Chemotherapy in COVID-19 pandemic: to give or not to give?

COVID-19 is a new pathogen for humans, not much is known how it affects cancer patients, but definitely there is high risk for cancer patients contracting this disease. So to find a solution to this very challenging situation the oncologists need to formulate certain guiding principles for cancer treatment in this pandemic era. Authors have divided this cancer patients into four categories depending upon the urgency of giving chemotherapy. The lowest priority being Priority A where delaying chemotherapy till this pandemic gets over will not harm the patients much and the highest priority being given to Priority D where authors do not want even a delay of days/ week. It is Priority B and C where the decision needs to made by the clinicians. However, in case authors decide to give chemotherapy in present setting there are certain changes that needs to be made both on patient as well as the hospital end. Like higher degree of awareness among patients, rational usage of resources of the hospital etc. It is indeed a very difficult time for cancer patients who are trying to cope up with malignancy and for most of them; the coronavirus is an extra concern and worry. Till the time authors learn how best treat and care to this patients during this pandemic era do what you can do to keep you and your family stay safe and Healthy.

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The COVID-19 Pandemic: Role of Supportive Care in Cancer Patients

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2020.5.s1.259-261 ◽

2021 ◽

Vol 5 (S1) ◽

pp. 259-261

Author(s):

Wasimul Hoda ◽

Sachidanand Jee Bharati ◽

Abvinav Kumar ◽

Sanjay Kumar ◽

Chandrashekhar Choudhari ◽

...

Keyword(s):

Supportive Care ◽

Cancer Treatment ◽

Cancer Patients ◽

Cancer Care ◽

Virus Disease ◽

Healthcare Resources ◽

Corona Virus ◽

Difficult Time ◽

Basic Minimum

Cancer care is adversely affected by the corona virus disease 2019 (COVID-19). Due to increasing number of COVID-19 cases, all healthcare resources are diverted to take care of COIVD-19 patients. This is the most difficult time for cancer patients because cancer treatment is getting delayed or interrupted due to COVID-19. In this tough time, the supportive care can be continued with basic minimum resources and can provide a big relief to cancer patients.

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P656 Cardiac dysfunction in breast cancer patients treated with anthracyclines: a single-center experience

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.336 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

S Cardoso Torres ◽

C Sousa ◽

J Simoes ◽

P Maia Araujo ◽

A Nunes ◽

...

Keyword(s):

Breast Cancer ◽

High Risk ◽

Cancer Treatment ◽

Cancer Patients ◽

Cardiac Dysfunction ◽

Global Longitudinal Strain ◽

Antihypertensive Drug Therapy ◽

Breast Cancer Patients ◽

Single Center

Abstract Introduction Cardiac dysfunction is a well-documented side effect of cancer treatment, with significant morbidity and mortality. Cardio-oncology units play a vital role in the early identification and management of cancer therapy related cardiovascular side effects and provide a multidisciplinary care for cancer patients. Purpose To describe the incidence of cancer treatment related cardiac dysfunction (CTRCD) in a population of breast cancer patients (pts) under chemotherapy in a single center cardio-oncology unit, and to assess its predictors. Methods We retrospectively evaluated 83 women on anthracycline therapy for breast cancer, with or without anti-HER2 therapy, followed-up between January 2017 and July 2018. CTRCD was defined as more than 10% absolute reduction of LV ejection function (LVEF) to below 50%. Pts with >15% relative percentage reduction from baseline Global longitudinal strain (GLS) or with elevation of high-sensitivity Troponin I (hsTI) levels were considered to be at high risk for developing CTRCD and started cardioprotective treatment with an ACE inhibitor/ARB and a beta-blocker, as did pts with confirmed CRTCD. Also, in pts under antihypertensive drug therapy, switching drugs to cardioprotective ones was performed in the index consultation. Follow-up was organized in our cardio-oncology consultation at 0, 3, 6 and 12 months (or more frequently in selected high-risk cases). Interruption of chemotherapy was a joint decision of the oncology and cardiology teams. Results A total of 83 women with a mean age of 49 years (26-76) were included. 4 pts (4.8%) developed CTRCD. 28 pts (33.7%) were considered to be at high risk due to GLS reduction during follow-up and 17 pts (20.5%) were at high risk due to hsTI elevation. From all the baseline characteristics, only basal BNP correlated with CTRCD (p = 0.033). Other characteristics such as age, presence of cardiovascular risk factors and the previously proposed Cardiotoxicity Risk Score (CRS) did not. There was a high percentage of pts (51.8%; n = 43) under cardioprotective drugs. 37% of the pts initiated cardioprotective drugs following cardio-oncology consultation. Chemotherapy was discontinued in only 2 pts (2.4%). Conclusion CTRCD is difficult to predict by baseline clinical characteristics. Monitoring and management of CTRCD by a multidisciplinary cardio-oncology team resulted in a high rate of cardioprotective drugs use and low rate of permanent discontinuation of chemotherapy. Further studies are needed to further analyze the relationship between these two variables.

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