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Rasschaert M, Vanclooster P, Depauw L, Mertens T, Roelant E, Coenen E, Anguille S, Janssens A, Van Dam P, Peeters M. Meeting the Challenges in Cancer Care Management During the SARS-Cov-2 Pandemic: A Retrospective Analysis. Cancer Control 2021; 28:10732748211045275. [PMID: 34623943 PMCID: PMC8504214 DOI: 10.1177/10732748211045275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has overwhelmed the capacity of healthcare systems worldwide. Cancer patients, in particular, are vulnerable and oncology departments drastically needed to modify their care systems and established new priorities. We evaluated the impact of SARS-CoV-2 on the activity of a single cancer center. METHODS We performed a retrospective analysis of (i) volumes of oncological activities (2020 vs 2019), (ii) patients' perception rate of the preventive measures, (iii) patients' SARS-CoV-2 infections, clinical signs thereof, and (iv) new diagnoses made during the SARS-CoV-2 pandemic. RESULTS As compared with a similar time frame in 2019, the overall activity in total numbers of outpatient chemotherapy administrations and specialist visits was not statistically different (P = .961 and P = .252), while inpatient admissions decreased for both medical oncology and thoracic oncology (18% (P = .0018) and 44% (P < .0001), respectively). Cancer diagnosis plummeted (-34%), but no stage shift could be demonstrated.Acceptance and adoption of hygienic measures was high, as measured by a targeted questionnaire (>85%). However, only 46.2% of responding patients regarded telemedicine, although widely deployed, as an efficient surrogate to a consultation.Thirty-three patients developed SARS-CoV-2, 27 were hospitalized, and 11 died within this time frame. These infected patients were younger, current smokers, and suffered more comorbidities. CONCLUSIONS This retrospective cohort analysis adds to the evidence that continuation of active cancer therapy and specialist visits is feasible and safe with the implementation of telemedicine. These data further confirm the impact of SARS-CoV-2 on cancer care management, cancer diagnosis, and impact of infection on cancer patients.
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Alom S, Chiu CM, Jha A, Lai SHD, Yau THL, Harky A. The Effects of COVID-19 on Cancer Care Provision: A Systematic Review. Cancer Control 2021; 28:1073274821997425. [PMID: 33631953 PMCID: PMC8482720 DOI: 10.1177/1073274821997425] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/06/2021] [Accepted: 01/29/2021] [Indexed: 12/18/2022] Open
Abstract
This systematic review aims to gather primary data from cancer institutions that have implemented changes to cancer service provision amid the COVID-19 outbreak to inform future intervention and health care facility response strategies. A comprehensive literature search was done on Global Health Medline and EMBASE using pertinent key words and MeSH terms relating to COVID-19 and Cancer service provision. A total of 72 articles were selected for inclusion in this systematic review. Following the narrative synthesis that was conducted of the literature, 6 core themes that encompassed common cancer service intervention adopted by institutions were identified: (1) Testing and Tracking, (2) Outreach and Communication, (3) Protection, (4) Social Distancing (5) Treatment Management, (6) Service Restructuring. Since cancer patients are a high-risk population amid the COVID-19 pandemic, these areas of targeted intervention can be used to inform necessary actions in institutions facing similar risks, based on previous learning from numerous cancer centers globally.
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Rambeau A, Renou M, Bisiaux F, Chaustier H, Joyaux C, Le Caer F, Fourel L, Solem-Laviec H, Poiree B, Corbinais S, Delorme C, Leloup-Morit V. A supportive care dedicated hospitalization ward in comprehensive cancer center. Support Care Cancer 2020; 28:5781-5785. [PMID: 32219570 DOI: 10.1007/s00520-020-05421-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/17/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Supportive care development has created new needs in patients' care pathway. In order to anticipate, evaluate, and take care of patients' needs, a supportive care dedicated hospitalization ward was created in late 2016 in our comprehensive cancer center, including 15 beds (11 for week care and 4 for day care). We aimed to assess the activity of this supportive care ward in 2018. METHODS Data were extracted from weekly activity reports of supportive care ward and retrospectively analyzed. Those reports are automatically generated from hospitalization scheduling software. RESULTS In week care ward, 627 stays were recorded. Occupancy rate was 88%. Mean stay duration was 3.01 days. Main indications for week stay were pain evaluation and management (47.4%) and nutritional management (31.7%). In day care ward, 1191 stays were registered. Turnover rate was 1.18 patients/bed/day. Main indications for day stay were pain management (41.6%) and comprehensive geriatric assessment in oncology (22.8%). CONCLUSION The 2018 supportive care ward evaluation showed its viability in comprehensive cancer center. The main activity was based on pain and nutritional management.
