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1.
Curr Treat Options Oncol ; 22(12): 117, 2021 11 23.
Article in English | MEDLINE | ID: covidwho-1527505

ABSTRACT

OPINION STATEMENT: COVID-19 has transformed the care we provide to gynecologic oncology patients. In addition to directly impacting the diagnosis and treatment of women with gynecologic cancer, it has affected our patient's ability to undergo recommended surveillance and has made an impact on every caregiver providing care during this time. Herein we review the current literature on the impact of COVID-19 on gynecologic oncology and highlight new approaches and innovations that have resulted in gynecologic cancer care as a result of the pandemic. The impact of COVID-19 on the field of gynecologic oncology has been profound. In addition to directly impacting the diagnosis and treatment of women with cancer, it has also challenged the very ethics with which we practice medicine. The equitable distribution of resources is paramount to upholding the Hippocratic Oath which we all invoke. The COVID-19 pandemic has stripped this oath down to its very core, forcing all medical practitioners to scrutinize who gets what resources and when. As the pandemic continues to unfold, the question remains - in the setting of a strained and overburdened healthcare system, how do we maximize beneficence to one group of patients, while maintaining non-maleficence to others? As gynecologic oncologists, we are responsible for advocating for our patients to ensure that the quality of their cancer care is not compromised, while also not overutilizing resources that are sorely needed for the care of COVID-19 victims, and not making them more likely to succumb to COVID-19 by the very nature of the treatment we provide. The effects of the pandemic are far-reaching and broad, and many of these are yet to be determined. Future studies are needed to analyze how the above-utilized strategies in GYN cancer care during the pandemic will impact the long-term outcomes of our patients.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/standards , Genital Neoplasms, Female/therapy , Infection Control/methods , Oncologists/standards , Practice Patterns, Physicians'/standards , SARS-CoV-2/isolation & purification , COVID-19/diagnosis , COVID-19/transmission , Female , Genital Neoplasms, Female/virology , Humans
3.
J Chemother ; 33(4): 263-268, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-851462

ABSTRACT

The emergency caused by COVID-19 pandemic has imposed a sudden reorganization of the healthcare structures and has created consequences in cancer patients management. General clinical recommendations for cancer patients were released, even if limited clinical cancer-specific data were available. A number of critical issues have come out during COVID-19 pandemic in the management of patients with metastatic breast cancer (MBC). To explore the changes in the treatment of patients with MBC during COVID-19 pandemic, we promoted a survey to the oncologists operating in the Italian breast units. The results of this survey show that Italian oncologists have tried to ensure continuity of care for patients with MBC. De-escalation of cancer treatments, especially monotherapy administration, and greater use of oral anticancer drugs are the main changes that emerge from this survey. Some subgroups of patients, especially the elderly and endocrine-responsive patients, have been undertreated during the COVID-19 pandemic.


Subject(s)
Breast Neoplasms/pathology , Breast Neoplasms/therapy , COVID-19/epidemiology , Oncologists/organization & administration , Practice Patterns, Physicians'/organization & administration , Adult , Aged , Antineoplastic Agents/therapeutic use , Continuity of Patient Care , Female , Humans , Italy , Male , Middle Aged , Neoplasm Metastasis , Oncologists/standards , Pandemics , Practice Patterns, Physicians'/standards , SARS-CoV-2
4.
JCO Glob Oncol ; 6: 1461-1471, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-807637

ABSTRACT

PURPOSE: In response to the COVID-19 pandemic, the ASCO launched a Global Webinar Series to address various aspects of cancer care during the pandemic. Here we present the lessons learned and recommendations that have emerged from these webinars. METHODS: Fifteen international health care experts from different global regions and oncology disciplines participated in one of the six 1-hour webinars to discuss the latest data, share their experiences, and provide recommendations to manage cancer care during the COVID-19 pandemic. These sessions include didactic presentations followed by a moderated discussion and questions from the audience. All recommendations have been transcribed, categorized, and reviewed by the experts, who have also approved the consensus recommendations. RESULTS: The summary recommendations are divided into different categories, including risk minimization; care prioritization of patients; health care team management; virtual care; management of patients with cancer undergoing surgical, radiation, and systemic therapy; clinical research; and recovery plans. The recommendations emphasize the protection of patients and health care teams from infections, delivery of timely and appropriate care, reduction of harm from the interruption of care, and preparation to handle a surge of new COVID-19 cases, complications, or comorbidities thereof. CONCLUSION: The recommendations from the ASCO Global Webinar Series may guide practicing oncologists to manage their patients during the ongoing pandemic and help organizations recover from the crisis. Implementation of these recommendations may improve understanding of how COVID-19 has affected cancer care and increase readiness to manage the current and any future outbreaks effectively.


