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1.
Eur Arch Otorhinolaryngol ; 279(3): 1453-1460, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1265494

ABSTRACT

BACKGROUND: In the present study, we have shared our experience in managing head neck cancers, especially the oral malignancies, during the crisis of COVID 19. MATERIALS AND METHODS: Patients with oral cancers underwent pedicle/local flaps and free flaps reconstruction based on the availability of intensive care unit and comorbidities of the patients. The clinical outcomes were compared at the end of one week, one month, and three months after the primary surgery. RESULTS: Pedicle/local flaps were used in 25 cases and radial/fibular free flaps were used in 8 cases for the reconstruction of soft tissue defects. Patients with pedicle flap reconstruction had better clinical outcomes, including lesser ICU stay as compared to free flaps. CONCLUSION: Pedicle flap can be a valid alternative to the free flap for the soft tissue reconstruction in advanced oral malignancies during the COVID pandemic period in the Indian subcontinent, especially with limited infrastructure of the hospitals.


Subject(s)
COVID-19 , Free Tissue Flaps , Head and Neck Neoplasms , Reconstructive Surgical Procedures , COVID-19/epidemiology , Head and Neck Neoplasms/surgery , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
2.
Indian J Otolaryngol Head Neck Surg ; : 1-5, 2021 Apr 22.
Article in English | MEDLINE | ID: covidwho-1202250

ABSTRACT

Social stigma is the spoilation of the social image of an individual, which leads to the social disapproval of the individual by the community. Patients of many diseases like HIV, deafness, and reproductive disorders often face social disproval. Head & neck cancer survivors perceived stigma due to the mutilation that occurred after surgical treatment procedures. The novel coronavirus is a recently emerged zoonotic viral agent that affects the respiratory system of humans. Following its outbreak from the Wuhan city of China, the COVID-19 spreaded fiercely around the globe, forming a pandemic. Since COVID-19 is a contagious disease with no available treatment, social distancing is considered as the best strategy to prevent the geometric spread of infection. With the social distancing model, the head & neck cancer survivors along with the various other stakeholders perceived stigma being a high-risk group for COVID-19 infection. As the pool of caregivers is diminished due to pandemic, head & neck cancer survivors face increased social isolation and perceived stigma in asking for help from relatives. At the time of the pandemic, social support is critical to fighting against the disease. Social distancing should be maintained along with communication with the patients through calls, text, and online social platforms. It is not wise to stigmatize disease as, in that case, patients who are infected with the disease will try to hide it and avoid seeking medical care. With the promotion of social distancing, it is crucial to convey awareness regarding not to stigmatize the disease.

3.
Plast Reconstr Surg Glob Open ; 9(3): e3545, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1199579

ABSTRACT

The coronavirus disease 2019 posed an unprecedented strain to plastic surgery services. The scarcity of validated guidelines-at the beginning of this healthcare crisis-to direct clinical, ethical, transparent decision-making for head and neck cancer patients requiring palliative reconstructive surgery was a difficult situation. We report a 15-year-old girl with an advanced chemoresistant rare radiotherapy-induced mandibular osteosarcoma during the early phase of the pandemic in the United States in mid-March 2020, when official recommendations for triage were still developing. Local guidelines suggested canceling all elective procedures, and allowed operating emergency and/or nonelective cases only. Many surgeons declined surgery due to patient's poor prognosis and high perioperative risk, but her mother pursued different professional opinions elsewhere. However, upon Beaumont hospital approval, the patient underwent radical en bloc resection of the tumor, hemimandibulectomy, zygomatic resection, maxillectomy, and hemipalate resection followed by reconstruction with free fibula osteocutaneous and anterolateral thigh flaps. The challenging decision to proceed with surgery was based on evidence-based and objective risk-stratifying scores, available at the time, and ethical recommendations from emerging reliable published literature. Despite a favorable postoperative outcome, the patient expired due to cardiac complications of the disease. Our patient taught us that ethical decision-making, sound clinical judgment, and a patient-centered individualized approach remain pivotal aspects of the medical profession. Although the surgery will not provide a cure for the disease, we have found that palliative reconstructive surgery can greatly improve patient's quality of life, and help family cope with the advancing stages of disease.

