Evolution of Cancer Care in Response to the COVID-19 Pandemic

ERICA. COOMES, a HUMAID O. AL-SHAMSI , b BRANDON M. MEYERS, c WALEED ALHAZZANI, d AHMAD ALHURAIJI, e ROY F. CHEMALY, f MESHARI ALMUHANNA, g ROBERT A. WOLFF, h NUHAD K. IBRAHIM, i MELVIN L.K. CHUA, j SEBASTIEN J. HOTTE, c TAREK ELFIKI, k GIUSEPPE CURIGLIANO, l CATHY ENG, m AXEL GROTHEY, n CONGHUA XIEo
The Oncologist 2020 May 21

We agree with Souadka et al. that health care systems and oncology centers must prepare for the possibility for subsequent epidemic waves, as intensive societal control measures are relaxed [2]. In the acute phase, out of necessity we have had to make adjustments to typical treatment protocols to account for anticipated disruptions of health system capacity. For example, in the short term, should significant delay in operative intervention be unavoidable, then consideration may be given to using chemotherapy in the neoadjuvant setting.

Unfortunately, during the early phases of the pandemic, due in part to fear of infection, patients may have even avoided health care settings for acute medical conditions; this has been hypothesized as an explanation for the significant decrease in admissions for acute coronary syndrome during the Italian outbreaks of COVID-19 [3]. However, in the long term we need to optimize ongoing access to care to ensure safe delivery of therapy for both acute and chronic medical conditions; the large-scale implementation of virtual and telemedicine is one such intervention that has been rapidly deployed to maintain continuity of care [4, 5].

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