COVID-19 May Delay Some Cancer Treatments

Three cancer specialists in the United States who reviewed the report agreed that cancer treatment may require patient-doctor discussions at this time.

Amy Moore directs science and research at the GO2 Foundation for Lung Cancer in Washington, D.C. She believes that lung cancer patients, especially, “may have elevated risk [of coronavirus infection] compared to other cancer types.”

Also, Moore said, “hospital admissions and recurrent visits increase risk, reinforcing the importance of patients talking to their physicians regarding their own personal treatment plan.”

Dr. Wasif Saif is medical director at the Northwell Health Cancer Institute in Lake Success, N.Y. He stressed that the study population was very small, so the findings must be considered preliminary. But certain patterns emerged.

“Cancer patients were deemed to be at highest risk for severe complications, including admission to the intensive care unit requiring invasive ventilation, or death,” Saif noted. “Additionally, diagnosis of cancer was associated with a shorter time to development of severe events when compared to non-cancer patients.”

Because hospitals are especially potent venues for coronavirus infection, Saif believes that “tough decisions have to be made during this COVID-19 crisis whether to delay [cancer] treatment or simplify the treatment.”

But Dr. Adil Akhtar, director of inpatient clinical operations at Karmanos Cancer Institute at McLaren Oakland in Pontiac, Mich., took a slightly different view.

He agreed that cancer patients appear to be at higher odds of coronavirus infection, but added that “cancer programs across the U.S. have already implemented robust infection and environmental controls, as per the [U.S. Centers for Disease Control and Prevention] guidelines.”

Akhtar added that, as per guidelines from the American Society of Clinical Oncology, at this time “there is no direct evidence to support changing or withholding chemotherapy or immunotherapy in patients with cancer.”

He believes it’s tough to determine, on an individual patient basis, whether the risk of contracting COVID-19 outweighs the benefit to be gained from continued cancer care.

So “clinical decisions should be individualized that consider factors such as the risk of cancer recurrence if therapy is delayed, modified or interrupted; the number of cycles of therapy already completed, and the patient’s tolerance of treatment,” Akhtar said.

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Sources

SOURCES: Amy Moore, Ph.D., director, science and research, GO2 Foundation for Lung Cancer, Washington, D.C.; Wasif Saif, M.D., deputy physician-in-chief and medical director, Northwell Health Cancer Institute, Lake Success, N.Y.; Adil Akhtar, M.D., associate professor, Department of Medical Oncology and Hematology, Oakland University-William Beaumont School of Medicine, and  director, Inpatient Clinical Operations, Karmanos Cancer Institute at McLaren Oakland, Pontiac, Mich., and chief, Division of Palliative and End of Life Care, Michigan Health Professionals; March 25, 2020,JAMA Oncology

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