4.
Eur Arch Otorhinolaryngol ; 279(2): 907-943, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1198430

ABSTRACT

PURPOSE: The coronavirus pandemic has redefined the practice of head and neck surgeons in the management of oncology patients. Several countries have issued practice recommendations in that context. This review is a collaboration of the YO-IFOS (Young Otolaryngologists of the International Federation of Otolaryngological Societies) group in order to summarize, in a systematic way, all available guidelines and provide clear guidelines for the management of head and neck cancer patients in the COVID-19 pandemic. METHODS: This systematic review was performed according to the PRISMA statements. Inclusion criteria for the systematic review were based on the population, intervention, comparison, and outcomes according to (PICO) framework. The AGREE II (Appraisal of Guidelines for Research and Evaluation II) instrument was used to assess quality of all practice guidelines included in this review. RESULTS: Recommendations include adjustments regarding new patients' referral such as performing a pre-appointment triage and working in telemedicine when possible. Surgical prioritization must be adjusted in order to respect pandemic requirements. High-grade malignancies should, howeve,r not be delayed, due to potential serious consequences. Many head and neck interventions being aerosol-generating procedures, COVID-19 testing prior to a surgery and adequate PPE precautions are essential in operating rooms. CONCLUSION: These recommendations for head and neck oncology patients serve as a guide for physicians in the pandemic. Adjustments and updates are necessary as the pandemic evolves.


Subject(s)
COVID-19 , Head and Neck Neoplasms , COVID-19 Testing , Head and Neck Neoplasms/therapy , Humans , Pandemics , SARS-CoV-2
5.
Support Care Cancer ; 29(11): 6297-6304, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1188099

ABSTRACT

BACKGROUND: Head and neck cancer (HNC) survivors are particularly vulnerable to the deleterious consequences of lockdown and social distancing. The psychosocial effects of the COVID-19 pandemic on this group are still unknown, and we want to explore how their quality of life (QoL) has changed in this unique situation. MATERIALS AND METHODS: An online survey, composed of pandemic-specific items, plus the EORTC QLQ-C30, was administered to a cohort of HNC survivors. Using previously published reference values as a control group, we have evaluated the impact of the pandemic on their QoL. We have also explored the differences between those who had received a total laryngectomy (LP, laryngectomized population) vs other HNC patients, in order to assess the role of tracheostomy in this regard. RESULTS: One hundred and twenty-one HNC patients completed the survey. The scores of the physical (80.5 vs 85, p = 0.028), role (78 vs 84, p = 0.030), and emotional functioning (76 vs 81, p = 0.041) were significantly different in the two groups, with worse functioning in our patients. Comparing LP with the other HNC patients, social (76.6 vs 88.9, p = 0.008) and physical functioning (75.5 vs 86.1, p = 0.006) were significantly worse in the former group. LP also reported a greater perception that others are afraid to be close to them (1.67 vs 1.32, p = 0.020). No differences were found between LP with and without voice prosthesis. CONCLUSIONS: Our results show how HNC patients are at high risk for a worsening in QoL because of the ongoing COVID-19 global pandemic.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Communicable Disease Control , Humans , Pandemics , Quality of Life , SARS-CoV-2 , Surveys and Questionnaires , Survivors
6.
Tumori ; 108(3): 240-249, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1183475

