PHILADELPHIA (March 30, 2020)—A group of Fox Chase Cancer Center clinicians featured their expertise in an article that advised physicians on the best approach to take with patients who have been diagnosed or are currently under treatment for cancer during the ongoing COVID-19 pandemic. The article was published today in the Annals of Internal Medicine.
“Oncology specialists as well as other providers regularly involved in the diagnosis, active treatment, and longitudinal follow-up of cancer patients must consider how to 1) balance a delay in cancer diagnosis or treatment against the risk for a potential COVID-19 exposure, 2) mitigate the risks for significant care disruptions associated with social distancing behaviors, and 3) manage the appropriate allocation of limited health care resources in this unprecedented time of health care crisis,” the authors wrote.
The authors note that COVID-19 disproportionally harms the elderly and those with comorbidities, so a current or past cancer diagnosis appears to place infected patients at substantially increased risk. That fact is borne out by first reports from China, where the virus originated. Cancer patients in China with COVID-19 infections had a higher risk of “significant” morbidity, including requirements for support with ventilators or death.
The article’s authors were Alexander Kutikov, MD, and Robert G. Uzzo, MD, of the Department of Surgical Oncology; David S. Weinberg, MD, MSc, of the Department of Medicine; Martin J. Edelman, MD, and Richard I. Fisher, MD, of the Department of Hematology/Oncology; and Eric M. Horwitz, MD, FABS, FASTRO, of the Department of Radiation Oncology.
“Many solid tumors (such as lung or pancreatic cancer) and some hematologic cancers (such as acute leukemia) require immediate diagnosis and treatment. However, other common early-stage cancers (breast, prostate, cervical, nonmelanoma skin) may not,” the authors wrote.
“The quality of evidence in some cases is inadequate to support ‘one size fits all’ statements applicable to every patient. However, experienced oncology providers should feel confident exercising judgment regarding which patients need to initiate or continue treatment owing to their tumor’s more aggressive biology versus those who can tolerate a delay.”
Click here to read the full text of the article, “A War on Two Fronts: Cancer Care in the Time of COVID-19.”