Optimizing cancer care during the COVID-19 pandemic

  • ACS, ASCO

  • Par Pavankumar Kamat
  • Résumés d'articles
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Takeaway

  • Cancer care must continue during the ongoing COVID-19 pandemic, but changes may be required in the way some care is delivered. 

Key points

  • The American Cancer Society recommends putting routine cancer screening on the back burner to conserve clinical resources and reduce exposure to health care facilities.
  • Recommendations from the American Society of Clinical Oncology (ASCO):
    • Elective surgeries at inpatient facilities should be rescheduled if possible.
    • Essential surgeries should be scheduled after consideration of the potential harms of delaying surgery.
    • No direct evidence supports alterations in systemic treatment regimens during the pandemic, so routinely stopping anticancer or immunosuppressive therapy is not recommended.
  • ASCO recommends individualizing clinical decisions:
    • Stopping treatment may be an option for patients in deep remission and on maintenance therapy. 
    • Consider switching from intravenous to oral therapies for some patients.
    • If there is local COVID-19 transmission at a particular cancer center, consider taking a 2-week treatment break or shifting treatment to another facility.
    • Assess the medical and logistical feasibility of home infusions.
    • With regard to modifying or withholding chemotherapy, consider both the indication and goals of care, as well as where the patient is in the treatment regimen and tolerance to the therapy.
    • With regard to delaying or modifying adjuvant treatment, consider the risk for compromised disease control and long-term survival. 
  • For allogeneic stem cell transplantation candidates, delaying treatment may be reasonable if the disease is currently well controlled with conventional treatment.
  • Currently, no evidence addresses prophylactic antiviral therapy for patients undergoing active cancer treatment, but data might become available at any time.

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.