ABSTRACT

OBJECTIVE: To capture and monitor flu-like symptoms in relation to the clinical characteristics and the oncologic treatment of a large head and neck cancer (HNC) patient cohort during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS: Patients were monitored through by 2 rounds of interviews. Clinical characteristics of patients with no symptoms (group 0) and of those reporting ⩾1 (group A), ⩾3 (group B), or ⩾5 symptoms (group C) were analyzed. Patients with ⩾1 symptom at both interviews were defined as group A2. RESULTS: Five hundred patients with HNC were analyzed. A higher frequency of patients with the following characteristics was observed in group A vs group 0: active treatment (40% vs 24%, p = 0.0002), gastrostomy (6% vs 2%, p = 0.027), recent active treatment (48% vs 29%, p < 0.0001), and higher number of concomitant medications (p = 0.01). A lower median age was observed in group B vs group no-B (patients with fewer than three symptoms) (59 vs 63.55 years, p = 0.016) and in group A2 vs group no-A2 (patients without at least one symptom at both interviews) (56 vs 63 years, p = 0.021); patients in group B received more recent active treatment than those in group no-B and in group A2 vs those in group no-A2 (p = 0.024 and 0.043, respectively); patients in group B had a lower body mass index than those in group no-B (22.4 vs 23.93 kg/m2, p = 0.0066). CONCLUSIONS: This work is based on patient-reported symptoms and signs independently of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. In the future, these results might serve as a a benchmark for clinicians triaging and managing patients with HNC during infectious outbreaks involving flu-like symptoms.


Subject(s)
COVID-19 , Head and Neck Neoplasms , COVID-19/epidemiology , Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/therapy , Humans , Medical Oncology , Middle Aged , Pandemics , SARS-CoV-2
7.
Oral Dis ; 2021 Apr 14.
Article in English | MEDLINE | ID: covidwho-1183246

ABSTRACT

OBJECTIVE: To evaluate whether the coronavirus disease 2019 has increased anxiety, depression, and distress levels in head and neck cancer (HNC) patients undergoing radiotherapy (RT). METHODS: In this cross-sectional study, RT-HNC patients were surveyed using the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression and the distress thermometer (DT) for distress. HADS scores were compared with data pre-COVID-19. Additionally, we evaluated the COVID-19 impact on daily routines, treatment, and cancer care through a questionnaire. RESULTS: Fifty patients were included. The HADS mean score and estimated rates were 4.34 (±4.06)/22% for anxiety and 5.08 (±4.82)/22% for depression; in comparison, our historical control had 4.04 (±3.59)/20% for anxiety (p = .79) and 4.03 (±3.62)/17% for depression (p = .49). Mean DT score was 3.68 (±2.77). Responders were aware of COVID-19, afraid of having medical complications, believed it was life-threatening, did not miss appointments, believed their treatment was not impacted, and felt safe at the hospital amid the pandemic. CONCLUSION: This study suggests that anxiety, depression, and distress levels found in RT-HNC patients did not increase during the pandemic. Patients were afraid of being infected by COVID-19; however, they complied with their cancer treatment.

8.
Tumori ; 108(3): 230-239, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1181055

ABSTRACT

OBJECTIVE: To describe the approach and outcomes from two cancer centres in Southern and Northern Europe during the first wave of coronavirus disease 2019 (COVID-19) of patients with head and neck cancer (HNC). METHODS: Data collection was performed on a retrospective cohort of patients surgically treated for primary HNC between March and May 2020, using data from two tertiary hospitals: the European Institute of Oncology (Milan) and Guy's & St Thomas' NHS Foundation Trust (London). RESULTS: We included 77 patients with HNC. More patients with COVID-19 were taking angiotensin-converting enzyme (ACE) inhibitors and had Clavien-Dindo Classification grade I compared to negative patients, respectively (60% vs 22% [p = 0.058] and 40% vs 8% [p = 0.025]). Multivariate logistic regression analyses confirmed our data (p = 0.05 and 0.03, respectively). Sex and age were statistically significantly different (p = 0.05 and <0.001 respectively), showing more male patients (75% vs 53.66%, respectively) and more elderly patients in Italy than in the United Kingdom (patients aged >63 years: 69.44% vs 29.27%). CONCLUSIONS: This study presents a large cohort of patients with HNC with nasopharyngeal swab during the first peak of the COVID-19 pandemic in Europe. Patients with HNC with COVID-19 appeared more likely to develop postsurgical complications and to be taking ACE inhibitors. The preventive measures adopted guaranteed the continuation of therapeutic surgical intervention.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Aged , COVID-19/epidemiology , Europe/epidemiology , Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/therapy , Humans , Male , Pandemics , Retrospective Studies
9.
Expert Rev Respir Med ; 15(3): 393-401, 2021 03.
Article in English | MEDLINE | ID: covidwho-897071

