"Background: The Covid-19 pandemic has significantly impacted cancer care
worldwide. The aim of this study was to capture the impact of Covid-19 on melanoma
patients during the national state of emergency.
Material and methods: We sent a survey to the members of the Romanian
Melanoma patient community between April - May 2020.
Results: We received feedback from 108 patients. Forty percent of the respondents
experienced difficulties in accessing healthcare services, while 56% found it difficult or
impossible to speak with their physician. With regard to feeling safe in healthcare
facilities, 60% of patients felt safe in the private sector, versus 48% in public hospitals.
Over half of the respondents delayed investigations such as dermoscopy, imaging, and
laboratory tests by their own initiative, while a third saw investigation delayed upon
their physician’s initiative. We found no significant delays in the administration of
systemic therapies for advanced disease. While e-prescriptions for melanoma
treatments were not communicated and implemented consistently, we noted an
increased interest in telemedicine and social media networks by physicians.
Spontaneous patient reports collected in the same period further show the lack of
access to melanoma diagnostic surgery, insufficient management of side effects of
different treatments, difficulties in obtaining pain medication, alterations in the
administration schemes of both immunotherapies and target therapies, and
cumbersome access to Covid-19 testing.
Conclusions: Our results provide a melanoma-specific perspective on the impact of
Covid-19 on patients that is unexpectedly nuanced with regards to patient
subpopulations and captures differences in impact between systemic treatment and
Journal of Medical and Radiation Oncology
Journal homepage: www.jmedradonc.org
Original research
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other interventions. In addition, this proof-of-concept study demonstrates the ability of virtual patient communities to sensitively detect and report issues in health care provision, offering the opportunity for timely intervention. Based on our findings, we formulate a set of recommendations on how to save-guard melanoma care during the pandemic, some of which we believe to be generalizable to other patient communities."