Healthcare authorities must immediately plan for cancer care during pandemics

A UAE-led research review has noted that global healthcare authorities should immediately plan for cancer care delivery during a pandemic.

The research review, funded by the Khalifa Foundation, was developed by an international collaborative effort to determine practical approaches to manage cancer patients during the COVID-19 outbreak.

It also aims to address the challenges associated with cancer care during the pandemic, said the review published in the latest edition of The Oncologist, a medical journal dedicated to translating the latest research developments into the best multidimensional care for cancer patients.

The research noted that the newly identified zoonotic coronavirus, SARS-CoV-2, characterised by rapid human-to-human transmission, places cancer patients at higher risk of developing infections.

"Cancer patients appear to have an estimated two-fold increased risk of contracting SARS-CoV-2 than the general population," the research said. This is because cancer patients are more susceptible to infection than individuals without cancer, because malignancy and anti-cancer therapy result in an immunosuppressive state.

With the World Health Organisation, WHO, declaring the novel coronavirus outbreak a pandemic, there is an urgent need to address the impact of such pandemic on cancer patients, the review pointed out. "This includes changes to resource allocation, clinical care, and the consent process during a pandemic."

Studies and research regarding preparedness plans for cancer patients' care during an infectious pandemic are limited, the review highlighted.

It went on to say that accumulating evidence suggests cancer patients are at higher risk of COVID-19 infection and more likely to have higher morbidity and mortality than the general population.

The primary challenge when planning for a pandemic is the issue of human resource management. The research review noted that "strong leadership within oncology and haematology teams nationally and locally will be needed to ensure timely and proportionate implementation of contingency plans, which balance risks and protect patients and healthcare workers as infections rise."

Strategies must be implemented to minimise the interruption of treatment of cancer patients, the review suggested. It included recommendations on resource allocations, medication shortages, diagnosis, telemedicine and hospitalisation.

The main management strategies for patients with cancer during the COVID-19 pandemic include clear communication and education about hand hygiene, infection control measures, high-risk exposure, and the signs and symptoms of the COVID-19, the review explained.

Risk-benefit considerations for active intervention for cancer patient populations during an infectious disease pandemic must be individualised, the review recommended. It went on to add that consideration for postponing elective surgery or chemotherapy for cancer patients with low risk of progression "should be considered on a case-by-case basis."

Minimising outpatients visits and elective admissions can help in mitigating exposure and possible further transmission, the research noted. Telemedicine may be used to support patients during infectious pandemic to minimise visits and risk of exposure, it added.