Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 187
Filter
1.
Oncol Nurs Forum ; 48(4): 403-411, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1378127

ABSTRACT

PURPOSE: To describe the experiences of Turkish parents of hospitalized children with cancer during the COVID-19 pandemic. PARTICIPANTS & SETTING: Participants were recruited at the pediatric hematology-oncology clinic of a university hospital in Turkey. A purposive sampling strategy was used to identify participants. Parents who had a child aged 0-18 years with cancer were eligible. METHODOLOGIC APPROACH: This study was conducted using a descriptive qualitative research design. Semistructured individual interviews with 14 parents of children with cancer were used for data collection. Data were analyzed using the content analysis method. FINDINGS: Two main themes with related subthemes were identified that revealed the lived experiences of parents of children with cancer. IMPLICATIONS FOR NURSING: Pediatric oncology nurses can develop clinical practices that help parents to cope with anxiety about COVID-19. Nurses should share with parents current and valid information about the child's care during the pandemic. Future research should examine the experiences of children with cancer and their parents from different cultures during the COVID-19 pandemic.


Subject(s)
COVID-19 , Child, Hospitalized , Neoplasms , Child , Humans , Neoplasms/therapy , Pandemics , Parents , Qualitative Research , SARS-CoV-2 , Turkey
2.
JCO Clin Cancer Inform ; 5: 695-700, 2021 06.
Article in English | MEDLINE | ID: covidwho-1278134

ABSTRACT

PURPOSE: Health care priorities of individuals may change during a pandemic, which may, in turn, affect health services utilization. We examined Canadians' online relative search interest in five common solid tumors (breast, colon, lung, prostate, and thyroid) during the COVID-19 pandemic to that observed in the same months in the prior 5 years. METHODS: We conducted a cross-sectional retrospective study using Google Trends aggregate anonymous online search data from Canada. We compared the respective relative search volumes for breast, colon, lung, prostate, and thyroid cancers for the months March-November 2020 with the mean for the same months in 2015-2019. Welch's two-sample t tests were performed and the raw P values were then adjusted using Benjamini-Hochberg procedure to correct for multiple comparisons. The level of statistical significance was defined by choosing false discovery rate at .05 for the primary analysis. RESULTS: We observed temporary statistically significant reductions in Canadians' relative search volumes for various cancers, largely early in the pandemic, in the spring of 2020. Specifically, significant reductions (after adjustment for multiple comparisons) were observed for breast cancer in April, May, and October 2020; colon cancer in March and April of 2020; lung cancer in April and September 2020; and prostate cancer in April and May 2020. Thyroid cancer relative search volumes were not significantly different from those observed prior to the pandemic. CONCLUSION: Although Canadians' online interest in various cancers temporarily waned early in the COVID-19 pandemic, recent relative search volumes for various cancers are largely not significantly different from prior to the pandemic.


Subject(s)
COVID-19 , Information Seeking Behavior , Internet , Neoplasms , Search Engine , Canada , Cross-Sectional Studies , Humans , Pandemics , Retrospective Studies
3.
Int J Clin Oncol ; 26(8): 1569-1574, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1274856

ABSTRACT

BACKGROUND: COVID-19, the novel coronavirus has caused a global pandemic affecting millions of people around the world. Although children, including children with cancer, have been found to be affected less commonly and less severely than adults, indirect effects of the pandemic on the diagnosis and treatment of children with cancer have been less described. METHODS: A survey was performed in the four largest tertiary pediatric hematology-oncology medical centers in Israel. Clinical and laboratory data were collected from the medical files of patients diagnosed or treated with cancer during April-October 2020. RESULTS: Seventeen patients are described, who had a significant delay in diagnosis or treatment of cancer. These represent approximately 10% of all pediatric cancer diagnosed during the study period in these centers. A main cause of delay was fear of exposure to COVID-19 (fears felt by the patient, parent, physician, or decision-makers at the institution; or the implementation of national guidelines). Delays also resulted from co-infection with COVID-19 and the attribution of the oncologic symptoms to the infection. In addition, treatment was delayed of patients already diagnosed with cancer, due to COVID-19 infection detected in the patient, a family member, or a bone marrow donor. CONCLUSION: Fear from the COVID-19 pandemic may result in delayed diagnosis and treatment of children with cancer, which may carry a risk to dismal prognosis. It is crucial that pediatricians and patients alike remember that other diseases still prevail and must be thought of and treated in a timely fashion.

