Cancer or COVID-19? A Review of Guidelines for Safe Cancer Care in the Wake of the Pandemic
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COVID-19
Cancer or COVID-19? A Review of Guidelines for Safe Cancer Care in the Wake of the Pandemic Manit K. Gundavda 1 & Kaival K. Gundavda 2 Accepted: 2 November 2020 / Published online: 21 November 2020 # Springer Nature Switzerland AG 2020
Abstract In the wake of the COVID-19 pandemic, due to reasons beyond control, health care workers have struggled to deliver treatment for the patients with cancer. The concern for otherwise healthy patients with curable cancers that require timely intervention or therapy is the risk of contracting COVID-19 may outweigh the benefits of cancer treatment. Lack of international guidelines leaves health care providers with a case-to-case approach for delivering optimal cancer care in the wake of the pandemic. Transition to telemedicine has somewhat bridged the gap for in-office visits, but there is a continuing challenge of delays in cancer screening or significant decline of new diagnoses of cancers due to the pandemic. We aim to propose a balance in risk from treatment delay versus risks from COVID-19 with emphasis on treatment modality (surgery, radiation, and systemic therapy) as well as supportive care for cancer patients, and therefore have reviewed the publications and recommendations from international societies and study groups available as of October 2020. Keywords Cancer care . COVID-19 pandemic . Disruptioninoncologycare . Resumption ofelectivesurgeries . Supportivecancer care . Re-planning radiation therapy . Medical oncology treatments . Prevention of SARS-CoV-2 infection . International society guidelines . Literature review
This article is part of the Topical Collection on COVID-19 Key Points • Patients with confirmed SARS-CoV-2 infection within 7 days before or 30 days after surgery had an overall 30-day mortality of 24%. • Prioritization of treatments and testing of patients prior to institutional procedures should be implemented as standard protocol. • Radiation therapy for head-neck, nasopharyngeal, and lung fields should be actively monitored, possibly owing to the unknown effect on respiratory complications associated with COVID-19. • Patients that have tested negative for SARC-CoV-2 are recommended to continue anticancer therapy that might be critical for tumor control. • The risk of in-hospital COVID-19 death was significantly higher for non-hematologic malignancies diagnosed 1 to 5 years prior to SARSCoV-2 infection and the risk for hematologic malignancies continued to remain high even after 5 years. • Mental and physical health of clinicians should be given utmost importance as they are the ones at high risk for stress and fatigue breakdown during the pandemic. * Manit K. Gundavda [email protected]
1
Department of Orthopaedic Oncology, P. D. Hinduja National Hospital and Medical Research Centre, Andheri West, Mumbai, Maharashtra 400053, India
Kaival K. Gundavda [email protected]
2
Department of Surgical Oncology, Tata Memorial hospital, 93, Ground floor, Main Building, Mumbai, Maharashrta 400012, India
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Introduction The acute
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