The COVID-19 Pandemic has affected individuals worldwide and has especially interfered with cancer patients’ care, argue contributing authors of “Uncertainty upon Uncertainty: Supportive Care for Cancer and COVID-19.” Two of the contributing authors to “Uncertainty upon uncertainty: Supportive Care for Cancer and COVID-19, Dr. Annie Young and Dr. Ian Olver were interviewed to provide additional thoughts and insights around the pandemic and the effects on supportive care for cancer patients.
What concerns about the COVID-19 pandemic prompted you to write this editorial?
Dr. Olver explained how the sudden disruption of COVID-19 worldwide affected the cancer patient population. He has seen screening decline because individuals are afraid they might contract the virus while at the clinic. We will likely see an increase in patients with late-stage diagnoses. Patients also have less access to supportive care as resources were redirected to COVID initiatives while the usual family and community resources were disrupted by travel and social distancing restrictions. Dr. Young said the stress of the pandemic is even more heightened for cancer patients. Patients changed hospitals, changed treatments, and declined trials. Resources were re-deployed to support COVID initiatives. Psychosocial resources are therefore essential.
How is the COVID-19 pandemic affecting patients with respect to appropriate supportive care during treatment?
“Initially services were disrupted and patients were reluctant to attend hospitals or clinics in case that increased their chances of exposure and medical staff were also exploring how to protect themselves while supporting their patients,” said Dr. Olver. However, accelerated by the pandemic, solutions for telemedicine were utilized, and while not always a substitute for face-to-face interactions, they are a necessary response for patient safety. Dr. Young echoed the message saying, “access to appropriate supportive care during treatment was both tricky and patchy... and affecting most patients negatively.” It took the entire hospital team to reassure the patients throughout all of the changes, including telemedicine consults or a simple phone call to maintain communication and engagement.
How can clinicians help alleviate some of the challenges cancer patients are facing?
“Clinicians had to innovate and adapt their practices to protect their patients and themselves,” said Dr. Olver, “Communication was the key. Patients with cancer had to feel supported and not overlooked.” It is critical to accurately disseminate patient information and do remote monitoring. It is critical to reinforce COVID prevention behaviors given cancer patients are a higher risk. “By doing what they always do – showing compassion and kindness; providing timed and targeted information (a therapy in itself), and being polite and honest,” said Dr. Young. It is even more important now to monitor patients’ needs and acting on and managing patients’ top concerns.
What recommendations can you give cancer patients to help them to participate effectively in their care during the pandemic?
During the pandemic, Dr. Olver recommends that patients keep things on schedule, report side effects promptly, maintain appropriate COVID safety procedures and be tested promptly if symptoms of the virus occur. Dr. Young urged patients to remain in routine contact with their care team to talk about their concerns. Patients should follow a healthy lifestyle. She also encourages patients to speak with other cancer patients (especially survivors) to help reduce patients’ anxiety.
What changes do you anticipate brought by the pandemic are likely to become the “new norm” post-COVID?
“I believe the more widespread use of telemedicine for patient care and support will continue post COVID. This can help alleviate the disparities caused by distance and being in lower socioeconomic groups,” said Dr. Olver. Personal hygiene practices should continue and the health system will establish protocols to enable an immediate and effective response to a future pandemic.“I call it, the ‘next norm’ as life is going to seesaw for a good while, yet. I hope the kindness seen at the beginning of the pandemic continues... Social circumstances, for many, in particular the disadvantaged, will deteriorate further,” stated Dr. Young. She agrees that telemedicine will continue and that this will bring many advantages. However, due to the “digital divide” for some cancer patients, telemedicine and phone calls cannot always replace the human contact of face-to-face interaction.