5.
JMIR Cancer ; 7(2): e27384, 2021 Jun 08.
Article in English | MEDLINE | ID: covidwho-1273310

ABSTRACT

BACKGROUND: Patients with cancer are particularly vulnerable to stress and anxiety during the COVID-19 pandemic. Social distancing is critical for patients with cancer; however, it can also reduce their access to psychosocial coping resources. OBJECTIVE: The aim of this study was to explore patient experiences to generate a model of how virtual mind-body programs can support the psychosocial well-being of patients with cancer. METHODS: We conducted a qualitative study among patients (aged ≥18 years) who participated in a virtual mind-body program offered by a National Cancer Institute-designated Comprehensive Cancer Center during the COVID-19 pandemic. The program consisted of mind-body group therapy sessions of fitness, yoga, tai chi, dance therapy, music therapy, and meditation. Live integrative medicine clinicians held each session via Zoom videoconferencing for 30-45 minutes. In semistructured phone interviews (n=30), patients were asked about their overall impressions and perceptions of the benefits of the sessions, including impacts on stress and anxiety. Interviews were analyzed using grounded theory. RESULTS: Among the 30 participants (average age 64.5 years, SD 9.36, range 40-80, 29 female), three major themes were identified relating to experiences in the virtual mind-body program: (1) the sessions helped the patients maintain structured routines and motivated them to adhere to healthy behaviors; (2) the sessions enhanced coping with COVID-19-related-stressors, allowing patients to "refocus" and "re-energize"; and (3) the sessions allowed patients to connect, fostering social relationships during a time of isolation. These themes informed the constructs of a novel behavioral-psychological-social coping model for patients with cancer. CONCLUSIONS: Virtual mind-body programming supported patients with cancer during the COVID-19 pandemic through a behavioral-psychological-social coping model by enhancing psychological coping for external stressors, supporting adherence to motivation and health behaviors, and increasing social connection and camaraderie. These programs have potential to address the behavioral, psychological, and social challenges faced by patients with cancer during and beyond the COVID-19 pandemic. The constructs of the conceptual model proposed in this study can inform future interventions to support isolated patients with cancer. Further clinical trials are needed to confirm the specific benefits of virtual mind-body programming for the psychosocial well-being and healthy behaviors of patients with cancer.

6.
Res Sq ; 2021 Jun 11.
Article in English | MEDLINE | ID: covidwho-1270324

ABSTRACT

Background: While pre-existing cardiovascular disease (CVD) appears to be associated with poor outcomes in patients with Coronavirus Disease 2019 (COVID-19), data on patients with CVD and concomitant cancer is limited. Evaluate the effect of underlying CVD and CVD risk factors with cancer history on in-hospital mortality in those with COVID-19. Methods: Data from symptomatic adults hospitalized with COVID-19 at 86 hospitals in the US enrolled in the American Heart Association’s COVID-19 CVD Registry was analyzed. The primary exposure was cancer history. The primary outcome was in-hospital death. Multivariable logistic regression models were adjusted for demographics, CVD risk factors, and CVD. Interaction between history of cancer with concomitant CVD and CVD risk factors were tested. Results: Among 8222 patients, 892 (10.8%) had a history of cancer and 1501 (18.3%) died. Cancer history had significant interaction with CVD risk factors of age, body mass index (BMI), and smoking history, but not underlying CVD itself. History of cancer was significantly associated with increased in-hospital death (among average age and BMI patients, adjusted odds ratio [aOR]=3.60, 95% confidence interval [CI]: 2.07-6.24; p<0.0001 in those with a smoking history and aOR=1.33, 95%CI: 1.01 - 1.76; p=0.04 in non-smokers). Among the cancer subgroup, prior use of chemotherapy within 2 weeks of admission was associated with in-hospital death (aOR=1.72, 95%CI: 1.05-2.80; p=0.03). Underlying CVD demonstrated a numerical but statistically nonsignificant trend toward increased mortality (aOR=1.18, 95% CI: 0.99 - 1.41; p=0.07). Conclusion: Among hospitalized COVID-19 patients, cancer history was a predictor of in-hospital mortality. Notably, among cancer patients, recent use of chemotherapy, but not underlying CVD itself, was associated with worse survival. These findings have important implications in cancer therapy considerations and vaccine distribution in cancer patients with and without underlying CVD and CVD risk factors.

