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Delayed Urological Cancer Care during the COVID-19 Pandemic: Urologists' Experience.
Wittmann, Daniela; Faris, Anna; Montie, James E; Chisholm, Stephanie; Duby, Ashley; O'Dell, Diana; Sarle, Richard; Johnston, William K; Morgan, Todd M; Hawley, Sarah T; An, Lawrence C; Herrel, Lindsey A.
  • Wittmann D; University of Michigan, Ann Arbor, Michigan.
  • Faris A; University of Michigan, Ann Arbor, Michigan.
  • Montie JE; University of Michigan, Ann Arbor, Michigan.
  • Chisholm S; Michigan Urological Surgery Improvement Collaborative (MUSIC), Ann Arbor, Michigan.
  • Duby A; Bladder Cancer Advocacy Network, Bethesda, Maryland.
  • O'Dell D; University of Michigan, Ann Arbor, Michigan.
  • Sarle R; University of Michigan, Ann Arbor, Michigan.
  • Johnston WK; Michigan Urological Surgery Improvement Collaborative (MUSIC), Ann Arbor, Michigan.
  • Morgan TM; Michigan Urological Surgery Improvement Collaborative (MUSIC), Ann Arbor, Michigan.
  • Hawley ST; Oakland University, Rochester, Michigan.
  • An LC; University of Michigan, Ann Arbor, Michigan.
  • Herrel LA; Michigan Urological Surgery Improvement Collaborative (MUSIC), Ann Arbor, Michigan.
Urol Pract ; 8(3): 367-372, 2021 May.
Article in English | MEDLINE | ID: covidwho-1276296
ABSTRACT

INTRODUCTION:

The arrival of coronavirus disrupted health care systems and forced delays in cancer treatment. We explored the experience of urologists who had to delay their patients' cancer care.

METHODS:

Urologists who treat prostate, bladder, and renal cancers, selected through purposive sampling, responded to a survey about cancer treatment delay. They were asked about their practice setting, decision making and interactions with patients, and they were asked to reflect on their personal experience. A 0 to 10 point scale, modeled on the National Comprehensive Cancer Network' Distress Thermometer (NCCN-DT), validated for cancer patients with cancer, was used to estimate physician distress. We used descriptive statistics to analyze survey results.

RESULTS:

Of the 64 participating urologists, 98% delayed surgical treatment; fewer delayed cases of advanced cancers (42% for ≥T3/T4 or Gleason ≥8 prostate cancers, 58% for muscle invasive bladder cancer, 61% for ≥T2 renal cancers). They reported feeling anxious (44%) and helpless (29%), and their median distress score was 5 (range 0-10). They relied on their own risk assessments (67%) and consulted colleagues (56%) and national guidelines (53%) when making treatment deferral decisions. They identified a number of concerns as they resumed surgeries.

CONCLUSIONS:

Based on a comparison to the NCCN-DT clinical cutoff distress level of 4, urologists experienced moderately high levels of distress as they delayed cancer care during the COVID-19 pandemic and expressed concerns going forward. While the focus on patient care is paramount in a pandemic, it is important to recognize physician distress and develop practical and psychological strategies for distress mitigation.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Urol Pract Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Journal: Urol Pract Year: 2021 Document Type: Article