Maintaining treatment volumes during the COVID-19 pandemic.

103 Background: Uninterrupted care is essential for optimal outcomes in cancer care. The COVID-19 pandemic presented numerous challenges in providing continuity of care for many facilities. Our practice was able to deliver ongoing treatment for a large volume of our patients while maintaining a safe environment. Methods: A practice-wide effort to continue therapy in cancer patients undergoing active treatment began in March 2020 as the peak of the pandemic was beginning in Tennessee. Those patients who were receiving active treatment continued the planned treatment while reducing non-acute treatment visits. We assessed the volume of patients receiving treatments in our facilities for two periods: JanuaryDecember 2019 and January-May 2020. We compared the aggregate number of chemotherapy infusions, therapeutic infusions and injections as well as total treatments. Results: Overall, treatments remained relatively stable without a significant change in treatment volumes. There was a 3.69% decline in total treatment with therapeutic infusions (-9.68%) and injections (-7.85%) which accounted for the majority of deferred treatments. Chemotherapy infusions remained stable with an average increase (1.90%) in treatments. Conclusions: During the COVID-19 pandemic, our facility was able to maintain stable treatment numbers while providing safe care to our patients. We had no known diagnosed COVID-19 cases from potential exposures in our clinics. Decreases in treatment reflected less critical therapies. There did seem to be a delay for chemotherapy/immunotherapy that seemed to resolve as the peak passed for this region. Offloading of less critical treatments can result in continued treatment of cancer patients during a pandemic. [Table: see text]

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Early palliative care versus standard care in haematologic cancer patients at their last active treatment: study protocol of a feasibility trial

BMC Palliative Care ◽

10.1186/s12904-020-00561-w ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Silvia Tanzi ◽

Stefano Luminari ◽

Silvio Cavuto ◽

Elena Turola ◽

Luca Ghirotto ◽

...

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Study Protocol ◽

Active Treatment ◽

Standard Care ◽

Feasibility Trial ◽

Early Palliative Care

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Active treatment near the end-of-life in metastatic cancer patients

Annals of Oncology ◽

10.1093/annonc/mdv346.03 ◽

2015 ◽

Vol 26 ◽

pp. vi114

Author(s):

S. Bolzonello ◽

E. Poletto ◽

L. Gerratana ◽

M. Bonotto ◽

M. Cinausero ◽

...

Keyword(s):

End Of Life ◽

Cancer Patients ◽

Active Treatment ◽

Metastatic Cancer

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Comparison Between VMAT and IMRT in Remaining Volume at Risk for Large Volume Head and Neck Cancer Patients

Novel Approaches in Cancer Study ◽

10.31031/nacs.2021.06.000626 ◽

2021 ◽

Author(s):

Doaa Raafat Ali

Keyword(s):

At Risk ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Large Volume

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Pandemic and resilience: A qualitative analysis of the emotional impact of the COVID-19 pandemic on breast cancer patients in active treatment

Cognition Brain Behavior An Interdisciplinary Journal ◽

10.24193/cbb.2021.25.13 ◽

2021 ◽

Vol 25 (3) ◽

pp. 243-259

Author(s):

Silvia Nicolescu ◽

Adriana Băban

Keyword(s):

Breast Cancer ◽

Qualitative Analysis ◽

Cancer Patients ◽

Active Treatment ◽

Emotional Regulation ◽

Emotional Experience ◽

Emotional Impact ◽

Breast Cancer Patients ◽

Emotional Resilience ◽

Insight Into

The COVID-19 pandemic has had an unequivocal disruptive impact on all walks of life. Cancer care and the patients involved have been especially affected due to disruptions in treatment scheduling and enhanced vulnerability to COVID-19 infection. The present study undertook an exploratory qualitative analysis to investigate the emotional impact the COVID-19 pandemic has had on breast cancer patients undergoing active treatment. Ten breast cancer patients were interviewed concerning their illness and pandemic perception. To supplement their perspective, we also interviewed six psycho-oncologists on the emotional impact the pandemic has had on the patients they provide care to. The data collected during the interviews was inductively analysed using thematic analysis. The resulting themes showed patients to have experienced increased emotional distress symptoms, while prioritising the cancer treatment over the threat of infection. Those that had developed emotional regulation skills prior to the pandemic, along their cancer journey, made good use of them, providing proofs of emotional resilience. More vulnerable patient groups have also been highlighted, such as those that did not previously develop such healthy emotional regulation skills, newly diagnosed cancer patients and those lacking social support. Our study provides a useful insight into the emotional experience of the assessed oncology patients during the Covid-19 pandemic, and useful insight into the mechanisms that build resilience and flexibility for this population.