7.
J Bone Oncol ; 29: 100375, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1267729

ABSTRACT

Optimum management of patients with cancer during the COVID-19 pandemic has proved extremely challenging. Patients, clinicians and hospital authorities have had to balance the risks to patients of attending hospital, many of whom are especially vulnerable, with the risks of delaying or modifying cancer treatment. Those whose care has been significantly impacted include patients suffering from the effects of cancer on bone, where delivering the usual standard of care for bone support has often not been possible and clinicians have been forced to seek alternative options for adequate management. At a virtual meeting of the Cancer and Bone Society in July 2020, an expert group shared experiences and solutions to this challenge, following which a questionnaire was sent internationally to the symposium's participants, to explore the issues faced and solutions offered. 70 respondents, from 9 countries (majority USA, 39%, followed by UK, 19%) included 50 clinicians, spread across a diverse range of specialties (but with a high proportion, 64%, of medical oncologists) and 20 who classified themselves as non-clinical (solely lab-based). Spread of clinician specialty across tumour types was breast (65%), prostate (27%), followed by renal, myeloma and melanoma. Analysis showed that management of metastatic bone disease in all solid tumour types and myeloma, adjuvant bisphosphonate breast cancer therapy and cancer treatment induced bone loss, was substantially impacted. Respondents reported delays to routine CT scans (58%), standard bone scans (48%) and MRI scans (46%), though emergency scans were less affected. Delays in palliative radiotherapy for bone pain were reported by 31% of respondents with treatments often involving only a single dose without fractionation. Delays to, or cancellation of, prophylactic surgery for bone pain were reported by 35% of respondents. Access to treatments with intravenous bisphosphonates and subcutaneous denosumab was a major problem, mitigated by provision of drug administration at home or in a local clinic, reduced frequency of administration or switching to oral bisphosphonates taken at home. The questionnaire also revealed damaging delays or complete stopping of both clinical and laboratory research. In addition to an analysis of the questionnaire, this paper presents a rationale and recommendations for adaptation of the normal guidelines for protection of bone health during the pandemic.

8.
Front Oncol ; 10: 577696, 2020.
Article in English | MEDLINE | ID: covidwho-1264351

ABSTRACT

Immune checkpoint inhibitors (ICI) have become the standard of care treatment for several tumor types. ICI-induced pneumonitis is a serious complication seen with treatment with these agents. Cancer has been reported to be one of the risk factors for severe coronavirus disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that has engulfed the world in the last couple of months. In patients with cancer treated with ICI who present at the emergency department with respiratory symptoms during the COVID-19 pandemic, correct diagnosis can be challenging. Symptoms and radiological features of ICI pneumonitis can be overlapping with those of COVID-19 related pneumonia. For the latter, dexamethasone and remdesivir have shown encouraging results, while vaccines are currently being evaluated in phase III trials. The mainstay of treatment in ICI pneumonitis is immunosuppressive therapy, as this is a potentially fatal adverse event. It has been speculated that immunosuppression may be associated with increased risk of progression to severe COVID-19, especially during the early stage of infection with SARS-CoV-2. Therefore, distinction between these two entities is warranted. We summarize the clinical, radiological features as well as additional investigations of both entities, and suggest a diagnostic algorithm for distinction between the two. This algorithm may be a supportive tool for clinicians to diagnose the underlying cause of the pneumonitis in patients treated with ICI during this COVID-19 pandemic.