Subject(s)
Coronavirus Infections/prevention & control , Global Health , Medical Oncology/standards , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Betacoronavirus/pathogenicity , COVID-19 , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/transmission , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Health Services Accessibility/trends , Humans , Infection Control/organization & administration , Infection Control/standards , Medical Oncology/organization & administration , Medical Oncology/trends , Neoplasms/diagnosis , Neoplasms/immunology , Oncologists/organization & administration , Oncologists/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/transmission , SARS-CoV-2 , Telemedicine/organization & administration , Telemedicine/standards , Telemedicine/trends
6.
Future Oncol ; 16(26): 2007-2016, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-615630

ABSTRACT

Management of cancer patients during the COVID-19 pandemic is a worldwide challenge - in particular in developing countries where the risk of saturation of health facilities and intensive care beds must be minimized. The first case of COVID-19 was declared in Morocco on 2 March 2020, after which a panel of Moroccan experts, consisting of medical oncologists from universities and regional and private oncology centers, was promptly assembled to conduct a group reflection on cancer patient's management. The main objective is to protect the immunocompromised population from the risk of COVID-19, while maintaining an adequate management of cancer, which can quickly compromise their prognosis. Recommendations are provided according to each clinical situation: patients undergoing treatment, new cases, hospitalized patients, palliative care and surveillance.


Subject(s)
Coronavirus Infections/prevention & control , Medical Oncology/standards , Neoplasms/therapy , Oncologists/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Delivery of Health Care , Developing Countries , Humans , Medical Oncology/organization & administration , Morocco/epidemiology , Neoplasms/diagnosis , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic , SARS-CoV-2
7.
J Gynecol Oncol ; 31(4): e68, 2020 07.
Article in English | MEDLINE | ID: covidwho-382022

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Genital Neoplasms, Female/epidemiology , Pneumonia, Viral/epidemiology , COVID-19 , Disease Outbreaks/statistics & numerical data , Female , Guidelines as Topic , Gynecology/standards , Health Planning Guidelines , Humans , Oncologists/standards , Pandemics , SARS-CoV-2
8.
J Gynecol Oncol ; 31(4): e72, 2020 07.
Article in English | MEDLINE | ID: covidwho-381768

ABSTRACT

The World Health Organization (WHO) classified the novel coronavirus (i.e., coronavirus disease 2019 [COVID-19]) as a global public health emergency. COVID-19 threatens to curtail patient access to evidence-based treatment. Medicine is changing, basically due to the limited available resources. In the field of gynecologic oncology, we have to re-design our treatments' paradigm. During COVID-19 pandemic outbreak, the highest priority is to achieve the maximum benefit from less demanding procedures. Extensive procedures should be avoided, in order to reduce hospitalization and postoperative events that might increase the in-hospital spread of the virus. There are ongoing concerns on the use of laparoscopic procedures, related to the possible contamination of the staff working in the operation room. Other minimally invasive techniques, including, vaginal surgery as well as robotic-assisted and isobaric procedures would be preferred over laparoscopy. A fair allocation of resources is paramount adequate treatments.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Disease Outbreaks/prevention & control , Genital Neoplasms, Female/therapy , Pneumonia, Viral/therapy , COVID-19 , Coronavirus Infections/epidemiology , Disease Outbreaks/statistics & numerical data , Female , Genital Neoplasms, Female/epidemiology , Guidelines as Topic , Gynecology/standards , Humans , Oncologists/standards , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2
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