ABSTRACT

Objective: To assess the patterns and trends of influenza and pneumonia-attributed deaths among cancer patients in the United States.Methods: Surveillance, Epidemiology and End Results (SEER) database was accessed and cancer patients diagnosed 1975-2016 who have been included in the SEER-9 registries were included. The primary endpoint of the study is standardized mortality rate (SMR; calculated as observed/ Expected (O/E) ratio for death from influenza and pneumonia among cancer patients).Results: The current study evaluates a total of 3,579,199 cancer patients (diagnosed 1975-2016) within the SEER-9 registries; and influenza and pneumonia-attributed deaths represent 1.5% of the recorded deaths for this cohort. SMR for influenza/ pneumonia-attributed death within the first year following cancer diagnosis was 1.88 (1.83-1.94);while SMR for influenza/pneumonia-attributed death following the first year was 1.11 (1.10-1.12). Within the first year following cancer diagnosis, SMR from influenza/pneumonia was higher among individuals with black race (SMR for white race: 1.75 (95% CI: 1.69-1.81) while SMR for black race: 2.90 (95% CI: 2.65-3.16), lung cancer (SMR for lung cancer: 4.39 (95% CI: 4.11-4.69)), head and neck cancer (SMR for oral cavity/ pharynx cancer: 4.02 (95% CI: 3.50-4.59)), lymphomas (SMR for lymphoma: 3.28 (95% CI: 2.92-3.68)), leukemias (SMR for leukemia: 3.32 (95% CI: 2.89-3.80)) and myeloma (SMR for myeloma: 3.91 (95% CI: 3.28-4.63)).Conclusions: Cancer patients are more likely to have influenza/ pneumonia-attributed death compared to the general US population. This risk is higher among patients with lung cancer, head and neck cancer, and hematological malignancies.


Subject(s)
Influenza, Human , Lung Neoplasms , Occupational Diseases , Pneumonia , Cohort Studies , Humans , Pneumonia/diagnosis , United States/epidemiology
10.
Am Soc Clin Oncol Educ Book ; 41: 1-11, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1166954

ABSTRACT

The overwhelming majority of head and neck cancers and related deaths occur in low- and middle-income countries, which have challenges related to burden of disease versus access to care. Yet the additional health care burden of the COVID-19 pandemic has also impacted access to care for patients with head and neck cancer in the United States. This article focuses on challenges and innovation in prioritizing head and neck cancer care in Sub-Saharan Africa, the Indian experience of value-added head and neck cancer care in busy and densely populated regions, and strategies to optimize the management of head and neck cancer in the United States during the COVID-19 pandemic.


Subject(s)
COVID-19 , Head and Neck Neoplasms/therapy , Health Services Accessibility , Medical Oncology , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/mortality , Health Priorities , Health Services Needs and Demand , Humans , Needs Assessment , Treatment Outcome
11.
Clin Otolaryngol ; 46(4): 729-735, 2021 07.
Article in English | MEDLINE | ID: covidwho-1155875