9.
Int J Nurs Stud Adv ; 3: 100030, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1260755

ABSTRACT

BACKGROUND: Healthcare services have responded to the challenges of service delivery during COVID-19 with telehealth and hybrid models of care. However, there is limited understanding of the experiences of care amongst people affected by cancer and how their experiences may change and evolve against the shifting landscape of COVID-19 incidence, mortality, vaccination and refinements in service delivery. OBJECTIVES: This study explores the experiences of cancer care amongst people affected by cancer in Ireland during the COVID-19 pandemic. This paper presents the results of the initial cross-sectional semi-structured interviews and the longitudinal qualitative research design which will be employed in this study. DESIGN: A longitudinal descriptive qualitative study. SETTING: Ireland. PARTICIPANTS: People living with and after cancer or caring for someone with cancer during the COVID-19 pandemic. METHODS: Participants were recruited to the study via social media advertisements and consented to participate in up to three semi-structured interviews between January and July 2021. Initial semi-structured interviews were conducted with 16 participants in January 2021. Participants completed measures of resilience (2-item Connor-Davidson Resilience Scale) and distress (The National Comprehensive Cancer Network Distress Thermometer). Interviews were recorded, transcribed and analysed thematically. RESULTS: Participants reported low levels of distress and moderate to high levels of resilience on average. Three themes were generated from analysis of the first phase of cross-sectional interviews. Participants described a counterbalance of being cautious of infection and keeping safe through prevention and shielding strategies. Although hospitals felt safe and were working efficiently, some participants felt COVID-19 had compromised person-centredness and empathy in care. While participants valued the measures taken to minimize infection risk, substitution of face-to-face appointments with telehealth services and attending essential face-to-face appointments alone restricted participants' access to professional and social support. Despite this, many participants felt public health measures to reduce transmission of COVID-19 had created a sense of not missing out, feeling safe and reduced difficult social interactions requiring explanation of their diagnosis. CONCLUSIONS: There is an opportunity to learn from the experiences of healthcare delivery from the perspectives of people affected by cancer during the COVID-19 pandemic. The results highlight the complexities and dualities of living with, after or caring for someone with cancer during the COVID-19 pandemic. Opportunities for longitudinal qualitative research to explore the evolving experiences, concerns and persistent and emerging unmet information and clinical needs within the rapidly changing socio-political, socio-cultural and healthcare contexts of the COVID-19 pandemic are highlighted.

10.
BMJ Open ; 11(6): e045679, 2021 06 02.
Article in English | MEDLINE | ID: covidwho-1255597

ABSTRACT

INTRODUCTION: Childhood cancers are a leading cause of non-communicable disease deaths for children around the world. The COVID-19 pandemic may have impacted on global children's cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children's Non-Communicable Diseases is currently undertaking the first international cohort study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short-term to medium-term impacts on childhood cancer outcomes. METHODS AND ANALYSIS: This is a multicentre, international cohort study that will use routinely collected hospital data in a deidentified and anonymised form. Patients will be recruited consecutively into the study, with a 12-month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anticancer treatment for the following cancers: acute lymphoblastic leukaemia, Burkitt lymphoma, Hodgkin lymphoma, Wilms tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas and neuroblastomas. Patients must be newly presented or must be undergoing active anticancer treatment from 12 March 2020 to 12 December 2020. The primary objective of the study was to determine all-cause mortality rates of 30 days, 90 days and 12 months. This study will examine the factors that influenced these outcomes. χ2 analysis will be used to compare mortality between low-income and middle-income countries and high-income countries. Multilevel, multivariable logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. ETHICS AND DISSEMINATION: At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally and internationally. The results will be submitted for publication in a peer-reviewed journal.