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Distribution, infrastructure, and expertise of heart failure and cardio-oncology clinics in a developing network: temporal evolution and challenges during the coronavirus disease 2019 pandemic. ESC Heart Fail 2020; 7:3408-3413. [PMID: 33284510 PMCID: PMC7675676 DOI: 10.1002/ehf2.12870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/22/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
The Hellenic Heart Failure Association has undertaken the initiative to develop a national network of heart failure clinics (HFCs) and cardio-oncology clinics (COCs). We conducted two questionnaire surveys among these clinics within 17 months and another during the coronavirus disease 2019 outbreak to assess adjustments of the developing network to the pandemic. Out of 68 HFCs comprising the network, 52 participated in the first survey and 55 in the second survey. The median number of patients assessed per week is 10. Changes in engaged personnel were encountered between the two surveys, along with increasing use of advanced echocardiographic techniques (23.1% in 2018 vs. 34.5% in 2020). Drawbacks were encountered, concerning magnetic resonance imaging and ergospirometry use (being available in 14.6% and 29% of HFCs, respectively), exercise rehabilitation programmes (applied only in 5.5%), and telemedicine applications (used in 16.4%). There are 13 COCs in the country with nine of them in the capital region; the median number of patients being assessed per week is 10. Platforms for virtual consultations and video calls are used in 38.5%. Coronavirus disease 2019 outbreak affected provision of HFC services dramatically as only 18.5% continued to function regularly, imposing hurdles that need to be addressed, at least temporarily, possibly by alternative methods of follow-up such as remote consultation. The function of COCs, in contrast, seemed to be much less affected during the pandemic (77% of them continued to follow up their patients). This staged, survey-based procedure may serve as a blueprint to help building national HFC/COC networks and provides the means to address changes during healthcare crises.
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Kanesvaran R, Chia CS, Yap SP, Wang MLC, Tham CK, Lim ST, Hwang WYK, Kwek JW. Cancer Versus COVID-19: A Coordinated Disease Outbreak Response System (DORS) to Combat COVID-19 at the National Cancer Centre Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020; 49:807-809. [PMID: 33283845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Ng KYY, Zhou S, Tan SH, Ishak NDB, Goh ZZS, Chua ZY, Chia JMX, Chew EL, Shwe T, Mok JKY, Leong SS, Lo JSY, Ang ZLT, Leow JL, Lam CWJ, Kwek JW, Dent R, Tuan J, Lim ST, Hwang WYK, Griva K, Ngeow J. Understanding the Psychological Impact of COVID-19 Pandemic on Patients With Cancer, Their Caregivers, and Health Care Workers in Singapore. JCO Glob Oncol 2020; 6:1494-1509. [PMID: 33017179 PMCID: PMC7640379 DOI: 10.1200/go.20.00374] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.
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Frara S, Rodriguez-Carnero G, Formenti AM, Martinez-Olmos MA, Giustina A, Casanueva FF. Pituitary Tumors Centers of Excellence. Endocrinol Metab Clin North Am 2020; 49:553-564. [PMID: 32741488 DOI: 10.1016/j.ecl.2020.05.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pituitary tumors are common and require complex and sophisticated procedures for both diagnosis and therapy. To maintain the highest standards of quality, it is proposed to manage patients in pituitary tumors centers of excellence (PTCOEs) with patient-centric organizations, with expert clinical endocrinologists and neurosurgeons forming the core. That core needs to be supported by experts from different disciplines such as neuroradiology, neuropathology, radiation oncology, neuro-ophthalmology, otorhinolaryngology, and trained nursing. To provide high-level medical care to patients with pituitary tumors, PTCOEs further pituitary science through research publication, presentation of results at meetings, and performing clinical trials.