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the differences in surgical capacity for head and neck cancer in the UK between the first wave (March-June 2020) and the current wave (Jan-Feb 2021) of the COVID-19 pandemic. DESIGN: REDcap online-based survey of hospital capacity. SETTING: UK secondary and tertiary hospitals providing head and neck cancer surgery. PARTICIPANTS: One representative per hospital was asked to report the capacity for head and neck cancer surgery in that institution. MAIN OUTCOME MEASURES: The principal measures of interests were new patient referrals, capacity in outpatients, theatres and critical care; therapeutic compromises constituting delay to surgery, de-escalated surgery and therapeutic migration to non-surgical primary modality. RESULTS: Data were returned from approximately 95% of UK hospitals with a head and neck cancer surgery specialist service. 50% of UK head and neck cancer patients requiring surgery have significantly compromised treatments during the second wave: 28% delayed, 10% have received radiotherapy-based treatment instead of surgery, and 12% have received de-escalated surgery. Surgical capacity has been more severely constrained in the second wave (58% of pre-pandemic level) compared with the first wave (62%) despite the time to prepare. CONCLUSIONS: Some hospitals are overwhelmed by COVID-19 and unable to offer essential cancer surgery, but all have neighbouring hospitals in their region retaining good (or even normal) capacity. It is noteworthy that very few patients have been appropriately redirected away from the hospitals most constrained by their burden of COVID-19. The paucity of an effective central or regional strategic response to this evident mismatch between demand and surgical capacity is to the detriment of our head and neck cancer patients.


Subject(s)
COVID-19/epidemiology , Head and Neck Neoplasms/surgery , Otorhinolaryngologic Surgical Procedures/methods , Pandemics , SARS-CoV-2 , Tertiary Care Centers , Comorbidity , Head and Neck Neoplasms/epidemiology , Humans , United Kingdom/epidemiology
12.
Virchows Arch ; 479(3): 585-595, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1130775

ABSTRACT

The role of digital pathology in remote reporting has seen an increase during the COVID-19 pandemic. Recently, recommendations had been made regarding the urgent need of reorganizing head and neck cancer diagnostic services to provide a safe work environment for the staff. A total of 162 glass slides from 109 patients over a period of 5 weeks were included in this validation and were assessed by all pathologists in both analyses (digital and conventional) to allow intraobserver comparison. The intraobserver agreement between the digital method (DM) and conventional method (CM) was considered almost perfect (κ ranged from 0.85 to 0.98, with 95% CI, ranging from 0.81 to 1). The most significant and frequent disagreements within trainees encompassed epithelial dysplasia grading and differentiation among severe dysplasia (carcinoma in situ) and oral squamous cell carcinoma. The most frequent pitfall from DM was lag in screen mirroring. The lack of details of inflammatory cells and the need for a higher magnification to assess dysplasia were pointed in one case each. The COVID-19 crisis has accelerated and consolidated the use of online meeting tools, which would be a valuable resource even in the post-pandemic scenario. Adaptation in laboratory workflow, the advent of digital pathology and remote reporting can mitigate the impact of similar future disruptions to the oral and maxillofacial pathology laboratory workflow avoiding delays in diagnosis and report, to facilitate timely management of head and neck cancer patients. Graphical abstract.


Subject(s)
COVID-19 , Carcinoma in Situ/pathology , Digital Technology , Image Interpretation, Computer-Assisted , Maxillary Neoplasms/pathology , Microscopy , Mouth Neoplasms/pathology , Squamous Cell Carcinoma of Head and Neck/pathology , Telepathology , Biopsy , Diagnosis, Differential , Humans , Observer Variation , Predictive Value of Tests , Reproducibility of Results , Workflow
13.
Eur Arch Otorhinolaryngol ; 278(12): 5081-5085, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1118225

