scholarly journals Impacts of COVID-19 on Liver Cancers: During and after the Pandemic

Liver Cancer ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 491-502 ◽  
Author(s):  
Stephen Lam Chan ◽  
Masatoshi Kudo
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Hepatic Injury ◽  
Healthcare Services ◽  
Current Data ◽  
Mitigation Measures ◽  
Medical Illness ◽  
Cancer Management ◽  
Liver Cancers ◽  
The Impact

Background: The pandemic of coronavirus disease 2019 (COVID-19) has diverted resources from healthcare services for patients with chronic medical illness such as cancer. COVID-19 also causes organ dysfunction, complicating cancer treatment. In most countries with an outbreak of COVID-19, modifications of cancer management have been adopted to accommodate the crisis and minimize the exposure of cancer patients to the infection. In countries where COVID-19 numbers are subsiding, medical teams should also be prepared to resume normal practices gradually. Here, we aim to review the literature on the impact of COVID-19 on patients with hepatocellular carcinoma (HCC) as well as discuss modifications to the management of HCC during and after recovery from the pandemic. Summary: Based on current data, 10–40% of patients with COVID-19 have hepatic injury characterized by an elevation of transaminases and/or hyperbilirubinemia. Multiple mechanisms contribute to the hepatic injury, including direct viral entry to hepatocytes/cholangiocytes, immune-mediated hepatitis, hypoxia, and drug-related hepatotoxicity. In patients with HCC, COVID-19 may exacerbate existing chronic liver disease and complicate the management of cancer. Cancer patients generally have a higher risk of infection and worse outcome, especially those who have recently undergone cancer treatment. Although HCC is under-represented in COVID-19 series, mitigation measures should be implemented to minimize the exposure of patients to the virus. A decision on the treatment of HCC should be balanced with consideration of the availability of medical resources, the level of infection risk of COVID-19, and the risk-benefit ratio of the individual patient. In areas where the COVID-19 outbreak is subsiding, clinicians should be prepared to manage a surge of HCC patients with higher disease burdens and complications. Key Messages: Mitigation measures to protect at-risk patients, such as those with cancers, from SARS-CoV-2 infection should be exercised and the impact of COVID-19 on this group of patients should be thoroughly studied.

Does a treatment delay affect the survival of octogenarian patient population?

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 149-149
Author(s):  
Ali Mehmood Raufi ◽  
Hassaan Jafri ◽  
Todd W. Gress
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Patient Population ◽  
Gynecological Cancer ◽  
Eastern Cooperative Oncology Group ◽  
Treatment Delay ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Management ◽  
The Impact

149 Background: The cancer management of the elderly patient is an increasingly important and challenging issue. The aim of this retrospective analysis is to evaluate the impact of treatment delay on survival outcome of cancer in octogenarian patients. Methods: From 2006 to 2015, established cancer patients age 80 and above who received treatment at our comprehensive cancer center were retrospectively reviewed. We evaluated the relationship between a delay in cancer treatment of more than 30 days in the octogenarian patient and survival using Kaplan-Meier survival and Cox proportional hazards models. Results: There were 235 octogenarian cancer patients available for evaluation and 115 of these had a delay in initiation of cancer treatment ( > 30 days). Mean age was 83.7 years the treatment delay (TD) group and 83.9 in the no treatment delay (NTD) group (p = 0.70) Eastern Cooperative Oncology Group (ECOG) score of 2 or more was present in 22.6% of the TD group and 18.3% of the NTD group (p = 0.42). Metastatic disease was higher in the NTD group (22.5% vs. 11.3% TD group; p = 0.051). There were more breast (36.5% TD vs. 12.5% NTD group) and lung cancer (26.9% TD vs. 18.3% NTD group) in the TD group, and more genitourinary (20.8% NTD vs. 9.6% TD group) and gynecological cancer (20.8% NTD vs. 15.6% TD group) in the NTD group (p < 0.001 for overall comparison). Median overall survival was higher in the TD group (50 vs. 24 months NTD group; p = 0.001). Treatment delay was still associated with improved survival even after adjusting for age, gender, ECOG, stage of disease, and type of tumor (HR 0.64, CI 0.44-0.92). Conclusions: We found that a delay in cancer treatment in the octogenarian patient was associated with better overall survivial. Bias in regards to the reasons for the treatment delay may exist and could have affected our results. We attempted to minimize this bias by adjusting for characteristics that influence treatment between our two study groups. Nevertheless, our findings suggest that a delay in cancer treatment at minimum did not adversely affect mortality in this older patient population.

scholarly journals P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Soham Bandyopadhyay
Keyword(s):  
Cohort Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Multivariate Logistic Regression Analysis ◽  
Global Health Research ◽  
Cancer Outcomes ◽  
Paediatric Cancer ◽  
Cancer Management ◽  
Anti Cancer ◽  
The Impact

Abstract Introduction Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients 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 (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short 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 de-identified 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 anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate 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.

scholarly journals The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

2021 ◽  
Author(s):  
Ahmed M Badheeb ◽  
Mohamed A Badheeb ◽  
Hamdi A Alhakimi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Saudi Arabia ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Cancer Center ◽  
Anti Cancer ◽  
Before And After ◽  
The Difference ◽  
The Impact

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.