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Jenssen BP, Leone F, Evers-Casey S, Beidas R, Schnoll R. Building Systems to Address Tobacco Use in Oncology: Early Benefits and Opportunities From the Cancer Center Cessation Initiative. J Natl Compr Canc Netw 2020; 17:638-643. [PMID: 31200354 DOI: 10.6004/jnccn.2019.7312] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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The New Era in Lung Cancer Care. ONCOLOGY-NEW YORK 2020; 34:302-304. [PMID: 32785923 DOI: 10.46883/onc.2020.3408.0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ONCOLOGY recently sat down with Mark G. Kris, MD, of Memorial Sloan Kettering Cancer Center to discuss the recent trends in lung cancer treatment.
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Rais G, Amaoui B, Lahlou L, Ouazni M, Fares S. Spécificités de la réorganisation de la prise en charge des patients cancéreux au cours de la pandémie COVID-19 dans un centre régional d´oncologie au Maroc. Pan Afr Med J 2020; 35:114. [PMID: 33282069 PMCID: PMC7687472 DOI: 10.11604/pamj.supp.2020.35.23280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/17/2020] [Indexed: 11/21/2022] Open
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Lee JJ, Chu E. The UPMC Hillman Cancer Center Approach to the Management of Colorectal Cancer During the COVID-19 Pandemic Era. Clin Colorectal Cancer 2020; 19:146-148. [PMID: 32811719 PMCID: PMC7347322 DOI: 10.1016/j.clcc.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 01/12/2023]
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Biganzoli L, Cardoso F, Beishon M, Cameron D, Cataliotti L, Coles CE, Delgado Bolton RC, Trill MD, Erdem S, Fjell M, Geiss R, Goossens M, Kuhl C, Marotti L, Naredi P, Oberst S, Palussière J, Ponti A, Rosselli Del Turco M, Rubio IT, Sapino A, Senkus-Konefka E, Skelin M, Sousa B, Saarto T, Costa A, Poortmans P. The requirements of a specialist breast centre. Breast 2020; 51:65-84. [PMID: 32217457 PMCID: PMC7375681 DOI: 10.1016/j.breast.2020.02.003] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/15/2022] Open
Abstract
This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ESMO. To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
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Walker K. Prostate cancer in Scotland: an evolutionary journey. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:S4. [PMID: 32463751 DOI: 10.12968/bjon.2020.29.10.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Ramirez RA, Bren‐Mattison Y, Thiagarajan R, Boudreaux JP, Marsala AJ, Ryan P, Maluccio MA. A Neuroendocrine Tumor Specialty Center in New Orleans' (NOLANETS) Response to Patient Care During the COVID-19 Pandemic. Oncologist 2020; 25:548-551. [PMID: 32369669 PMCID: PMC7356714 DOI: 10.1634/theoncologist.2020-0279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022] Open
Abstract
This commentary outlines the steps taken by the New Orleans Louisiana Neuroendocrine Tumor Specialists to minimize the risk of patient exposure to SARS‐CoV‐2 but to continue to provide safe, high‐quality care during the COVID‐19 pandemic.