ABSTRACT

PURPOSE: Impact of COVID-19 pandemic on healthcare is huge. We intended to demonstrate how COVID-19 pandemic affected primary head and neck oncology patient's referral and admission to a tertiary center by comparing the retrospective patient data in March-September 2020 and the same period in 2019. METHODS: In this cross-sectional study, from March 15th, 2020 to September 15th, 2020, medical records of 61 patients (Group 1) diagnosed and scheduled for surgery for head and neck cancer in our tertiary care center were revised and compared with 64 head and neck cancer patients treated in the same institution in the same time period of the previous year (Group2). Surgical site, TNM stages, need for reconstruction with flap, time from first symptom occurrence to first admission to our institution, and time to surgery were noted. RESULTS: In Group 1, out of 56 patients, 26 were diagnosed with T1-2 tumor, while 30 had T3-4 tumor. In Group 2, 43 of 60 patients had T1-2 tumor, while only 17 of them were diagnosed with T3-4 tumor. The rate of T3-4 tumors had significantly increased in 2020 when compared to 2019 (p = 0.049). In oral cavity cancer patients, N stage was significantly increased in Group 1 when compared to Group 2 (p = 0.024). Need for reconstruction with regional or free flaps were significantly increased in oral cavity cancer patients (p = 0,022). The mean time from the beginning of the first symptom to the admission was 19.01 ± 4.6 weeks (ranging between 11 and 32 weeks) in Group 1, while it was 16.6 ± 5.9 weeks in Group 2 (ranging between 6 and18 weeks); with significant increase (p = 0,02). The time to surgery from first admission was 3.4 ± 2.5 and 2.9 ± 1.2 weeks in Group 1 and 2, respectively, with no statistically significant difference (p = 0.06). CONCLUSION: The COVID-19 pandemic has caused delay in the diagnosis and treatment of many diseases as such in head and neck cancers. Admission with advanced stage disease and the need for more complex reconstructive procedures were increased. During the pandemic, the management of other diseases that cause mortality and morbidity should not be neglected and priorities should be determined.


Subject(s)
COVID-19 , Free Tissue Flaps , Head and Neck Neoplasms , Reconstructive Surgical Procedures , Cross-Sectional Studies , Head and Neck Neoplasms/epidemiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
14.
Head Neck ; 43(6): 1872-1880, 2021 06.
Article in English | MEDLINE | ID: covidwho-1116767

ABSTRACT

BACKGROUND: The coronavirus disease 2019 pandemic has led to increased telemedicine visits. This study examines current preferences and barriers for telemedicine among patients with head and neck cancer. METHODS: Single institution retrospective analysis of 64 patients scheduling visits with the head and neck surgical oncology clinic at a tertiary academic medical center. Data were collected detailing patient preferences and barriers regarding telemedicine appointments. Patients electing to participate in telemedicine were compared to those preferring in-person appointments. RESULTS: Most patients (68%) were not interested in telemedicine. Preference for in-person examination was the most common reason for rejecting telemedicine, followed by discomfort with or limited access to technology. Patients elected telemedicine visits to avoid infection and for convenience. CONCLUSIONS: When given a choice, patients with head and neck cancer preferred in-person visits over telemedicine. Although telemedicine may improve health care access, patient preferences, technology-related barriers, and limitations regarding cancer surveillance must be addressed moving forward.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Telemedicine , Head and Neck Neoplasms/therapy , Humans , Retrospective Studies , SARS-CoV-2
15.
Head Neck ; 43(6): 1890-1897, 2021 06.
Article in English | MEDLINE | ID: covidwho-1111193

ABSTRACT

BACKGROUND: Due to COVID-19, diagnostic delays and a surge of advanced head and neck cancer (HNC) is anticipated. We hereby evaluate patient and tumor characteristics before and during the early COVID-19 period. METHODS: Retrospective review of patients with HNC presented at a multidisciplinary tumor conference from May 14, 2020 to June 18, 2020 was performed and compared to a similar 6-week period a year before. Demographics, time to diagnosis, and tumor characteristics were analyzed. RESULTS: There was a 25% reduction in newly diagnosed malignancies. Groups were similar in baseline characteristics, duration of symptoms, and time to diagnosis. However, median primary tumor size was significantly larger (p = 0.042) and T stage more advanced for mucosal subsites (p = 0.025) in the COVID-19 group. CONCLUSION: Our findings suggest increased tumor burden in patients with HNC presenting during the pandemic, despite a similar time to diagnosis. This may become more pronounced as the pandemic duration is extended.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/epidemiology , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
16.
Eur Arch Otorhinolaryngol ; 278(11): 4441-4448, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1081343