Thromboembolic events in hospitalized cancer patients: Impact on stay duration and cost for four major cancer localizations.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 186-186
Author(s):  
Florian Scotte ◽  
Alexandre Vainchtock ◽  
Nicolas Martelli ◽  
Isabelle Borget
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Thromboembolic Events ◽  
Cancer Management ◽  
Venous Thromboembolic Events ◽  
The Impact

186 Background: Cancer patients represent an at-risk population for Venous Thromboembolic Events (VTE). Our study aimed to evaluate the impact of VTE on the length and cost of hospital stay in French patients hospitalized for breast cancer (BC), colon cancer (CC), lung cancer (LC) or prostate cancer (PC). Methods: The French national hospital database (PMSI) and the disease-specific ICD-10 codes were used to identify BC, CC, LC or PC patients diagnosed in 2010 who were hospitalized with a VTE during the following two years. We selected stays during which a VTE occurred but was not the main reason of hospitalization (cancer was classified as primary/related diagnosis and VTE as significant associated diagnosis). Those stays were matched and compared to similar stays (same cancer and same reason for hospitalization) without VTE. Costs were calculated using the French official tariffs, from the perspective of the third-party payer. Results: We identified 214 stays for breast cancer during which a VTE occurred and was classified as significant associated diagnosis, 843 stays for colon cancer, 1301 for lung cancer, and 126 for prostate cancer. The comparison between those stays and similar stays without VTE showed significant increase of hospital stay duration in patients experiencing VTE. Median duration rose from 4 to 7 days in BC patients, from 8 to 16 days in CC, from 2 to 9 days in LC and from 6 to 10 days in PC. Consequently, the median expenditure per stay increased by 37% in BC patients with VTE (up to € 5,518), by 61% in CC (up to € 9,878), by 202% in LC (up to € 7,308) and by 22% in PC (up to € 6,200). Conclusions: When occurring during hospitalization, VTE made cancer management much heavier: patients faced prolonged hospital stays whereas healthcare system faced significant additional cost. Better prevention and follow-up measures could reduce this burden, and benefit both patients and hospitals. [Table: see text]

scholarly journals The Impact of Cancer Treatment “Out-of-Pocket” Costs on the Mental Health of Chemotherapy Patients: A Comparative Study

2021 ◽  
Author(s):  
Thiago Artioli ◽  
Karine Corcione Turke ◽  
Aline Hernandez Marquez Sarafyan ◽  
Beatriz Boos Ortolani ◽  
Ingrid Victoria Maria Biondo Edle von Schmadel ◽  
...  
Keyword(s):  
Mental Health ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Unified Health System ◽  
The Impact ◽  
Out Of Pocket Costs

Abstract Introduction: Anxiety and depression are prevalent comorbidities in cancer patients. Although cancer treatment is funded by the Brazilian Unified Health System (SUS), economic burden is also borne by patients through out-of-pocket costs. Our study sought to evaluate the impact of out-of-pocket costs of cancer treatment on depression, anxiety and stress levels in cancer patients.Methods: Observational, cross-sectional and analytical study conducted in 2021. Patients undergoing chemotherapy were being treated at tertiary hospital affiliated with the SUS and enrolled in research protocols at research center. To evaluate out-of-pocket costs, we used a socioeconomic questionnaire to identify costs and time spent by patients. Primary outcomes were prevalence of depression and anxiety, as determined by the Hospital Anxiety and Depression Scale (HADS), and prevalence of stress, as determined using a stress thermometer.Results: 195 patients were included. Among included patients, 61% were female, and mean age was 57 years. Patients' median overall out-of-pocket costs was R$ 453.80 (US$ 78.92). Based on the HADS, 62.1% of patients had possible or probable depression/anxiety. There was no correlation between overall out-of-pocket spending and levels of depression/anxiety. However, when stratified by cost-time variables, there was a negative correlation between spending on telephones and HADS (rho = -0.140; P = 0.049) and positive correlations between spending on medications (rho = 0.140; P = 0.05) and time spent purchasing medications (rho = 0.157; P = 0.029) with HADS.Conclusion: Although overall spending was not directly correlated with mental health, specific costs impacted levels of anxiety, depression and stress.