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Lödel S, Ostgathe C, Heckel M, Oechsle K, Gahr S. Standard Operating Procedures (SOPs) for Palliative Care in German Comprehensive Cancer Centers - an evaluation of the implementation status. BMC Palliat Care 2020; 19:62. [PMID: 32359346 PMCID: PMC7196237 DOI: 10.1186/s12904-020-00565-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/22/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The working group for palliative medicine within the Comprehensive Cancer Center (CCC) network funded by the German Cancer Aid in Germany has developed and published 14 Standard Operating Procedures (SOPs) for palliative care in CCCs. This study analyzed to what extent these SOPs have been implemented in the clinical routine in the CCC network one year after their publication. METHODS An online-based survey on the implementation status, limitations in daily practice and further themes was conducted between April and July 2018. In total, 125 health professionals in specialized palliative care from all 16 CCC locations were invited to participate. The data were analyzed descriptively using SPSS. RESULTS The response rate was 52.8%. More than half of the respondents (57.6%) knew about the free availability of SOPs on the CCC network website. The extent to which each SOP was being used actively in practice by the survey respondents ranged from a low of 22.7% (for the "Fatigue" SOP) to a highest of 48.5% (for the "Palliative Sedation" and "Respiratory Distress" SOPs). The respondents became aware of the SOP through recommendations from colleagues, team meetings or from the head of the department. The SOPs "Respiratory distress of an adult palliative patient" and "Palliative sedation" were perceived as the most practically oriented and understandable. Barriers to use SOPs were mainly limited time resources and lack of knowledge of existence and availability. CONCLUSIONS In practice, better knowledge about the SOPs and at the same time increased use can be achieved through systematic training or discussion of SOPs in regular team meetings. There is a need to take measures to optimize the implementation in clinical practice.
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Acoba JD, Berenberg JL. University of Hawai'i Cancer Center Connection: University of Hawai'i Cancer Center: Collaboration Through Partnership with the National Cancer Institute. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:171-173. [PMID: 32432224 PMCID: PMC7226314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Denys A, Guiu B, Chevallier P, Digklia A, de Kerviler E, de Baere T. Interventional oncology at the time of COVID-19 pandemic: Problems and solutions. Diagn Interv Imaging 2020; 101:347-353. [PMID: 32360351 PMCID: PMC7177103 DOI: 10.1016/j.diii.2020.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023]
Abstract
COVID-19 pandemic modifies in-depth interventional oncology practice. Identification of aerosol-generating procedures is crucial for safety. Curative treatment of cancers should not be delayed during the COVID-19 pandemic. Solutions to overcome shortage in anesthesiology resources are described.
The COVID-19 pandemic has deeply impacted the activity of interventional oncology in hospitals and cancer centers. In this review based on official recommendations of different international societies, but also on local solutions found in different expert large-volume centers, we discuss the changes that need to be done for the organization, safety, and patient management in interventional oncology. A literature review of potential solutions in a context of scarce anesthesiologic resources, limited staff and limited access to hospital beds are proposed and discussed based on the literature data.
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MESH Headings
- Aerosols
- Age Factors
- Anesthesia, General
- Anesthesiology/statistics & numerical data
- Betacoronavirus
- Biopsy/adverse effects
- Biopsy/methods
- COVID-19
- COVID-19 Testing
- Cancer Care Facilities/organization & administration
- Carcinoma, Hepatocellular/therapy
- Carcinoma, Renal Cell/therapy
- Chemoembolization, Therapeutic/methods
- Clinical Laboratory Techniques/methods
- Colonic Neoplasms/pathology
- Coronavirus Infections/complications
- Coronavirus Infections/diagnosis
- Coronavirus Infections/epidemiology
- Coronavirus Infections/transmission
- Databases, Factual
- Health Personnel/statistics & numerical data
- Health Resources/organization & administration
- Health Resources/supply & distribution
- Hospital Bed Capacity/statistics & numerical data
- Hospitalization/statistics & numerical data
- Humans
- Hyperthermia, Induced/methods
- Kidney Neoplasms/therapy
- Liver Neoplasms/therapy
- Lung Neoplasms/secondary
- Lung Neoplasms/therapy
- Neoplasms/complications
- Neoplasms/therapy
- Palliative Care/methods
- Pandemics
- Pneumonia, Viral/complications
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/transmission
- SARS-CoV-2
- Triage