ABSTRACT

PURPOSE: Head and neck cancer (HNC) patients may experience fears regarding cancer recurrence (FoR) and of catching COVID-19. There could be unease for attending hospital clinics for face to face (F2F) examination. F2F benefit in cancer surveillance has to be balanced against the risk of virus transmission. This study aimed to report perceptions of fear of cancer and fear of COVID-19 and to report patient preference for follow-up consultation in HNC survivors during the COVID-19 pandemic. METHODS: The study ran from lockdown in England on 24th March to 29th July 2020. Patients were offered preference to postpone their consultation, to have it by telephone, or F2F. A postal survey was undertaken in the 2 weeks post-consultation (actual or postponed). RESULTS: There were 103 patients. Initial action by consultant and patient resulted in 51 postponed consultations, 35 telephone consultations and 17 F2F meetings, with 10 F2F triggered by the patient. There were 58 responders to the survey and most (39) had a clear preference for one mode of follow-up consultation during the COVID-19 pandemic, with half (19) preferring F2F. A similar response was seen regarding their consultations in general to address unmet needs and concerns, with 38 having a preferred mode, 29 preferring F2F. Serious fears about recurrence and COVID-19 were at relatively low levels with a tendency to be more concerned about recurrence. CONCLUSION: Any redesign of mode and frequency of out-patient follow-up in light of COVID-19 should be undertaken in discussion with patient groups and with individual patients.


Subject(s)
COVID-19 , Communicable Disease Control , Fear , Humans , Neoplasm Recurrence, Local/epidemiology , Pandemics , Referral and Consultation , SARS-CoV-2
17.
Eur Arch Otorhinolaryngol ; 278(1): 275-278, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1064479

ABSTRACT

PURPOSE: The objective of this report is to outline our early experience with head and neck cancer patients in a tertiary referral center, during the SARS-Cov2 pandemic, and to describe the poor outcomes of patients who acquired the infection. METHODS: In this case series from a single-center, national tertiary referral center for head and neck cancer we describe three consecutive head and neck cancer patients who contracted SARS-Cov2 during their inpatient stay. RESULTS: Of the three patients described in our case series that contracted SARS-Cov2, two patients died from SARS-Cov2 related illness. CONCLUSION: We have demonstrated the significant implications that SARS-Cov2 has on head and neck cancer patients, with 3 patients acquiring SARS-Cov2 in hospital, and 2 deaths in our that cohort. We propose a complete separation in the location of where these patients are being managed, and also dedicated non-SARS-Cov2 staff for their peri-operative management. LEVEL OF EVIDENCE: IV.


Subject(s)
COVID-19 , Head and Neck Neoplasms/mortality , Postoperative Complications/virology , Cohort Studies , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Male , Pandemics , Postoperative Complications/mortality , SARS-CoV-2 , Tertiary Care Centers
18.
Infect Agent Cancer ; 16(1): 9, 2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1067250