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Assessment of National Comprehensive Cancer Network (NCCN) guideline adherence for lung cancer in a community teaching hospital during COVID-19 pandemic.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e20589 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e20589-e20589

Author(s):

Mahati Paravathaneni ◽

Vihitha Thota ◽

Bohdan Baralo ◽

Sana Mulla ◽

Eugene Jinkyu Choi ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Carcinoma ◽

Cancer Patients ◽

Cell Lung Cancer ◽

Active Treatment ◽

Primary Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Nccn Guidelines

e20589 Background: Coronavirus disease 2019 (COVID-19) evolved into a worldwide pandemic leading to devastating complications. In healthcare, significant changes were made to reallocate resources to cater to an increasing number of hospital admissions and prevent infection spread. Reallocation of the health care staff led to the scarcity of care in outpatient facilities, including infusion centers, until the widespread adoption of Telehealth. Treating lung cancer patients with immunochemotherapy and radiotherapy has been incredibly challenging due to the pandemic, especially in regard to balancing malignancy treatment with limiting exposure of vulnerable patients to acute life-threatening infection. In addition, being unable to provide appropriate treatment to cancer patients can result in decreased functional capacity, loss of treatment window, and increased mortality. A multidisciplinary approach can prevent these outcomes by anticipating challenges early and streamlining resources appropriately to provide better patient care. In this study, we aimed to assess the adherence of NCCN guidelines for lung cancer at a community hospital in Philadelphia during the pandemic. Methods: A retrospective chart review was performed of patients diagnosed and receiving active treatment for primary lung cancer between March 1, 2020, and December 31, 2020, at Mercy Catholic Medical Center. Fifty cases of primary lung cancer undergoing active treatment were identified. Type and staging of lung cancer, NCCN guidelines’ adherence, COVID-19 exposure, and missed treatments were reviewed and analyzed. Results: Of the 50 cases reviewed, 92% had non-small cell lung cancer (NSCLC), and 8% had small cell lung cancer (SCLC). Among NSCLC, 72% had adenocarcinoma, 12% had squamous cell carcinoma, and 8% had large cell carcinoma. Stage IV lung cancer consisted of 46%, followed by 34% of stage I, 14% of stage III, and 6% of stage II. NCCN guideline-directed treatment was initiated in 88% (44/50) of the total patients, with the remaining 12% of the patients either refusing treatment (8%) or were lost to follow-up (4%). COVID-19 infection was diagnosed in 35% of the patients, of which 60% missed less than two chemotherapy sessions and 40% of COVID-19 positive patients who required hospitalization missed more than two cycles. 28% of patients missed treatment sessions due to other factors. This resulted in 61% (27/44) of patients having a disruption in NCCN guideline-directed treatment at some point during the pandemic. Conclusions: Our study results reflect upon the need for developing effective strategies in managing cancer patients. When possible, switching to oral regimens, redefining regimen administration intervals, postponing invasive investigations for asymptomatic patients, and utilizing telemedicine as appropriate should be considered.

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COVID‐19 in cancer patients on active systemic therapy – Outcomes from LMIC scenario with an emphasis on need for active treatment

Cancer Medicine ◽

10.1002/cam4.3423 ◽

2020 ◽

Vol 9 (23) ◽

pp. 8747-8753

Author(s):

Anant Ramaswamy ◽

Lingaraj Nayak ◽

Nirmalya Roy Moulik ◽

Manju Sengar ◽

Girish Chinnaswamy ◽

...

Keyword(s):

Cancer Patients ◽

Active Treatment ◽

Systemic Therapy ◽

Therapy Outcomes

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Distress and body image due to altered appearance in posttreatment and active treatment of breast cancer patients and in general population controls

Palliative & Supportive Care ◽

10.1017/s1478951517000062 ◽

2017 ◽

Vol 16 (2) ◽

pp. 137-145 ◽

Cited By ~ 5

Author(s):

Danbee Kang ◽

Eun-Kyung Choi ◽

Im-Ryung Kim ◽

Seok Jin Nam ◽

Jeong Eon Lee ◽

...

Keyword(s):

Breast Cancer ◽

Body Image ◽

General Population ◽

Cancer Patients ◽

Active Treatment ◽

Breast Cancer Survivors ◽

Breast Cancer Patients ◽

Skin Changes ◽

Population Controls

ABSTRACTObjective:Our objective was to evaluate long-term altered appearance, distress, and body image in posttreatment breast cancer patients and compare them with those of patients undergoing active treatment and with general population controls.Method:We conducted a cross-sectional survey between May and December of 2010. We studied 138 breast cancer patients undergoing active treatment and 128 posttreatment patients from 23 Korean hospitals and 315 age- and area-matched subjects drawn from the general population. Breast, hair, and skin changes, distress, and body image were assessed using visual analogue scales and the EORTC BR–23. Average levels of distress were compared across groups, and linear regression was utilized to identify the factors associated with body image.Results:Compared to active-treatment patients, posttreatment patients reported similar breast changes (6.6 vs. 6.2), hair loss (7.7 vs. 6.7), and skin changes (5.8 vs. 5.4), and both groups had significantly more severe changes than those of the general population controls (p < 0.01). For a similar level of altered appearance, however, breast cancer patients experienced significantly higher levels of distress than the general population. In multivariate analysis, patients with high altered appearance distress reported significantly poorer body image (–20.7, CI95% = –28.3 to –13.1) than patients with low distress.Significance of results:Posttreatment breast cancer patients experienced similar levels of altered appearance, distress, and body-image disturbance relative to patients undergoing active treatment but significantly higher distress and poorer body image than members of the general population. Healthcare professionals should acknowledge the possible long-term effects of altered appearance among breast cancer survivors and help them to manage the associated distress and psychological consequences.

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