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Sokolic R. The Sickle Cell Disease Multidisciplinary Clinic at the Lifespan Cancer Institute. RHODE ISLAND MEDICAL JOURNAL (2013) 2020; 103:25-27. [PMID: 32236157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Mobley EM, Swami U, Mott S, Ounda A, Milhem M, Monga V. A Retrospective Analysis of Clinical Trial Accrual of Patients Presented in a Multidisciplinary Tumor Board at a Tertiary Health Care Center and Associated Barriers. Oncol Res Treat 2020; 43:196-203. [PMID: 32222709 PMCID: PMC8188843 DOI: 10.1159/000506840] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/26/2020] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Cancer clinical trial accruals have been historically low and are affected by several factors. Multidisciplinary Tumor Board Meetings (MTBM) are conducted regularly and immensely help to devise a comprehensive care plan including discussions about clinical trial availability and eligibility. OBJECTIVES To evaluate whether patient discussion at MTBM was associated with a higher consent rate for clinical trials at a single tertiary care center. METHODS Institutional electronic medical records (EMR) and clinical trials management system (OnCore) were queried to identify all new patient visits in oncology clinics, consents to clinical trials, and MTBM notes between January 1, 2011 and December 31, 2015. The association between MTBM discussion and subsequent clinical trial enrollment within 16 weeks of the new patient visit was evaluated using a χ2 test. RESULTS Between January 1, 2011 and December 31, 2015, 11,794 new patients were seen in oncology clinics, and 2,225 patients (18.9%) were discussed at MTBMs. MTBM discussion conferred a higher rate of subsequent clinical trial consent within 16 weeks following the patient's first consultation in an oncology clinic: 4.1% for those who were discussed at a MTBM compared to 2.8% for those not discussed (p < 0.01). CONCLUSIONS This study provides evidence that MTBMs may be effective in identifying patients eligible for available clinical trials by reviewing eligibility criteria during MTBM discussions. We recommend discussion of all new patients in MTBM to improve the quality of care provided to those with cancer and enhanced clinical trial accrual.
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Chen ATC, Moniz CMV, Ribeiro-Júnior U, Diz MDPE, Salvajoli JV, Da Conceição Vasconcelos KGM, Auler-Júnior JOC, Cecconello I, Abdala E, Hoff PMG. How should health systems prepare for the evolving COVID-19 pandemic? Reflections from the perspective of a Tertiary Cancer Center. Clinics (Sao Paulo) 2020; 75:e1864. [PMID: 32294673 PMCID: PMC7134548 DOI: 10.6061/clinics/2020/e1864] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/27/2020] [Indexed: 01/08/2023] Open
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Hui D, De La Rosa A, Chen J, Dibaj S, Guay MD, Heung Y, Liu D, Bruera E. State of palliative care services at US cancer centers: An updated national survey. Cancer 2020; 126:2013-2023. [PMID: 32049358 PMCID: PMC7160033 DOI: 10.1002/cncr.32738] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/15/2019] [Accepted: 12/29/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND This study examined the changes in outpatient palliative care services at US cancer centers over the past decade. METHODS Between April and August 2018, all National Cancer Institute (NCI)-designated cancer centers and a random sample of 1252 non-NCI-designated cancer centers were surveyed. Two surveys used previously in a 2009 national study were sent to each institution: a 22-question cancer center executive survey regarding palliative care infrastructure and attitudes toward palliative care and an 82-question palliative care program leader survey regarding detailed palliative care structures and processes. Survey findings from 2018 were compared with 2009 data from 101 cancer center executives and 96 palliative care program leaders. RESULTS The overall response rate was 69% (140 of 203) for the cancer center executive survey and 75% (123 of 164) for the palliative care program leader survey. Among NCI-designated cancer centers, a significant increase in outpatient palliative care clinics was observed between 2009 and 2018 (59% vs 95%; odds ratio, 12.3; 95% confidence interval, 3.2-48.2; P < .001) with no significant changes in inpatient consultation teams (92% vs 90%; P = .71), palliative care units (PCUs; 26% vs 40%; P = .17), or institution-operated hospices (31% vs 18%; P = .14). Among non-NCI-designated cancer centers, there was no significant increase in outpatient palliative care clinics (22% vs 40%; P = .07), inpatient consultation teams (56% vs 68%; P = .27), PCUs (20% vs 18%; P = .76), or institution-operated hospices (42% vs 23%; P = .05). The median interval from outpatient palliative care referral to death increased significantly, particularly for NCI-designated cancer centers (90 vs 180 days; P = 0.01). CONCLUSIONS Despite significant growth in outpatient palliative care clinics, there remain opportunities for improvement in the structures and processes of palliative care programs.
