibility/standards , Humans , Infection Control/standards , International Cooperation , Medical Oncology/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires/statistics & numerical data
17.
Clin J Oncol Nurs ; 25(1): 41-47, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1084640

ABSTRACT

BACKGROUND: The COVID-19 pandemic generated challenges to the delivery of safe, efficient, and high-quality cancer care. In ambulatory oncology, where most cancer care is delivered, these challenges required the rapid development of infrastructure. OBJECTIVES: This article describes challenges to the design and implementation of ambulatory oncology infrastructures that support clinical oncology care during a pandemic. METHODS: This article reviews clinical experiences in interprofessional, multicenter, academic, and community settings during the COVID-19 pandemic. Cohesive and efficient services, collaborative processes, and workflows; patient triage and symptom management; technology and equipment; and communication strategies are discussed. National ambulatory care guidelines and practice recommendations are included as applicable and available. FINDINGS: Continued treatment delivery and support for patients with cancer, as well as infrastructure to minimize viral exposure to patients and oncology healthcare workers, are essential when caring for this high-risk population.


Subject(s)
Ambulatory Care/standards , COVID-19/nursing , Medical Oncology/standards , Neoplasms/nursing , Oncology Nursing/standards , Practice Guidelines as Topic , Telemedicine/standards , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2 , United States/epidemiology
18.
Eur J Cancer ; 147: 154-160, 2021 04.
Article in English | MEDLINE | ID: covidwho-1077873

ABSTRACT

The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious coronavirus disease (COVID-19) has posed a unique challenge to medical staff, patients and their families. Patients with cancer, particularly those with haematologic malignancies, have been identified to be at high risk to develop severe COVID-19. Since publication of our previous guideline on evidence-based management of COVID-19 in patients with cancer, research efforts have continued and new relevant data has come to light, maybe most importantly in the field of vaccination studies. Therefore, an update of our guideline on several clinically important topics is warranted. Here, we provide a concise update of evidence-based recommendations for rapid diagnostics, viral shedding, vaccination and therapy of COVID-19 in patients with cancer. This guideline update was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology by critically reviewing the currently available data on these topics applying evidence-based medicine criteria.


Subject(s)
COVID-19 Testing/standards , COVID-19 Vaccines/therapeutic use , COVID-19 , Neoplasms , SARS-CoV-2/physiology , Virus Shedding/physiology , Antiviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19/virology , COVID-19 Testing/methods , Evidence-Based Medicine/standards , Evidence-Based Medicine/statistics & numerical data , Germany/epidemiology , Hematologic Neoplasms/diagnosis , Hematologic Neoplasms/epidemiology , Hematologic Neoplasms/therapy , Hematologic Neoplasms/virology , Hematology/organization & administration , Hematology/standards , Humans , Immunization, Passive/methods , Immunization, Passive/standards , Infectious Disease Medicine/organization & administration , Infectious Disease Medicine/standards , Medical Oncology/organization & administration , Medical Oncology/standards , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/therapy , Neoplasms/virology , SARS-CoV-2/immunology , Societies, Medical/standards , Vaccination/methods , Vaccination/standards
19.
Clin Breast Cancer ; 21(1): e128-e135, 2021 02.
Article in English | MEDLINE | ID: covidwho-1064942

ABSTRACT

BACKGROUND: From the first case of SARS-CoV-2 infection in Wuhan (China), the infection spread all around the world causing a pandemic of coronavirus disease-2019 (COVID-19). Spain has been one of the most severely affected countries, and Madrid has reported a high number of cases and deaths. We discuss our strategies for optimal breast cancer management during COVID-19 pandemic. PATIENTS AND METHODS: This was a retrospective observational study at Clínico San Carlos Hospital to analyze the management of patients with breast cancer during the pandemic outbreak and the surgical strategy after the pandemic outbreak. We created a practical and dynamic tool based on a "traffic light" system for prioritizing surgical time. Every patient was contacted by telephone with a preoperative COVID-19 protocol. After surgical procedures, patient satisfaction was assessed using the European Organisation for Research and Treatment of Cancer in-patient satisfaction with cancer care questionnaire (EORTC IN-PATSAT32). RESULTS: Patients with breast cancer actively treated with surgical procedures were put on a waiting list and received systemic therapy. Telemedicine was used to evaluate any side effects and to avoid unnecessary hospital visits. Surgery was only considered after the pandemic outbreak, and then, only those procedures designed to minimize surgical complications and, therefore, reduce hospital stay. We also measured patients' satisfaction with medical and nursing scales that resulted in a "very good" evaluation tending to "excellent". CONCLUSION: It is necessary to adapt management of oncology treatment and surgical strategy to optimize resources during the COVID-19 pandemic. Patients' perception of care quality and the degree of patients' satisfaction with health services has potential relevance in the absence of outcome data.


Subject(s)
Breast Neoplasms/therapy , COVID-19/epidemiology , Breast Neoplasms/pathology , Breast Neoplasms/surgery , COVID-19/prevention & control , Disease Management , Female , Humans , Medical Oncology/organization & administration , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Retrospective Studies , SARS-CoV-2 , Spain/epidemiology , Telemedicine , Waiting Lists
20.
Cancer Invest ; 39(1): 15-20, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1066087

ABSTRACT

Coronavirus disease outbreak has affected all aspect of clinical care including cancer clinical trials. To minimize exposure of frail cancer patients, an implementation of telemedicine was retained. The impact of this implementation on primary and secondary endpoints criteria of ongoing clinical trials was analyzed. Out of 128 oncology clinical trials, 25 (19%) had an implementation of teleconsultation. Poor data reporting induced mainly a bias on qualitative and descriptive primary endpoints than those assessing efficacy (80% vs 20%; p < 0.001). The integration of telemedicine and E-technologies in the medical practices and clinical trials must be designed and validated.


Subject(s)
COVID-19/prevention & control , Clinical Trials as Topic/methods , Medical Oncology/methods , Neoplasms/therapy , SARS-CoV-2/isolation & purification , Telemedicine/methods , COVID-19/epidemiology , COVID-19/virology , Clinical Trials as Topic/standards , Clinical Trials as Topic/statistics & numerical data , Disease Outbreaks , Humans , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Neoplasms/classification , Neoplasms/diagnosis , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/standards , Outcome Assessment, Health Care/statistics & numerical data , Research Report/standards , SARS-CoV-2/physiology , Telemedicine/standards , Telemedicine/statistics & numerical data
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