Subject(s)
COVID-19 , Neoplasms , Adolescent , Child , Cohort Studies , Developed Countries , Humans , Multicenter Studies as Topic , Neoplasms/epidemiology , Observational Studies as Topic , Pandemics , SARS-CoV-2
12.
J Endocr Soc ; 5(6): bvab059, 2021 Jun 01.
Article in English | MEDLINE | ID: covidwho-1243826

ABSTRACT

The COVID-19 pandemic has forced endocrinologists to utilize telemedicine to care for their patients. There is limited information on the experience of endocrinologists in managing patients with thyroid cancer virtually. We sent a 9-item questionnaire to endocrinologists and endocrine surgeons at our institution to better understand the barriers and benefits of caring for patients with thyroid cancer via telemedicine, as well as how we can incorporate telemedicine into our future care of patients with this malignancy. Among the 9 physicians who responded, the majority listed technological issues with the virtual platform as a challenge in caring for patients with thyroid cancer remotely. Additional barriers included difficulty in expressing empathy, decreased ability to coordinate care with the interdisciplinary team, and lack of the physical examination. Benefits included compliance with social distancing measures and convenience for patients with American Thyroid Association (ATA) low-risk thyroid cancer who presented for follow-up visits. Overall, physicians were satisfied or strongly satisfied with caring for patients with thyroid cancer remotely, especially low-risk patients on long-term follow-up. That said, they recommend that some patients be seen in person after the pandemic, including symptomatic patients and ATA high-risk patients. While the COVID-19 pandemic has allowed endocrinologists to manage patients with thyroid cancer remotely, the providers have faced challenges, some of which can be improved upon. Further studies will help determine how telemedicine affects patient outcomes, including satisfaction, disease progression, and survival, which will inform how we may incorporate this practice into our future care of patients with thyroid cancer.

13.
BMJ Open ; 11(5): e050131, 2021 05 24.
Article in English | MEDLINE | ID: covidwho-1242208

ABSTRACT

OBJECTIVES: To investigate how the COVID-19 pandemic affected the number of people aged 50+ years presenting to primary care with features that could potentially indicate cancer, and to explore how reporting differed by patient characteristics and in face-to-face vs remote consultations. DESIGN, SETTING AND PARTICIPANTS: A retrospective cohort study of general practitioner (GP), nurse and paramedic primary care consultations in 21 practices in South-West England covering 123 947 patients. The models compared potential cancer indicators reported in April-July 2019 with April-July 2020. MAIN OUTCOME MEASURES: Potential indicators of cancer were identified using code lists for symptoms, signs, test results and diagnoses listed in the National Institute for Health and Care Excellence suspected cancer referral guidance (NG12). RESULTS: During April-July 2019, 17% of registered patients aged 50+ years reported a potential cancer indicator in a consultation with a GP or nurse. During April-July 2020, this reduced to 11% (incidence rate ratio (IRR) 0.64, 95% CI 0.62 to 0.67, p<0.001). Reductions in potential cancer indicators were stable across age group, sex, ethnicity, index of multiple deprivation quintile and shielding status, but less marked in patients with mental health conditions than without (IRR 0.75, 95% CI 0.72 to 0.79, interaction p<0.001). Proportions of GP consultations with potential indicators of cancer reduced between 2019 and 2020 for face-to-face consultations (IRR 0.84, 95% CI 0.76 to 0.92, p<0.001) and increased for remote consultations (IRR 1.17, 95% CI 1.07 to 1.29, p=0.001), although it remained lower in remote consulting than face-to-face in April-July 2020. This difference was greater for nurse/paramedic consultations (face-to-face: IRR 0.61, 95% CI 0.44 to 0.83, p=0.002; remote: IRR 1.60, 95% CI 1.10 to 2.333, p=0.014). CONCLUSION: The number of patients consulting with presentations that could potentially indicate cancer reduced during the first wave of the COVID-19 pandemic. Patients should be encouraged to continue contacting primary care for persistent signs and symptoms, and GPs and nurses should be encouraged to probe patients for further information during remote consulting, in the absence of non-verbal cues.