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Wind A, Gonçalves FR, Marosi E, da Pieve L, Groza M, Asioli M, Albini M, van Harten W. Benchmarking Cancer Centers: From Care Pathways to Integrated Practice Units. J Natl Compr Canc Netw 2019; 16:1075-1083. [PMID: 30181419 DOI: 10.6004/jnccn.2018.7035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 04/18/2018] [Indexed: 11/17/2022]
Abstract
Background: Structuring cancer care into pathways can reduce variability in clinical practice and improve patient outcomes. International benchmarking can help centers with regard to development, implementation, and evaluation. A further step in the development of multidisciplinary care is to organize care in integrated practice units (IPUs), encompassing the whole pathway and relevant organizational aspects. However, research on this topic is limited. This article describes the development and results of a benchmark tool for cancer care pathways and explores IPU development in cancer centers. Methods: The benchmark tool was developed according to a 13-step benchmarking method and piloted in 7 European cancer centers. Centers provided data and site visits were performed to understand the context in which the cancer center operates and to clarify additional questions. Benchmark data were structured into pathway development and evaluation and assessed against key IPU features. Results: Benchmark results showed that most centers have formalized multidisciplinary pathways and that care teams differed in composition, and found almost 2-fold differences in mammography use efficiency. Suggestions for improvement included positioning pathways formally and structurally evaluating outcomes at a sufficiently high frequency. Based on the benchmark, 3 centers indicating that they had a breast cancer IPU were scored differently on implementation. Overall, we found that centers in Europe are in various stages of development of pathways and IPUs, ranging from an informal pathway structure to a full IPU-type of organization. Conclusions: A benchmark tool for care pathways was successfully developed and tested, and is available in an open format. Our tool allows for the assessment of pathway organization and can be used to assess the status of IPU development. Opportunities for improvement were identified regarding the organization of care pathways and the development toward IPUs. Three centers are in varying degrees of implementation and can be characterized as breast cancer IPUs. Organizing cancer care in an IPU could yield multiple performance improvements.
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Ogba N, Arwood NM, Bartlett NL, Bloom M, Brown P, Brown C, Budde EL, Carlson R, Farnia S, Fry TJ, Garber M, Gardner RA, Gurschick L, Kropf P, Reitan JJ, Sauter C, Shah B, Shpall EJ, Rosen ST. Chimeric Antigen Receptor T-Cell Therapy. J Natl Compr Canc Netw 2019; 16:1092-1106. [PMID: 30181421 DOI: 10.6004/jnccn.2018.0073] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 11/17/2022]
Abstract
Patients with relapsed or refractory (R/R) cancers have a poor prognosis and limited treatment options. The recent approval of 2 chimeric antigen receptor (CAR) autologous T-cell products for R/R B-cell acute lymphoblastic leukemia and non-Hodgkin's lymphoma treatment is setting the stage for what is possible in other diseases. However, there are important factors that must be considered, including patient selection, toxicity management, and costs associated with CAR T-cell therapy. To begin to address these issues, NCCN organized a task force consisting of a multidisciplinary panel of experts in oncology, cancer center administration, and health policy, which met for the first time in March 2018. This report describes the current state of CAR T-cell therapy and future strategies that should be considered as the application of this novel immunotherapy expands and evolves.
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MESH Headings
- Advisory Committees
- Cancer Care Facilities/organization & administration
- Drug Resistance, Neoplasm/immunology
- Health Policy
- Humans
- Immunotherapy, Adoptive/adverse effects
- Immunotherapy, Adoptive/methods
- Immunotherapy, Adoptive/trends
- Interdisciplinary Communication
- Medical Oncology/organization & administration
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/therapy
- Neoplasms/immunology
- Neoplasms/therapy
- Receptors, Chimeric Antigen/immunology
- Societies, Medical/organization & administration
- T-Lymphocytes/immunology
- T-Lymphocytes/transplantation
- Transplantation, Autologous/adverse effects
- Transplantation, Autologous/methods
- Transplantation, Autologous/trends
- United States
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