scholarly journals The Era of Covid-19; Its’ Impact on Cancer Patient Experience in Southwest Nigeria

2021 ◽  
Vol 9 (4) ◽  
pp. 211-231
Author(s):  
Aisagbonhi Henry
Keyword(s):  
Cancer Patient ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Patient Experience ◽  
Health Care Services ◽  
Cancer Management ◽  
Care Services ◽  
Public Health Professionals ◽  
Southwest Nigeria ◽  
The Cost

Patients have developed a well-informed sense of validation concerning maintaining hygiene standards. The pandemic, somehow in disguise, presented the valuable perspective of life reflection and gratitude. The attitude of a majority of patients engaged was immensely that of a deep reflection of the privilege of having access to early diagnosis, treatment, and adequate support. However, the complaints of the past, knowing that they are alive and have hope to keep fighting on with gratitude and sense of acceptance. However, they wished that the experience of the social media – health engagement platform should continue as it provided a good level of the bridge of gap of information. The cost of treatment remains a major concern as it largely translates to possible dropout from treatment courses for most cancer patients who can’t afford the current cost. The concerns of the cancer patients and survivors during and after the covid-19 pandemic are similarly a concern to public health professionals worldwide. The need to aid their return to routine health care services is more important and therefore requires an urgent reorganization of cancer management services. An urgent intervention should be focused on patient re-orientation /pandemic control, staff training and retraining, awareness campaign, screening and result accessibility, special pandemic services, amongst others. The outcome reflected a very huge level of poor cancer patient experience in the public cancer treatment centres, while the reverse is the case with the private cancer treatment centres. This can be managed if an urgent intervention as proffered is implemented.

National survey of physicians practice patterns: Fertility preservation and cancer patients

2009 ◽  
Vol 27 (18_suppl) ◽  
pp. CRA9508-CRA9508 ◽  
Author(s):  
G. Quinn ◽  
S. T. Vadaparampil ◽  
P. Jacobsen ◽  
J. Lee ◽  
J. Lancaster ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Practice Patterns ◽  
The United States ◽  
Future Research ◽  
Nurse Training ◽  
Educational Materials ◽  
Childbearing Age ◽  
Future Fertility ◽  
The Impact

CRA9508 Background: Addressing the impact of cancer treatment on fertility is a high priority in providing quality cancer care to patients of childbearing age. Evidence suggests less than 50% of patients receive adequate fertility information prior to cancer treatment. This study assessed the practice patterns of physicians and identified perceptions of barriers to communication about fertility. Methods: A 37 item survey was developed by a review of the literature and previous qualitative interviews. A random sample of physicians from the American Medical Association Masterfile was stratified by board specialty related to oncology. Three waves of surveys were distributed across the United States. The domains of the survey included demographics, knowledge, attitudes and practice behaviors related to FP with patients of childbearing age. Results: Of 1,979 physicians identified, a total of 613 physicians completed the survey, yielding a 33% response rate among oncologists. Oncologists with favorable attitudes towards FP were 4.9 times more likely to discuss the impact of cancer treatment on future fertility than those who have unfavorable attitudes. GYN or Medical/Hematological oncologists were 2.1 times more likely than other specialists to report feeling comfortable discussing FP with their patients. The majority of oncologists reported discussing FP with patients and indicated the primary barrier to discussion was a patient too ill to delay treatment. However, less than 25% of oncologists report referring patients for FP and only 38% report knowledge of the ASCO guidelines suggesting oncologists should discuss FP and refer all patients of childbearing age. Less than 25% of physicians surveyed reported distributing educational materials regarding FP. Conclusions: The majority of physicians in this survey report discussing FP; however they are not consulting specialists or providing educational materials to their patients. Future research will include the development of physician and nurse training curricula and interventions to facilitate discussion of FP between physicians and cancer patients. No significant financial relationships to disclose.