ABSTRACT

BACKGROUND: The medical community has been deeply involved in fighting the Coronavirus disease 2019 (COVID-19) pandemic and, as a consequence, the care of non-COVID-19 patients has been impacted. However, the treatment of head and neck cancer patients is not deferrable, and an integrated strategy is required. The aim of the current article is to present the experience in the management of head and neck patients during the COVID-19 pandemic at the research hospital "Casa Sollievo della Sofferenza". This review contains replicable and widely usable instructions on how to avoid delays in the diagnosis and treatment of head and neck tumors and to ensure a gradual return to elective procedures. MAIN TEXT: The Head and Neck Department of the research hospital "Casa Sollievo della Sofferenza" includes an Otolaryngology and a Maxillofacial Surgery Unit, both of which deal with the diagnosis and treatment of benign and malignant pathologies of the head and neck, as well as urgent/emergent consultations and surgical procedures that necessitate time sensitive operative management, such as cochlear implantation (CI). Given these premises and the complexity of the Department, the "COVID-19 organizing protocol" of the research hospital "Casa Sollievo della Sofferenza" was divided into two phases in accordance with the different stages of the pandemic and the priority of treatment. Special attention was given to the medical surveillance of health care workers and hospitalized patients, to the organization of the outpatient clinic and the operating setting as well as to the implementation of telehealth systems. CONCLUSIONS: The COVID-19 pandemic is going to be a long-term situation with lasting effects on the public health and the entire society. Therefore, an efficient health care system has to adopt a double strategy: always being ready for a "new wave" of the pandemic and not forgetting non-COVID-19 patients, among whom head and neck cancer patients represent a priority. More than 1 year since the first outbreak in Wuhan, this review offers a unique and helpful perspective that incorporates awareness of the disease.

19.
Laryngorhinootologie ; 100(2): 104-110, 2021 02.
Article in German | MEDLINE | ID: covidwho-1066006

ABSTRACT

OBJECTIVE: COVID-19 pandemic has impact on the oncology service system for tumor patients. What is the view of head and neck cancer patients (HNC) on this situation and which coping strategies were developed? MATERIAL & METHODS: In study 1 PRIO asked 433 tumor patients regarding their impressions/fears during the lockdown between April 15 and May 15, 2020 (online, standardized questionnaire). In 2nd study 292 tumor patients reported their pandemic-induced perceived changes and coping strategies by established questionnaires (WHO-5, MLQ, GrAw-7). An analysis of the HNC-data obtained by standardized questionnaires was performed. RESULTS: Study 1 had 91 HNC, study 2-84 HNC. Study 1 shows high stress levels for the majority of HNC (53,8 %). Personal fears regarding the own disease and therapies (39.6 %) are a central problem. The participants await physical (24.7 %) as well as psychological (21.3 %) consequences due to the pandemic and its current management. During the lockdown the isolation (banned visitors at any hospital) was discussed as critical main point by 58.5 % of HNC patients. Study 2 (after lockdown) underlined the mental stress caused by pandemic. Intensified relations within the families (58/100 points) as well as more intensive experience of nature and silence (58/60 points) are the most perceived changes in corona-times. HNC showed increased own inactivity (MLQ) and depressed well-being (WHO-5) and attention to the moment (GrAw-7). CONCLUSIONS: HNC patients have had high burden and fears due to the COVID-19 pandemic in spring 2020. Their views are important for further strategies to organize and stabilize the oncology service system during further pandemic periods.


Subject(s)
COVID-19 , Head and Neck Neoplasms , Adaptation, Psychological , Communicable Disease Control , Head and Neck Neoplasms/epidemiology , Head and Neck Neoplasms/therapy , Humans , Pandemics , SARS-CoV-2
20.
Indian J Otolaryngol Head Neck Surg ; : 1-7, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1062181

ABSTRACT

Thirty-two Head and Neck cancer patients were operated by surgical team of the Indian Institute of Head and Neck Oncology (IIHNO) in a period ranging from May 2020 to the first week of December 2020. Surgical procedures ranged from surgery for tongue cancer, resection of cancers of the oral mucosa/cheek (with or without reconstruction), as well as surgery for paranasal cancers and thyroid cancers, with an average duration of 3 h for the procedures. This article reviews this experience during the peak of covid pandemic regarding the approaches adopted by the team of the IIHNO, a flagship project of the Indore Cancer Foundation, a public charitable trust.

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