Subject(s)
COVID-19 , Neoplasms , England/epidemiology , Humans , Middle Aged , Neoplasms/epidemiology , Pandemics , Primary Health Care , Retrospective Studies , SARS-CoV-2
14.
Pediatr Hematol Oncol ; 38(8): 695-706, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1242072

ABSTRACT

An understanding of the behavior of SARS-CoV-2 in pediatric hematology-oncology patients is essential to the optimal management of these patients during the COVID-19 pandemic. This study describes the characteristics and outcomes of COVID-19 disease in children with cancer or hematologic disorders treated at a large children's hospital. A retrospective cohort study was conducted at Texas Children's Cancer and Hematology Center from January 1, 2020 to September 30, 2020. All patients with a primary hematology-oncology diagnosis and SARS-CoV-2 positivity by reverse transcription polymerase chain reaction were identified. Clinical and laboratory data were obtained from the medical record. Descriptive analyses were performed to evaluate COVID-19-related outcomes and risk factors for severe disease in this population. We identified 109 patients with COVID-19 disease, including 52 hematology, 51 oncology, and 6 HSCT patients; median age was 10.3 years (IQR 4.4-15.9), and 58.7% were male. Seventy-four percent of the patients were managed in the outpatient setting. Patients with sickle cell disease were more likely to require hospitalization. ICU care was needed in 8% (n = 9) of the entire cohort, and mechanical ventilation was required in 6.4% (6 oncology patients, 1 hematology patient). COVID-19 contributed to the deaths of two cancer patients. No deaths occurred in hematology or HSCT patients. In conclusion, the risk of severe COVID-19 complications is slightly higher in pediatric hematology-oncology patients than in the general pediatric population but lower than initially feared. For most asymptomatic patients, primary disease management may continue as planned, but treatment decisions must be individualized.


Subject(s)
COVID-19 , Hematologic Diseases , Neoplasms , COVID-19/complications , Child , Hematologic Diseases/epidemiology , Humans , Male , Neoplasms/epidemiology , Pandemics , Retrospective Studies , Texas/epidemiology
15.
Nat Med ; 27(7): 1280-1289, 2021 07.
Article in English | MEDLINE | ID: covidwho-1238011

ABSTRACT

Patients with cancer have high mortality from coronavirus disease 2019 (COVID-19), and the immune parameters that dictate clinical outcomes remain unknown. In a cohort of 100 patients with cancer who were hospitalized for COVID-19, patients with hematologic cancer had higher mortality relative to patients with solid cancer. In two additional cohorts, flow cytometric and serologic analyses demonstrated that patients with solid cancer and patients without cancer had a similar immune phenotype during acute COVID-19, whereas patients with hematologic cancer had impairment of B cells and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific antibody responses. Despite the impaired humoral immunity and high mortality in patients with hematologic cancer who also have COVID-19, those with a greater number of CD8 T cells had improved survival, including those treated with anti-CD20 therapy. Furthermore, 77% of patients with hematologic cancer had detectable SARS-CoV-2-specific T cell responses. Thus, CD8 T cells might influence recovery from COVID-19 when humoral immunity is deficient. These observations suggest that CD8 T cell responses to vaccination might provide protection in patients with hematologic cancer even in the setting of limited humoral responses.


