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How is colorectal cancer care changing in the era of COVID-19?

April 30, 2020

In just a few months, coronavirus (COVID-19) has transformed our lives. Despite the innumerable challenges, COVID-19 has created an opportunity for the revision of healthcare approaches and norms, including how cancer care is practiced.

As hospitals are increasingly forced to focus their resources on treating patients with COVID-19, fewer resources are directed toward patients with diseases that are not immediately life-threatening; including cancer, depending on the stage. In order to minimize cancer patients’ exposure to COVID-19, hospital or clinic visits have been limited to the absolute necessary. Many surgeons have suspended all non-urgent cancer surgeries, while procedures including routine scans that are not considered life-saving are being delayed. But cancer care is complicated—sometimes a given procedure or treatment may not necessarily be “life saving”, but an earlier intervention could prevent more serious complications and improve a patient’s quality of life in the long-term.

The focus is now on how to optimize the balance between effective cancer care and minimizing the risk of infection.

In response to COVID-19, use of telemedicine has skyrocketed. Patients are able to meet with their doctors online, avoiding contact with COVID-19-positive individuals in and around hospitals and clinics. So far, telemedicine has been well accepted by both patients and doctors, and is projected to continue beyond the pandemic. It has been especially useful for long-term follow-up patients and supportive care visits, such as those regarding sexual health or survivorship.

For patients on intravenous chemotherapies who need to be in the hospital to receive treatment, the importance of these drugs as part of a patient’s treatment must be considered and compared to their risk of infection. Overall, the pandemic has triggered a re-evaluation of many cancer treatments, and has promoted the removal of treatments that are not proving to be worth the risk.

Modified guidelines also suggest the option of skipping cycles or lowering the dosage of specific treatments. Whenever possible, it is also recommended to replace intravenous chemotherapy with oral therapy, allowing the patient to take their treatment at home and be accompanied by their doctor through telemedicine visits.

Cancer care is essential. Finding the balance between offering the best, most updated treatment and minimizing risk of infection will be crucial as patients continue their cancer journeys

References:

Marshall, J., Yarden, R., Weinberg, B. (2020). Colorectal cancer carein the age of coronavirus: strategies to reduce risk and maintain benefit. Colorectal Cancer. 2020 Apr; 0(0): 0.2217/crc-2020-0010. Published online 2020 Apr 16. doi: 10.2217/crc-2020-0010

Onclive. (2020). COVID-19 Management of CRC Patients: a Guide for Oncologists. [Webinar]. Retrieved from: https://www.onclive.com/inside-oncology/covid-19-management-of-crc-patients-a-guide-for-oncologists/covid19-management-of-crc-patients-a-guide-for-oncologists/

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