Three cancer specialists in the United States who reviewed the report agreed that cancer treatment may require doctor-patient 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 be at high risk [of coronavirus infection] compared to other cancers. “
Additionally, Moore said, “Hospital admissions and recurring visits increase the risk, reinforcing the importance of patients talking to their doctors about their own personal treatment plan.”
Dr. Wasif Saif is medical director of the Northwell Health Cancer Institute in Lake Success, New York. He stressed that the study population was very small, so the findings should be considered preliminary. But certain patterns emerged.
“Cancer patients were considered to be at the highest risk for serious complications, including admission to the intensive care unit requiring invasive ventilation or death,” said Saif. “Furthermore, the diagnosis of cancer was associated with a shorter time for the development of serious events compared to patients without cancer.”
Because hospitals are especially powerful places for coronavirus infection, Saif believes, “Difficult decisions must be made during this COVID-19 crisis without delay. [cancer] treatment or simplify treatment. “
But Dr. Adil Akhtar, director of inpatient clinical operations at the Karmanos Cancer Institute at McLaren Oakland in Pontiac, Michigan, took a slightly different view.
He agreed that cancer patients appear to be more likely to be infected with coronavirus, but added that “cancer programs in the United States have already implemented robust environmental and infection controls, according to the [U.S. Centers for Disease Control and Prevention] guidelines. “
Akhtar added that, according to the guidelines of the American Society for Clinical Oncology, at this time “there is no direct evidence to support the change or retention of chemotherapy or immunotherapy in cancer patients.”
He believes that it is difficult to determine, on a per individual patient basis, whether the risk of contracting COVID-19 outweighs the benefit of continuing cancer care.
So, “clinical decisions must be individualized that take into account factors such as the risk of cancer recurrence if therapy is delayed, modified or interrupted; the number of therapy cycles already completed and the patient’s tolerance for treatment,” said Akhtar.
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SOURCES: Amy Moore, Ph.D., director, science and research, GO2 Foundation for Lung Cancer, Washington, D.C .; Wasif Saif, M.D., Deputy Chief Medical Officer and Medical Director, Northwell Health Cancer Institute, Lake Success, N.Y .; Adil Akhtar, MD, Associate Professor, Department of Medical Oncology and Hematology, University of Oakland-William Beaumont School of Medicine, and Director, Inpatient Clinical Operations, Karmanos Cancer Institute at McLaren Oakland, Pontiac, Mich., AND chief of the Palliative and End of Life Care Division, Michigan health professionals; March 25, 2020,JAMA Oncology
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