Subject(s)
CD8-Positive T-Lymphocytes/immunology , COVID-19/immunology , Hematologic Neoplasms/immunology , Neoplasms/immunology , Aged , Antibodies, Viral/immunology , B-Lymphocytes/immunology , COVID-19/complications , COVID-19/mortality , Cohort Studies , Female , Hematologic Neoplasms/complications , Humans , Immunity, Cellular/immunology , Immunity, Humoral/immunology , Immunophenotyping , Logistic Models , Male , Middle Aged , Multivariate Analysis , Neoplasms/complications , Proportional Hazards Models , Prospective Studies , SARS-CoV-2 , Survival Rate
16.
Cancer Rep (Hoboken) ; 5(2): e1426, 2022 02.
Article in English | MEDLINE | ID: covidwho-1237412

ABSTRACT

BACKGROUND: Cancer care during the Covid-19 pandemic has been challenging especially in a developing country such as the Philippines. Oncologists were advised to prioritize chemotherapy based on the absolute benefit that the patient may receive, which outbalances the risks of Covid-19 infection. The results of this study will allow re-examination of how to approach cancer care during the pandemic and ultimately, help optimize treatment recommendations during this crisis. AIM: This study described the factors contributing to treatment delays during the pandemic and their impact on disease progression. MATERIALS AND RESULTS: This retrospective cohort study was done in St. Luke's Medical Center, a private tertiary healthcare institution based in Metro Manila, Philippines, composed of two facilities in Quezon City and Global City. Patients with solid malignancy with ongoing systemic cancer treatment prior to the peak of the pandemic were identified. Clinical characteristics and treatment data were compared between those with delayed and continued treatments. Multivariate analysis was done to determine factors for treatment delays and association of delays with disease progression and Covid-19 infection. Of the 111 patients, 33% experienced treatment delays and 67% continued treatment during the pandemic. There was a higher percentage of patients on palliative intent who underwent treatment delay, and 64% of delays were due to logistic difficulties. Treatment delays were significantly associated with disease progression (p < .0001). There was no evidence of association between delay or continuation of treatment and risk of Covid-19 infection. CONCLUSIONS: There was no difference in Covid-19 infection between those who delayed and continued treatment during the pandemic; however, treatment delays were associated with a higher incidence of disease progression. Our findings suggest that the risks of cancer progression due to treatment delays exceed the risks of Covid-19 infection in cancer patients implying that beneficial treatment should not be delayed as much as possible. Logistic hindrances were also identified as the most common cause of treatment delay among Filipino patients, suggesting that efforts should be focused into assistance programs that will mitigate these barriers to ensure continuity of cancer care services during the pandemic.


Subject(s)
Antineoplastic Agents/therapeutic use , COVID-19/epidemiology , Neoplasms/drug therapy , Time-to-Treatment/statistics & numerical data , Adult , Aged , COVID-19/immunology , COVID-19/prevention & control , COVID-19/transmission , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/statistics & numerical data , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Disease Progression , Female , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms/complications , Neoplasms/diagnosis , Neoplasms/immunology , Pandemics/prevention & control , Philippines/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
17.
Oncology (Williston Park) ; 34(9): 370-376, 2020 09 15.
Article in English | MEDLINE | ID: covidwho-1231670

ABSTRACT

In an asymptomatic 77-yearold woman, former 55 packyears smoker, a routine X-ray showed a 45-mm superior left lobe lesion. A chest CT scan confirmed a 36-mm superior left lobe lesion and an aortic-pulmonary lymph node enlargement measuring 42 mm, suspicious for neoplasia. A PET-CT scan showed an elevated uptake in the primary lesion, in the aortic-pulmonary lymph node, and in the left hilar lymph node with a standardized uptake value - 40 and 4.3, respectively. CT-guided lung biopsy showed a lung squamous cell carcinoma. An endobronchial ultrasound-guided transbronchial needle aspiration for lymph-node staging was negative for lymph node spread. Brain MRI was negative. Final staging was determined to be a IIIA (T2bN2) squamous cell carcinoma of the lung.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents, Immunological/therapeutic use , Carcinoma, Squamous Cell/therapy , Coronavirus Infections/diagnosis , Lung Neoplasms/therapy , Pneumonia, Viral/diagnosis , Pneumonia/diagnosis , Aged , Antibodies, Monoclonal/adverse effects , Antineoplastic Agents, Immunological/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Betacoronavirus , COVID-19 , Carboplatin/administration & dosage , Carcinoma, Squamous Cell/diagnostic imaging , Chemoradiotherapy , Consolidation Chemotherapy , Diagnosis, Differential , Female , Humans , Lung/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Paclitaxel/administration & dosage , Pandemics , Pneumonia/chemically induced , SARS-CoV-2
18.
Front Psychol ; 12: 647196, 2021.
Article in English | MEDLINE | ID: covidwho-1229228