Comparative study of prevalence and costs of depression and anxiety among elderly cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6595-6595
Author(s):  
Stacey DaCosta Byfield ◽  
Kae Tanudtanud ◽  
John Rich Barrientos ◽  
Kiesha Mae Lasquite ◽  
Kierstin Catlett
Keyword(s):  
Cancer Patients ◽  
Healthcare Spending ◽  
Healthcare Services ◽  
Medical Professional ◽  
Cancer Type ◽  
Depression And Anxiety ◽  
Cancer Breast ◽  
Pharmacy Claims ◽  
Cost Categories ◽  
The Impact

6595 Background: Depression and anxiety are common among cancer patients and can worsen outcomes. We studied the occurrence of depression and anxiety in three common cancers to investigate whether healthcare costs were greater for cancer patients with two mental health disorders (MHD), depression and anxiety, compared to patients without MHD. Methods: This retrospective analysis used deidentified medical and pharmacy claims from a large national U.S. health insurer. Patients were Medicare Advantage enrollees ≥65 years diagnosed with breast, colorectal, or prostate cancer and continuously enrolled from 1/2018–12/2019. We determined statistically whether the annual prevalence of the two MHDs varied by cancer types. Total costs and costs exclusive of MHD-related expenses in five sub-categories were compared: inpatient, emergency room, non-inpatient medical, professional, and pharmacy. Costs from 2019 claims were presented as per-patient per-month (PPPM). Direct depression- and anxiety-related costs were from claims with depression/anxiety diagnoses or drugs. The impact of MHDs on 2019 healthcare spending was examined using multiple linear regression, controlling for demographic and clinical characteristics. LASSO was used for variable selection. Mann-Whitney U tests compared differences in costs by service types between patients with and without MHDs. Results: Of 19,304 study patients, 8,916 (46%) had coexisting depression or anxiety: (i) 4% depression only; (ii) 27% anxiety only; (iii) 7% depression and anxiety; and (iv) 8% were on antidepressant without MHDs diagnoses. There were significant differences in the rates of MHDs between the three cancer groups, with the highest frequency in breast cancer ( breast vs colorectal. 56% vs 49%, p < 0.0005 ; breast vs prostate. 56% vs 38%, p < 0.0005; colorectal vs prostate. 49% vs 38%, p < 0.0005). After excluding the MHDs-related costs (PPPM mean = $44), the monthly spending was 54% higher for patients with MHDs ($2,184 MHDs vs. $1,406 non-MHDs). After adjusting for covariates, the PPPM costs were 23%–58% higher for the MHD-cohort vs. the non-MHD cohort for each cancer type ( non-MHD vs. with depression only, CI 13%–34%, p < 0.0001; non-MHD vs. with anxiety only, CI 40%-52%, p < 0.0001; non-MHD vs. with depression and anxiety, CI 48%-70%, p < 0.0001; non-MHD vs. with antidepressant only, CI 28%-45%, p < 0.0001). Higher costs in MHD-cohort were observed in all cost categories (p < 0.0001). Conclusions: We found high prevalence of MHDs in patients diagnosed with cancer. Analyses showed that total spending was significantly higher in individuals with cancer and MHD for all cost categories. Explanations for higher costs are unclear, as costs remain high even after adjusting for MHD-related care costs. Research on specific healthcare services driving higher costs and the risk factors for depression and anxiety is needed to address broader MHDs to improve cancer care.

The Impact of Multidisciplinary Therapy in Node-Positive Rectal Cancer

2010 ◽  
Vol 76 (10) ◽  
pp. 1163-1166 ◽  
Author(s):  
Matthew Roos ◽  
Jan H. Wong ◽  
Sharmila Roy-Chowdhury ◽  
Sharon S. Lum ◽  
John W. Morgan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Patients ◽  
Multidisciplinary Therapy ◽  
Cancer Management ◽  
Node Positive ◽  
California Cancer Registry ◽  
Significant Difference ◽  
The Impact ◽  
To Receive

Multidisciplinary therapy (MDT) of node-positive rectal cancer is considered optimal. We performed a retrospective cohort study of node positive rectal cancer patients diagnosed between January 1, 1994 and December 31, 2003 in Region 5 of the California Cancer Registry to determine the impact of MDT on disease specific survival (DSS). During the study period, 398 patients with stage III rectal cancer were identified. Only 251 patients (63.1%) received radiation (XRT). Patients receiving XRT had significantly improved survival when compared with those who did not (5 year DSS 55% with XRT vs 36% without XRT, median follow-up 43 months, P < 0.001). There was no statistically significant difference in T stage ( P = 0.41), the number of N1 patients ( P = 0.45), or the number of positive nodes harvested (mean 11.5 w/o XRT vs 12.8 w/XRT, P = 0.37) between patients receiving XRT and those who did not. Patients receiving XRT were far more likely to receive systemic chemotherapy (83% vs 27%, P < 0.0001). Multidisciplinary therapy of node-positive rectal cancer is associated with improved DSS. However, substantial numbers of node positive rectal cancer patients are not receiving MDT. Greater efforts are needed to implement consistent multidisciplinary algorithms into rectal cancer management.

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