ABSTRACT

Background: The number of cancer patients is constantly growing. Both WHO and IARC report that this number may reach up to 24 million new diagnosed cases in the next two decades. The proposed treatment and especially the diagnosis can have a significant impact on an individual's approach to the disease, as well as on the patient's quality of life. Objectives: The study aimed to assess the quality of life, feelings, and fear of cancer-treating oncological patients, before and during the COVID-19 pandemic. Material and Methods: The study used the standardized WHOQOL quality of life questionnaire in a shortened version, the COVID-19 fear scale (FCV-19S), and the AIS disease acceptance scale (in terms of cancer-related sensations). The questionnaire survey was conducted among patients of cancer clinics (Poland). The study was conducted in two stages-before the COVID-19 pandemic (May 2019) and during the COVID-19 pandemic (May 2020). Data from 450 correctly completed questionnaires were analyzed statistically. The obtained data were statistically processed using the Kruskal-Wallis and Mann-Whitney U test (p = 0.05). Results: Among the surveyed patients of the cancer clinic, the quality of life during the COVID-19 pandemic decreased by 2%, compared to the period before the pandemic. The frequency of negative feelings associated with cancer increased during the COVID-19 pandemic-by 11% more men, and 4.4% of women determined the frequency of negative feelings to be 2-3 times a week. The level of fear associated with COVID-19 was moderate (57.1%), with women having a higher level of fear (12.5% higher than men). Conclusion: The development of the epidemic is very important in terms of public health. COVID-19 should be considered as one of the factors that bring about sudden changes in the mental health of the population, which may result from the dynamic development of this disease, dramatic media coverage, and own experiences. It has been shown that the sudden appearance of such a large stressor causes a decrease in patients' quality of life and an increase in negative feelings associated with chronic disease.

19.
Am Soc Clin Oncol Educ Book ; 41: 1-10, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1229013

ABSTRACT

The COVID-19 pandemic has considerably changed health services for children with cancer worldwide by creating barriers throughout the care continuum. Reports available at this time suggest that asymptomatic and mild upper and lower respiratory tract syndromes are the most common presentation of COVID-19 in children with cancer. Nonetheless, severe cases of COVID-19 and deaths secondary to the infection have been reported. In addition to the direct effects of the severe acute respiratory syndrome coronavirus 2, children with cancer have suffered from the collateral consequences of the pandemic, including decreased access to diagnosis and cancer-directed therapy. The COVID-19 pandemic has presented unprecedented challenges to safe and effective care of children with cancer, including their enrollment in therapeutic clinical trials. Data from the Children's Oncology Group and Cancer Research U.K. Clinical Trials Unit show variability in the enrollment of children with cancer in clinical trials during the COVID-19 pandemic. However, the overall effects on outcomes for children with cancer undergoing care during the pandemic remain largely unknown. In this article, we review the current knowledge about the direct and collateral effects of the COVID-19 pandemic, including on clinical trial enrollment and operations.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care , Neoplasms/diagnosis , Neoplasms/therapy , Child , Clinical Trials as Topic , Hematopoietic Stem Cell Transplantation , Humans , Neoplasms/epidemiology , SARS-CoV-2 , United Kingdom/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL