1
|
Pergolotti M, Pisegna J, Chien LC, BrintzenhofeSzoc K, Kaur A, Battisti N, Canin B, Malone MV, Shahrokni A, Plotkin E, Boehmer LM, Ali I, Krok-Schoen JL. Healthcare providers' experiences of continuing care for older adults with cancer during the COVID-19 pandemic. J Cancer Surviv 2024; 18:1051-1058. [PMID: 36947288 PMCID: PMC10031692 DOI: 10.1007/s11764-023-01356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE The COVID-19 pandemic has caused great strain on older adults with cancer and their healthcare providers. This study explored healthcare providers' reported changes in cancer care, clinical barriers to care, patient questions, and the overall experiences of caring for older adults with cancer during the COVID-19 crisis. METHODS The Advocacy Committee of the Cancer and Aging Research Group and the Association of Community Cancer Centers developed a survey for healthcare providers of adults with cancer, inquiring about their experiences during the pandemic. Responses from the survey's four open-ended items were analyzed by four independent coders for identification of common themes using deductive and inductive methods. RESULTS Participants (n = 137) represented a variety of demographic and clinical experiences. Six overall themes emerged, including (1) telehealth use, (2) concerns for patient mental health, (3) patient physical and social isolation, (4) patient fear of contracting COVID-19, (5) continued disruptions to cancer care, and (6) patients seeking guidance, particularly regarding COVID-19 vaccination. Questions fielded by providers focused on the COVID-19 vaccination's safety and efficacy during older adults' cancer treatment. CONCLUSIONS Additional resources (e.g., technology support, established care guidelines, and sufficient staffing) are needed to support older adults with cancer and healthcare providers during the pandemic. Future research should explore universally effective in-person and virtual treatment strategies for older adults with cancer. IMPLICATIONS FOR CANCER SURVIVORS Persistence of telehealth barriers, particularly a lack of infrastructure to support telehealth visits, social isolation, and restrictive visitor policies as a result of COVID-19, negatively impacted the mental health of older adults with cancer.
Collapse
Affiliation(s)
- Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA
- University of North Carolina, Chapel Hill, NC, USA
- Colorado State University, Fort Collins, CO, USA
| | - Janell Pisegna
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- VA Eastern Colorado Healthcare System GRECC, Aurora, CO, USA
| | | | | | - Anahat Kaur
- Jacobi Medical Center, Bronx, New York, NY, USA
| | | | | | | | - Armin Shahrokni
- Hackensack Meridian Jersey Shore University Medical Center, Neptune Township, NJ, USA
| | - Elana Plotkin
- Association of Community Cancer Centers, Rockville, MD, USA
| | | | - Imran Ali
- Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Jessica L Krok-Schoen
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
2
|
Cherifi F, Gernier F, Jardin F, Lefevre-Arbogast S, Bastien E, Lequesne J, Rigal O, Quilan F, Clarisse B, Grellard JM, Binarelli G, Fernette M, Lange M, Richard D, Morel A, Griffon B, Pepin LF, Leconte A, Faveyrial A, Leheurteur M, Beauplet B, Joly F. Post-traumatic stress disorder symptoms and quality of life among older patients with cancer during the COVID-19 pandemic. J Geriatr Oncol 2023; 14:101634. [PMID: 37757587 DOI: 10.1016/j.jgo.2023.101634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/08/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION The Coronavirus (COVID-19) pandemic and its associated health restrictions have harmed the population psychologically. We aimed to compare the post-traumatic stress disorder (PTSD) symptoms and Quality of Life (QoL) in older French patients with cancer to the younger ones. MATERIALS AND METHODS This longitudinal multicenter study named COVIPACT began in April 2020 during the first French lockdown and has included 579 outpatients receiving treatment for a solid or hematological malignancy. Data were collected every three months, namely at the first release period (M3), at the second lockdown (M6), at the second release period (M9), and finally at the last curfew period (M12) in France. Standardized validated self-questionnaires were used to assess PTSD symptoms (using the Event Scale-Revised self-questionnaire), insomnia (through the Insomnia Severity Index questionnaire), QoL (using the Functional Assessment of Cancer Therapy - General questionnaire), and cognitive complaints (through the Functional Assessment of Cancer Therapy - Cognition questionnaire). Student (or Wilcoxon) tests and Chi-squared tests were used for continuous or discrete variables, respectively. We conducted linear mixed model to study the change during follow-up. RESULTS Out of 579 included patients, 157 (27%) were ≥ 70 years old at baseline, of whom 104 participated in the longitudinal study. At baseline, older patients reported fewer PTSD symptoms (17% versus 23%, p = .06), insomnia (17% versus 27%, p = .02), and cognitive complaint (3% versus 16%, p < .01) than younger patients. QoL at baseline was similar between age subgroups. We observed no significant difference in the trajectory of PTSD symptoms, insomnia, or emotional well-being between both groups during the follow-up. Cognitive complaints were lower at baseline in older patients but steadily increased during the follow-up and reached the same level as younger patients at one year. DISCUSSION One in five older patients reported PTSD symptoms, evolving similarly to younger patients during the first year of the COVID-19 pandemic. While cognitive complaints tend to recover in a bell-shaped curve at one year in younger patients, the trend is increasing in older ones. Screening for PTSD symptoms and late cognitive impairment should be given special attention in older patients. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT04366154.
Collapse
Affiliation(s)
- Francois Cherifi
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - François Gernier
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France.
| | - Fabrice Jardin
- Clinical Research Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France; Hematology Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France
| | - Sophie Lefevre-Arbogast
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Etienne Bastien
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Justine Lequesne
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Olivier Rigal
- Hematology Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France; Medical Oncology Department, Centre Henri Becquerel, UNICANCER, Rouen 76308, France
| | - Florian Quilan
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France
| | - Bénédicte Clarisse
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Jean-Michel Grellard
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Giulia Binarelli
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Marie Fernette
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Marie Lange
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| | - Doriane Richard
- Clinical Research Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France
| | - Adeline Morel
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France
| | - Bénédicte Griffon
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Louis-Ferdinand Pepin
- Clinical Research Department, Centre Henri Becquerel, UNICANCER, Rouen 76038, France
| | - Alexandra Leconte
- Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France
| | - Audrey Faveyrial
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France
| | - Marianne Leheurteur
- Medical Oncology Department, Centre Henri Becquerel, UNICANCER, Rouen 76308, France
| | - Bérengère Beauplet
- Department of Geriatric Medicine, Centre Hospitalier Universitaire de Caen Normandie, Normandie Univ, UNICAEN, INSERM U1086, ANTICIPE, Caen F-14000, France; Normandy Interregional Oncogeriatric Coordination Unit, Caen 14000, France
| | - Florence Joly
- Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France; Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France
| |
Collapse
|
3
|
Russo C, Mislang AR, Ferraioli D, Soto-Perez-de-Celis E, Colloca G, Williams GR, O'Hanlon S, Cooper L, O'Donovan A, Audisio RA, Cheung KL, Sarrió RG, Stauder R, Jaklitsch M, Cairo C, Gil LA, Sattar S, Kantilal K, Loh KP, Lichtman SM, Brain E, Kanesvaran R, Battisti NML. SIOG COVID-19 Working Group recommendations on COVID-19 therapeutic approaches in older adults with cancer. J Geriatr Oncol 2023; 14:101564. [PMID: 37393123 PMCID: PMC10288307 DOI: 10.1016/j.jgo.2023.101564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/23/2023] [Accepted: 06/21/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Chiara Russo
- Department of Medical Oncology, Léon Bérard, Comprehensive Cancer Centre, Lyon, France.
| | - Anna Rachelle Mislang
- Department of Medical Oncology, Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia.
| | - Domenico Ferraioli
- Department of Gynaecology, Léon Bérard, Comprehensive Cancer Centre, Lyon, France.
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Giuseppe Colloca
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Grant R Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
| | - Shane O'Hanlon
- University College Dublin, St Vincent's University Hospital, Dublin, Ireland.
| | - Lisa Cooper
- Department of Geriatric Medicine, Rabin Medical Center, Sackler Faculty of Medicine, Division of Aging, Department of Medicine, Tel Aviv University, Israel.
| | - Anita O'Donovan
- Applied Radiation Therapy Trinity (ARTT), Trinity St James's Cancer Institute, Trinity College, Dublin, Ireland.
| | - Riccardo A Audisio
- Department of Surgery, Sahlgrenska Academy - University of Gothenburg, Gothenburg, Sweden.
| | - Kwok-Leung Cheung
- School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK.
| | - Regina Gironés Sarrió
- Department of Medical Oncology, Hospital Universitari i Politècnic La FE, Valencia, Spain.
| | - Reinhard Stauder
- Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
| | - Michael Jaklitsch
- Brigham and Women's Hospital - Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
| | - Clarito Cairo
- National Integrated Cancer Control Program, Department of Health, Manila, Philippines.
| | - Luiz Antonio Gil
- Geriatric Center for Advanced Medicine - Hospital Sirio-Libanês, São Paulo, SP, Brazil.
| | - Schroder Sattar
- College of Nursing - University of Saskatchewan, Saskatoon, Canada.
| | - Kumud Kantilal
- School of Pharmacy, University of East Anglia, Norwich, UK.
| | - Kah Poh Loh
- University of Rochester Medical Center, Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, Rochester, NY, USA.
| | - Stuart M Lichtman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Etienne Brain
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
| | | | - Nicolò Matteo Luca Battisti
- Breast Unit - Department of Medicine Department, The Royal Marsden NHS Foundation Trus, Breast Cancer Research Division, The Institute of Cancer Research, London, UK.
| |
Collapse
|
4
|
Chahal M, Aljawi G, Harrison R, Nichol A, Thiessen B. Treatment Patterns and Outcomes of Patients with Grade 4 Glioma Treated with Radiation during the COVID-19 Pandemic. Curr Oncol 2023; 30:3091-3101. [PMID: 36975447 PMCID: PMC10046893 DOI: 10.3390/curroncol30030234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/25/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
During the first year of the COVID-19 pandemic there was a global disruption in the provision of healthcare. Grade 4 gliomas are rapidly progressive tumors, and these patients are at risk of poorer outcomes due to delays in diagnosis or treatment. We retrospectively evaluated the impact of the pandemic on treatment patterns and outcomes of patients with grade 4 gliomas in British Columbia. We identified a cohort of 85 patients treated with radiotherapy between March 2020–2021 (COVID era) and compared baseline characteristics, treatments, and outcomes with a control cohort of 79 patients treated between March 2018–2019 (pre-COVID era). There were fewer patients treated with radiotherapy over age 65 in the COVID era compared to the pre-COVID era (p = 0.037). Significantly more patients were managed with biopsy relative to partial or gross total resection during the COVID era compared to the pre-COVID era (p = 0.04), but there were no other significant differences in time to assessment, time to treatment, or administration of adjuvant therapy. There was no difference in overall survival between eras (p = 0.189). In this assessment of outcomes of grade 4 gliomas during the pandemic, we found that despite less aggressive surgical intervention during the COVID era, outcomes were similar between eras.
Collapse
Affiliation(s)
- Manik Chahal
- Division of Medical Oncology, British Columbia Cancer-Vancouver Cancer Centre, Vancouver, BC V5Z 4E6, Canada
- Correspondence:
| | - Ghufran Aljawi
- Division of Radiation Oncology, British Columbia Cancer-Vancouver Cancer Centre, Vancouver, BC V5Z 4E6, Canada
| | - Rebecca Harrison
- Division of Medical Oncology, British Columbia Cancer-Vancouver Cancer Centre, Vancouver, BC V5Z 4E6, Canada
| | - Alan Nichol
- Division of Radiation Oncology, British Columbia Cancer-Vancouver Cancer Centre, Vancouver, BC V5Z 4E6, Canada
| | - Brian Thiessen
- Division of Medical Oncology, British Columbia Cancer-Vancouver Cancer Centre, Vancouver, BC V5Z 4E6, Canada
| |
Collapse
|
5
|
Aparicio T, Layese R, Hemery F, Tournigand C, Paillaud E, De Angelis N, Quero L, Ganne N, Prat F, Pachev A, Galula G, Benderra MA, Canouï-Poitrine F. The 10-month mortality rate among older patients treated for digestive system cancer during the first wave of the COVID-19 pandemic: The CADIGCOVAGE multicentre cohort study. J Geriatr Oncol 2023; 14:101443. [PMID: 36709553 PMCID: PMC9883010 DOI: 10.1016/j.jgo.2023.101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 12/11/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and care pathways. Here, we assessed the mid-term impact of the COVID-19 pandemic on older adults with cancer before, during and after the lockdown period in 2020. MATERIALS AND METHODS We performed a retrospective, observational, multicentre cohort study of prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer in our institution between January 2018 until August 2020 were enrolled. RESULTS Data on 7,881 patients were analyzed. Although the overall 10-month mortality rate was similar in 2020 vs. 2018-2019, the mortality rate among for patients newly treated in the 2020 post-lockdown period was (after four months of follow-up) significantly higher. A subgroup analysis revealed higher mortality rates for (i) patients diagnosed in the emergency department during the pre-lockdown period, (ii) patients with small intestine cancer newly treated during the post-lockdown period, and (iii) patients having undergone surgery with curative intent during the post-lockdown period. However, when considering individuals newly treated during the lockdown period, we observed lower mortality rates for (i) patients aged 80 and over, (ii) patients with a biliary or pancreatic cancer, and (iii) patients diagnosed in the emergency department. DISCUSSION There was no overall increase in mortality among patients newly treated in 2020 vs. 2018-2019. Longer follow-up is needed to assess the consequences of the pandemic. A subgroup analysis revealed significant intergroup differences in mortality.
Collapse
Affiliation(s)
- Thomas Aparicio
- AP-HP, Saint Louis Hospital, Gastroenterology and Digestive Oncology Department, F-75010 Paris, France; Université de Paris, F-75000 Paris, France.
| | - Richard Layese
- AP-HP, Henri-Mondor Hospital, Public Health and Clinical Research department (URC Mondor), F-94010 Créteil, France; Univ Paris Est Creteil, INSERM, IMRB U955, F-94000 Creteil, France
| | - François Hemery
- AP-HP, Henri-Mondor Hospital, Medical Information Departement, F-94010 Créteil, France
| | | | - Elena Paillaud
- Univ Paris Est Creteil, INSERM, IMRB U955, F-94000 Creteil, France; AP-HP, Paris Cancer Institute CARPEM, Georges Pompidou Hospital, Geriatric Department, F-75015 Paris, France
| | - Nicola De Angelis
- AP-HP, Henri-Mondor Hospital, Digestive Surgery, F-94010 Créteil, France
| | - Laurent Quero
- Université de Paris, F-75000 Paris, France; AP-HP, Saint Louis Hospital, Radiotherapy Department, F-75010 Paris, France
| | - Nathalie Ganne
- AP-HP, Avicenne Hospital, Hepatology Department, F-93000 Bobigny, France
| | - Fredéric Prat
- Université de Paris, F-75000 Paris, France; AP-HP, Beaujon Hospital, Endoscopy Department, F-92110 Clichy, France
| | - Atanas Pachev
- AP-HP, Saint Louis Hospital, Radiology Department, F-75010 Paris, France
| | - Gilles Galula
- AP-HP, Tenon Hospital, Medical Oncology, F-75020 Paris, France
| | | | - Florence Canouï-Poitrine
- AP-HP, Henri-Mondor Hospital, Public Health and Clinical Research department (URC Mondor), F-94010 Créteil, France; Univ Paris Est Creteil, INSERM, IMRB U955, F-94000 Creteil, France
| |
Collapse
|
6
|
Kaur A, Pergolotti M, Battisti N, Krok-Schoen JL, Cabrera Chien L, Canin B, Malone MV, MacKenzie A, Ali I, Streck B, Shahrokni A, Plotkin E, Boehmer LB, BrintzenhofeSzoc K. Healthcare providers' attitudes towards delay in cancer treatment during COVID-19 pandemic. J Geriatr Oncol 2023; 14:101438. [PMID: 36682216 PMCID: PMC9842617 DOI: 10.1016/j.jgo.2023.101438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/08/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has created unprecedented obstacles leading to delays in treatment for older adults with cancer. Due to limited resources at the height of the pandemic, healthcare providers were constantly faced with ethical dilemmas regarding postponing or rescheduling care for their patients. MATERIALS AND METHODS Two survey-based studies were conducted at different time-points during the pandemic looking at factors affecting oncology care providers' attitudes towards delay in treatment for older adults with cancer. Eligible participants were recruited by email sent through professional organizations' listservs, email blasts, and social media. Change in provider attitude over time was analyzed by comparing responses from the 2020 and 2021 surveys. Data analysis included descriptive statistics and chi-squares. RESULTS In 2020, 17.5% of respondents were strongly considering/considering postponing cancer treatment for younger patients (age 30 and below), while 46.2% were considering delaying treatment for patients aged >85. These responses were in stark contrast to the results of the 2021 survey, where only 1.4% of respondents strongly considered postponing treatment for younger patients, and 13.5% for patients aged >85. DISCUSSION All recommendations to postpone treatment for older adults with cancer must be made after mutual discussion with the patient. Throughout the COVID-19 pandemic, oncology care providers had to consider multiple factors while treating patients, frequently making most decisions without appropriate institutional support.
Collapse
Affiliation(s)
- Anahat Kaur
- Albert Einstein College of Medicine, Jacobi Medical Center, New York, United States of America.
| | | | | | - Jessica L Krok-Schoen
- School of Health and Rehabilitation Sciences, Ohio State University, United States of America
| | | | - Beverly Canin
- Cancer and Aging Research Group, United States of America
| | | | - Amy MacKenzie
- Thomas Jefferson University, United States of America
| | - Imran Ali
- Icahn School of Medicine, Mount Sinai, United States of America
| | - Brennan Streck
- Cancer and Aging Research Group, United States of America
| | - Armin Shahrokni
- Jersey Shore University Medical Center, United States of America
| | - Elana Plotkin
- Association of Community Cancer Centers, United States of America
| | - Leigh B Boehmer
- Association of Community Cancer Centers, United States of America
| | - Karlynn BrintzenhofeSzoc
- Kent School of Social Work and Family Science, University of Louisville, United States of America
| |
Collapse
|
7
|
Velasco Yanez R, Frota Goyanna N, Carvalho Fernandes A, Moura Barbosa Castro R, Holanda da Cunha G, Silva Ferreira I, Miranda Mattos S, Magalhães Moreira T. Palliative Care in Breast Cancer During the COVID-19 Pandemic: A Scoping Review. Am J Hosp Palliat Care 2023; 40:351-364. [PMID: 35581537 PMCID: PMC9127630 DOI: 10.1177/10499091221101879] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has harmed the provision of palliative care (PC) services for women with breast cancer due to all the restrictions that came along with the virus. OBJECTIVE To map the available evidence on the situation of PC in breast cancer during the COVID-19 pandemic. METHODS A scoping review was carried out based on the methodology proposed by the Joanna Briggs Institute. The search was conducted in nine databases, one electronic repository, and one library, using controlled vocabularies. RESULTS Twenty-nine articles and seven documents were included. The majority (11.4% each) were published in the United Kingdom, Italy, and the United States, 38.9% addressed palliative radiotherapy (RT), and 47.2% consisted of recommendations. From the content analysis, five categories were obtained focused on the recommendations on changes in palliative treatment guidelines and the response of PC teams to the evolving crisis. CONCLUSIONS The evidence pointed to the management of general PC, palliative RT, palliative chemotherapy, management of metastatic breast cancer, and use of technologies in palliative care. No recommendations were found to manage frequent symptoms in PC, indicating the need to develop primary studies that investigate these aspects in detail in this vulnerable group. IMPLICATIONS The results contained in this document can provide professionals working in this field of care with a global view of how other teams have dealt with the pandemic, thereby identifying the best guidelines to apply in their reality, taking into account the clinical and social situation of each patient.
Collapse
Affiliation(s)
- Romel Velasco Yanez
- Universidade Federal do Ceará, Fortaleza, Brazil,Romel Velasco Yanez, Department of Nursing, Universidade Federal do Ceará, 1115 Alexandre Baraúna St, Rodolfo Teófilo, Fortaleza 60020-181, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Fernández-Ortega P, Diez de los Ríos de la Serna C. Componentes del edadismo o ageismo en la atención al paciente oncológico: una reflexion necesaria. ENFERMERIA CLINICA 2023. [DOI: 10.1016/j.enfcli.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
9
|
Fernández-Ortega P, Ríos de la Serna CDDL. Components of ageism in oncologic patient care: A necessary reflection. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:1-3. [PMID: 36707217 DOI: 10.1016/j.enfcle.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Paz Fernández-Ortega
- Coordinadora cap de Investigación en cuidados, Institut Català de Oncologia, Facultad de Medicina y Ciencias de la Salud. Profesora asociada, Departamento de Salud Pública, Mental y maternoinfantil. Bellvitge Campus, Universidad de Barcelona.
| | - Celia Diez de Los Ríos de la Serna
- Coordinadora cap de Investigación en cuidados, Institut Català de Oncologia, Facultad de Medicina y Ciencias de la Salud. Profesora asociada, Departamento de Salud Pública, Mental y maternoinfantil. Bellvitge Campus, Universidad de Barcelona
| |
Collapse
|
10
|
Saad ESP, Oualla K, Talibova N, Gening S, YousefYousef SG. Afebrile chemotherapy-induced neutropenia: an international survey spots oncologists’ routine clinical practice versus the standard of care and the impact of COVID-19. Support Care Cancer 2022; 30:9921-9928. [PMID: 36308556 PMCID: PMC9617534 DOI: 10.1007/s00520-022-07421-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/14/2022] [Indexed: 12/03/2022]
Abstract
Introduction Afebrile chemotherapy-induced neutropenia represents a frequent clinical situation where chemotherapy protocol, patient’s comorbidities, and disease status determine the risk of infection hence the management plan. Internationally distributed, this questionnaire aims to evaluate the routine practice and the impact of the COVID-19 pandemic on afebrile chemotherapy-induced neutropenia management. Material and methods Coordinators from Egypt, Morocco, Azerbaijan, and Russia developed a 12-item questionnaire using Google forms to explore how oncologists deal with afebrile chemotherapy-induced neutropenia. The link to the survey was available internationally through social media and to their local societies over the period from July to September 2021. Results We received 151 responses from 4 world regions: 58.9, 9.9, 11.3, and 15.2% from the Mena area, Russia, Europe, and Asia. The responses deviated from the guideline-driven practice as G-CSF was the most chosen option for intermediate risk that was statistically different based on the academic background of the treating physician. Half of the responders ignored patients and disease risk factors in the intermediate-risk cases that trend was statistically different based on the geographical distribution. The steroid was a valid option for intermediate and low-risk as per oncologists practicing in Russia. COVID-19 pandemic positively affected the rate of prescription of G-CSF as expected. Conclusion The disparities in the routine practice of oncologists based on their geographical and academic backgrounds highlight the need to analyze the underlying obstacles that hinder guideline-based practice like workload or lack of the proper knowledge.
Collapse
|
11
|
Rising incidence of late stage breast cancer after COVID-19 outbreak. Real-world data from the Italian COVID-DELAY study. Breast 2022; 65:164-171. [PMID: 35998429 PMCID: PMC9388078 DOI: 10.1016/j.breast.2022.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022] Open
Abstract
Purpose Methods Results Conclusions COVID-19 impacted on breast cancer (BC) diagnoses with a reduction of 25% in 2020. Fewer early-stage BC and more symptomatic patients were diagnosed during 2020. Timing of access to BC diagnosis, staging and treatment has not been affected by COVID-19. Less BC cases were reviewed in multidisciplinary tumor meetings during 2020.
Collapse
|
12
|
Veterovska-Miljkovic L, Ljatif-Petrusovska S, Jordanovski L, Ivanovska M, Bundaleska O, Brezovska E, Zdraveska N, Velkova E. Clinical Features and Analysis of Survival in a Sample of Patients Infected with SARS-COV-2 in the Specialized Hospital for Geriatric and Palliative Medicine “November 13” – Skopje. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: New worldwide intensive studies of a new virus called severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) have shown that in its clinical manifestations, the virus has an extremely different expression in different population groups, with age being found to be one of the most common and significant variables.
AIM: The objective of this study is to categorize the difference between clinical and laboratory parameters of a sample of patients infected with SARS-COV-2 in the Specialized Hospital for Geriatric and Palliative Medicine “November 13” – Skopje, between survived and deceased patients, impact on the number and severity of comorbidities on the severity of the clinical picture and the survival rate.
MATERIALS AND METHODS: In our study, we analyzed data from a sample of 113 patients hospitalized in our institution. The study is cross-sectional and observational, and in the methodology, we analyzed demographic data by gender and age groups, analysis of comorbidities, functional and nutritional status of patients, and risk factors for mortality and survival rate. For this purpose, we used several geriatric scores: Cumulative Illness Rating Scale scale–Geriatric (CIRS-G), degree of functional ability (Bartel), and the Geriatric Nutritional Index (GNRI) score.
RESULTS: The deceased patients had a significantly higher CIRS-G score, while no significant difference in functional (Bartel) and GNRI scores was found. Multivariate regression analysis showed that lymphocytopenia and low saturation were high-risk factors for death in the geriatric population.
CONCLUSION: Providing hospital-level care for the elderly with SARS-COV-2 contributes to a lower mortality rate.
Collapse
|
13
|
Maresca G, Anchesi S, Bonanno L, Bramanti A, Carnazza L, Cimino V, Corallo F, Lo Buono V, Giambò FM, Latella D, Parasporo N, De Cola MC. Feasibility, Usability, and Customer Satisfaction of the Tele-COVID19 Project, Sicilian Model. Medicina (B Aires) 2022; 58:medicina58081110. [PMID: 36013577 PMCID: PMC9415370 DOI: 10.3390/medicina58081110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives: In March 2020, COVID-19 pandemic affected the world. All countries, to limit viral transmission, imposed quarantine. This emergency exerted personal, social, economic, and psychological impact on people. For health systems, was needed to create alternative care pathways. Telemedicine can be helpful to reduce isolation, provide health care services, and monitor virus infections. Italian regions, including Sicily, have activated telemedicine services for management of patients with COVID-19. Objective: The purpose of study is to describe a Sicilian telemedicine model for management of COVID-19 patients, showing results on feasibility, usability and quality of service and patient satisfaction. Materials and Methods: This is a descriptive exploratory study on a telemedicine service for residents in Messina infected by COVID-19. It included monitoring of vital signs and specialist consultations (i.e., doctor, psychologists, social workers, and nutritionist biologists). Results: More than twenty percent (23.8%) of participants used tele-monitoring and tele-counselling services; 14.3% were only telemonitored. Participants judged positively telemedicine service (30% were quiet and 50% were very satisfied), as well as tool (70% were quiet and 10% were very satisfied). Telemonitoring had a low agreement (10% were slightly satisfied and 50% were neutral); tele-counselling had a high rate of satisfaction (40% quiet and 60% were very satisfied). Conclusions: This study showed that telemedicine model for Sicilian population affected by COVID-19 was feasible, easy to use and appreciated by patients. Our promising results allow us to assume that if in Sicily there was a return of the emergency, we would be ready to manage it This system can be the solution to remote management of these patients, to reduce isolation, provide health services, and monitor virus infections. The use of this technology should encourage future research to change the health care system and provides opportunities to ensure health and care for oneself and others.
Collapse
Affiliation(s)
| | | | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy
| | - Alessia Bramanti
- Department of Medicine, Surgery and Dentistry, Medical School of Salerno, University of Salerno, 84100 Salerno, Italy
| | - Lara Carnazza
- IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Vaidya JS, Vaidya UJ, Baum M, Bulsara MK, Joseph D, Tobias JS. Global adoption of single-shot targeted intraoperative radiotherapy (TARGIT-IORT) for breast cancer—better for patients, better for healthcare systems. Front Oncol 2022; 12:786515. [PMID: 36033486 PMCID: PMC9406153 DOI: 10.3389/fonc.2022.786515] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 06/28/2022] [Indexed: 12/30/2022] Open
Abstract
Micro abstractTargeted intraoperative radiotherapy (TARGIT-IORT) is delivered immediately after lumpectomy for breast cancer. We estimated its impact. At least 44,752 patients with breast cancer were treated with TARGIT-IORT in 260 centres in 35 countries, saving >20 million miles of travel and preventing ~2,000 non–breast cancer deaths. The TARGIT-IORT website (https://targit.org.uk/travel) provides maps and tools to find the nearest centre offering TARGIT-IORT and travel savings.BackgroundTargeted intraoperative radiotherapy (TARGIT-IORT) delivers radiotherapy targeted to the fresh tumour bed exposed immediately after lumpectomy for breast cancer. TARGIT-A trial found TARGIT-IORT to be as effective as whole-breast radiotherapy, with significantly fewer deaths from non–breast cancer causes. This paper documents its worldwide impact and provides interactive tools for clinicians and patients.MethodCentres using TARGIT-IORT provided the date of the first case and the total number of patients. We plotted these data on a customised Google Map. An interactive web-based tool provided directions to the closest centre. Using the data from the TARGIT-A trial, we estimated the total savings in travel miles, carbon footprint, and the number of non–breast cancer deaths that might be prevented.ResultsData from 242 (93%) of the 260 centres treating patients from 35 countries were available. From the first patient treated in 1998 to early 2020, at least 44,752 women with breast cancer have been treated with TARGIT-IORT. The TARGIT-IORT website (https://targit.org.uk/travel) displays the Google Map of centres with number of cases and an interactive tool for patients to find the nearest centre offering TARGIT-IORT and their travel savings. Scaling up to the already treated patients, >20 million miles of travel would have been saved and about 2,000 deaths prevented.ConclusionOne can ascertain the number of patients treated with a novel treatment. These data show how widely TARGIT-IORT has now been adopted and gives an indication of its beneficial worldwide impact on a large number of women with breast cancer.
Collapse
Affiliation(s)
- Jayant Sharad Vaidya
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
- *Correspondence: Jayant Sharad Vaidya, ;
| | - Uma Jayant Vaidya
- Medical Sciences Division Brasenose College, University of Oxford, Oxford, United Kingdom
| | - Michael Baum
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Max Kishor Bulsara
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
- Department of Biostatistics, University of Notre Dame, Fremantle, WA, Australia
| | - David Joseph
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Jeffrey S. Tobias
- Department of Clinical Oncology, University College London Hospitals, London, United Kingdom
| |
Collapse
|
15
|
Updated SIOG COVID-19 working group recommendations on COVID-19 vaccination among older adults with cancer. J Geriatr Oncol 2022; 13:1054-1057. [PMID: 35853816 PMCID: PMC9283597 DOI: 10.1016/j.jgo.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 12/22/2022]
|
16
|
Impact on the Nutritional Status and Inflammation of Patients with Cancer Hospitalized after the SARS-CoV-2 Lockdown. Nutrients 2022; 14:nu14132754. [PMID: 35807934 PMCID: PMC9268830 DOI: 10.3390/nu14132754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/20/2022] [Accepted: 06/29/2022] [Indexed: 02/01/2023] Open
Abstract
Many studies have demonstrated that malnutrition has a negative impact on quality of life and mortality in patients with cancer. During the SARS-CoV-2 lockdown, dietary intake changes were detected in the Spanish population, reflecting an increase in the consumption of fruit, bread, flours, and eggs. The present study analyzed the nutritional status of 728 patients with cancer admitted once the SARS-CoV-2 lockdown finished, comparing it with the previous year as well as with mortality rates. The Malnutrition Universal Screening Tool (MUST) was applied in the first 24 h after admission. Age, gender, days of stay, circulating concentrations of albumin, cholesterol, C-reactive protein (CRP), lymphocytes, prealbumin, and mortality data were analyzed. Patients with cancer admitted between June and December of 2020 exhibited no statistical differences in BMI, age, or gender as compared to patients admitted in 2019. Statistically significant differences in nutritional status (p < 0.05), albumin (p < 0.001), and CRP (p = 0.005) levels regarding lockdown were observed in relation with a small non-significant reduction in mortality. In conclusion, following the SARS-CoV-2 lockdown, an improved nutritional status in cancer patients at admission was observed with a decrease in the percentage of weight loss and CRP levels together with an increase in albumin levels compared to oncological patients admitted the previous year.
Collapse
|
17
|
Sattar S, Haase KR, Alibhai SM, Penz K, Szafron M, Harenberg S, Amir E, Kuster S, Pitters E, Campbell D, McNeely ML. Feasibility and efficacy of a remotely delivered fall prevention exercise program for community-dwelling older adults with cancer: Protocol for the STABLE trial. J Geriatr Oncol 2022; 13:1273-1280. [DOI: 10.1016/j.jgo.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
|
18
|
Smith JB, Willis EM, Hopkins-Walsh J. What does person-centred care mean, if you weren't considered a person anyway: An engagement with person-centred care and Black, queer, feminist, and posthuman approaches. Nurs Philos 2022; 23:e12401. [PMID: 35749609 DOI: 10.1111/nup.12401] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 11/28/2022]
Abstract
Despite the prominence of person-centred care (PCC) in nursing, there is no general agreement on the assumptions and the meaning of PCC. We sympathize with the work of others who rethink PCC towards relational, embedded, and temporal selfhood rather than individual personhood. Our perspective addresses criticism of humanist assumptions in PCC using critical posthumanism as a diffraction from dominant values We highlight the problematic realities that might be produced in healthcare, leading to some people being more likely to be disenfranchised from healthcare than others. We point to the colonial, homo- and transphobic, racist, ableist, and ageist consequences of humanist traditions that have influenced the development of PCC. We describe the deep rooted conditions that structurally uphold inequality and undermine nursing practice that PCC reproduces. We advocate for the self-determination of patients and emphasize that we support the fundamental mechanisms of PCC enabling patients' choice; however, without critical introspection, these are limited to a portion of humans. Last, we present limitations of our perspective based on our white*-cisheteropatriarchy** positionality. We point to the fact that any reimagining of models such as PCC should be carefully done by listening, following, and ceding power to people with diversity dimensions*** and the lived experience or expertise that exists from diverse perspectives. We point towards Black, queer feminism, and critical disabilities studies to contextualize our point of critique with humanism and PCC to amplify equity for all people and communities. Theory and philosophy are useful to understand restrictive factors in healthcare delivery and to inform systematic strategies to improve the quality of care so as not to perpetuate the oppression of groups of people with diversity dimensions. * We purposely capitalize Black and use lower case for white to decentre whiteness and as an intentional act of antiracism (see White Homework a podcast series by Tori W. Douglas). ** Cisheteropatriarchy describes people with intersecting identities of dominant social groups; cisgender is the gender identity that aligns with the gender you were assigned at birth, hetero means heterosexual, and patriarchy refers to structural systems of power based on maleness where women are often excluded and hold less power. *** With diversity dimensions, we refer to subjective lived experience and material realities of people that exist outside the 'dominant minorities' of white-cisheteropatriarchy, meaning groups of people in society who historically and currently hold more power and through this, structurally dominate the norms and possibilities of living for other people.
Collapse
Affiliation(s)
- Jamie B Smith
- Institute for Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eva-Maria Willis
- Institute for Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | |
Collapse
|
19
|
Tantirige NN, Yoganayagam N, Ilyas G, Wang Y, Harari D, Kalsi T. Impact of COVID-19 on Geriatric Oncology services in a single centre in the UK: Effect on service delivery and clinical characteristics of older patients with cancer seen via pre- and post- retrospective service evaluation. J Geriatr Oncol 2022; 13:1062-1065. [PMID: 35810120 PMCID: PMC9174148 DOI: 10.1016/j.jgo.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/01/2022] [Accepted: 06/03/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Nayanatara Nadeesha Tantirige
- GOLD, Department of Ageing & Health, Guy's & St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
| | - Nicola Yoganayagam
- GOLD, Department of Ageing & Health, Guy's & St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Ghania Ilyas
- GOLD, Department of Ageing & Health, Guy's & St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
| | - Yanzhong Wang
- School of Population Health & Environmental Sciences, King's College London, UK
| | - Danielle Harari
- GOLD, Department of Ageing & Health, Guy's & St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; Division of Health & Social Care Research, Kings College London, 5th Floor Addison House, Guy's Campus, London, SE1 1UL, UK
| | - Tania Kalsi
- GOLD, Department of Ageing & Health, Guy's & St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; Division of Health & Social Care Research, Kings College London, 5th Floor Addison House, Guy's Campus, London, SE1 1UL, UK.
| |
Collapse
|
20
|
Bogaert B, Buisson V, Kozlakidis Z, Saintigny P. Organisation of cancer care in troubling times: A scoping review of expert guidelines and their implementation during the COVID-19 pandemic. Crit Rev Oncol Hematol 2022; 173:103656. [PMID: 35337970 PMCID: PMC8942466 DOI: 10.1016/j.critrevonc.2022.103656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
This scoping review mapped the main themes in existing expert guidelines for cancer care issued during the COVID-19 crisis from the period of March 2020-August 2021. The guidelines published during the research period principally relate to the first two waves in Europe and until the beginning of the vaccination campaign. They elaborated recommendations for cancer care reorganisation, in particular triage and quality of care issues. The article highlights the ethical, epistemological, as well as practical reasons that guidelines were not always followed to provide some lessons learned for future crises to enable better guideline development processes. We also elaborate early evidence on the impact of triage decisions and different perspectives on cancer care reorganisation from ethics and social science literature.
Collapse
Affiliation(s)
- Brenda Bogaert
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France.
| | - Victoria Buisson
- Department of Social Sciences and Humanities, Centre Léon Bérard, Lyon, France.
| | - Zizis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France.
| | - Pierre Saintigny
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France; Univ Lyon, Claude Bernard Lyon 1 University, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.
| |
Collapse
|
21
|
Couderc AL, Ninove L, Nouguerède E, Rey D, Rebroin M, Daumas A, Tomasini P, Greillier L, Salas S, Duffaud F, Dahan L, Duluc M, Garcia ME, Pluvy J, Chaléat S, Farnault L, Venton G, Fourié T, Nurtop E, de Lamballerie X, Villani P, Charrel R, Correard F. Acceptance, efficacy, and safety of COVID-19 vaccination in older patients with cancer. J Geriatr Oncol 2022; 13:850-855. [PMID: 35589542 PMCID: PMC9108027 DOI: 10.1016/j.jgo.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 01/08/2023]
Abstract
Purpose The COVID-19 vaccination campaign began in December 2020, in France, and primarily targeted the oldest people. Our study aimed to determine the level of acceptance of vaccination in a population of older patients with cancer. Methods From January 2021, we offered vaccination with the BNT162b2 COVID-19 vaccine to all patients 70 years and older referred to our geriatric oncology center in Marseille University Hospital (AP-HM) for geriatric assessment before initiation of an oncological treatment. Objectives were to evaluate acceptance rate of COVID-19 vaccination and to assess vaccine safety, reactogenicity, and efficacy two months after the first dose. Results Between January 18, 2021 and May 7, 2021, 150 older patients with cancer were offered vaccination after a geriatric assessment. The majority were men (61.3%), with a mean age of 81 years. The two most frequent primary tumors were digestive (29.4%) and thoracic (18%). The vaccine acceptance rate was 82.6% and the complete vaccination rate (2 doses) reached 75.3%. Among the vaccinated patients, 15.9% reported mild side effects after the first dose and 23.4% after the second dose, mostly arm pain and fatigue. COVID-19 cases were observed in 5.1% of vaccinated patients compared with 16.7% in unvaccinated patients. Of the 22 vaccinated patients who agreed to have their serum tested, 15 had antibodies against the spike protein at day 21 after the first dose. Conclusion Our study showed a high acceptance rate of COVID-19 vaccination, with good tolerance in this frail population. These results highlight the benefits of organizing vaccination campaigns at the very beginning of oncological management in older patients. Clinical trial registration: This study was registered May 23, 2019 in ClinicalTrials.gov (NCT03960593).
Collapse
Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille University, CNRS, EFS, ADES, Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France.
| | - Laetitia Ninove
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Emilie Nouguerède
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France
| | - Dominique Rey
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France
| | | | - Aurélie Daumas
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Pascale Tomasini
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | | | | | - Laetitia Dahan
- Hepato-Gastro-Enterolgy Unit, CHU Timone, AP-HM, Marseille, France
| | - Muriel Duluc
- Hepato-Gastro-Enterolgy Unit, CHU Timone, AP-HM, Marseille, France
| | - Marie-Eve Garcia
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Johan Pluvy
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Solène Chaléat
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Laure Farnault
- Haematology and Cellular Therapy Department, AP-HM, Marseille, France
| | - Geoffroy Venton
- Haematology and Cellular Therapy Department, AP-HM, Marseille, France
| | - Toscane Fourié
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Elif Nurtop
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Patrick Villani
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille University, CNRS, EFS, ADES, Marseille, France
| | - Remi Charrel
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | | |
Collapse
|
22
|
Rubilar P, Hirmas M, Matute I, Browne J, Little C, Ruz G, Aguilera X, Ávila C, Vial P, Gutknecht Mackenzie T. Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile. Medwave 2022; 22:e8715. [PMID: 35435888 DOI: 10.5867/medwave.2022.03.002553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/16/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Older adults are at a higher risk of severe illness and death from COVID-19. This vulnerability increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pandemic on these establishments in lowand middle-income countries has been scant. This study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in long-term care facilities and estimate the impact of infection after the first wave of the pandemic. Methods A cross-sectional design with 2099 residents in three regions of Chile was carried out between September and November 2020. Measurement of antibodies was performed with a rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents, those who had a history of positive polymerase chain reaction tests, and those who died from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical dependence, and serological results were performed. In addition, we performed a correlation analysis between the seroprevalence of the centers by the municipality and the rate of confirmed cases. Results The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confidence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was 19.6%. A significant correlation was found between the seroprevalence of older adults residing in long-term care facilities and the cumulative incidence by municipalities. Conclusions The seroprevalence of older adults residing in long-term care facilities was higher than the general population. The high impact of infection among this population at the end of the first wave of the COVID-19 pandemic is similar to other countries. The centers' environment is directly related to COVID-19 infection. Morbidity and mortality monitoring systems should be implemented promptly to establish prevention and control measures.
Collapse
Affiliation(s)
- Paola Rubilar
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. Address: Av. Plaza 680 San Carlos de Apoquindo, Las Condes, Santiago, Chile. . ORCID: 0000-0003-3578-459X
| | - Macarena Hirmas
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-0959-0946
| | - Isabel Matute
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-6288-4601
| | - Jorge Browne
- Servicio Nacional del Adulto Mayor, Santiago, Chile. ORCID: 0000-0001-6586-7084
| | - Cedric Little
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, Chile. ORCID: 0000-0002-2419-8512
| | - Gonzalo Ruz
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Santiago, Chile. ORCID: 0000-0001-7740-9865
| | - Ximena Aguilera
- Centro de Epidemiología y Políticas de Salud, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-8153-6733
| | - Carlos Ávila
- Ministerio de Ciencia, Tecnología, Conocimiento e Innovación, Santiago, Chile. ORCID: 0000-0002-5327-1731
| | - Pablo Vial
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. ORCID: 0000-0002-4135-0416
| | | |
Collapse
|
23
|
Impact of COVID-19 on care of older adults with cancer: a narrative synthesis of reviews, guidelines and recommendations. Curr Opin Support Palliat Care 2022; 16:3-13. [DOI: 10.1097/spc.0000000000000584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Elkrief A, Hennessy C, Kuderer NM, Rubinstein SM, Wulff-Burchfield E, Rosovsky RP, Vega-Luna K, Thompson MA, Panagiotou OA, Desai A, Rivera DR, Khaki AR, Tachiki L, Lynch RC, Stratton C, Elias R, Batist G, Kasi A, Shah DP, Bakouny Z, Cabal A, Clement J, Crowell J, Dixon B, Friese CR, Fry SL, Grover P, Gulati S, Gupta S, Hwang C, Khan H, Kim SJ, Klein EJ, Labaki C, McKay RR, Nizam A, Pennell NA, Puc M, Schmidt AL, Shahrokni A, Shaya JA, Su CT, Wall S, Williams N, Wise-Draper TM, Mishra S, Grivas P, French B, Warner JL, Wildes TM. Geriatric risk factors for serious COVID-19 outcomes among older adults with cancer: a cohort study from the COVID-19 and Cancer Consortium. THE LANCET. HEALTHY LONGEVITY 2022; 3:e143-e152. [PMID: 35187516 PMCID: PMC8843069 DOI: 10.1016/s2666-7568(22)00009-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Older age is associated with poorer outcomes of SARS-CoV-2 infection, although the heterogeneity of ageing results in some older adults being at greater risk than others. The objective of this study was to quantify the association of a novel geriatric risk index, comprising age, modified Charlson comorbidity index, and Eastern Cooperative Oncology Group performance status, with COVID-19 severity and 30-day mortality among older adults with cancer. METHODS In this cohort study, we enrolled patients aged 60 years and older with a current or previous cancer diagnosis (excluding those with non-invasive cancers and premalignant or non-malignant conditions) and a current or previous laboratory-confirmed COVID-19 diagnosis who reported to the COVID-19 and Cancer Consortium (CCC19) multinational, multicentre, registry between March 17, 2020, and June 6, 2021. Patients were also excluded for unknown age, missing data resulting in unknown geriatric risk measure, inadequate data quality, or incomplete follow-up resulting in unknown COVID-19 severity. The exposure of interest was the CCC19 geriatric risk index. The primary outcome was COVID-19 severity and the secondary outcome was 30-day all-cause mortality; both were assessed in the full dataset. Adjusted odds ratios (ORs) and 95% CIs were estimated from ordinal and binary logistic regression models. FINDINGS 5671 patients with cancer and COVID-19 were included in the analysis. Median follow-up time was 56 days (IQR 22-120), and median age was 72 years (IQR 66-79). The CCC19 geriatric risk index identified 2365 (41·7%) patients as standard risk, 2217 (39·1%) patients as intermediate risk, and 1089 (19·2%) as high risk. 36 (0·6%) patients were excluded due to non-calculable geriatric risk index. Compared with standard-risk patients, high-risk patients had significantly higher COVID-19 severity (adjusted OR 7·24; 95% CI 6·20-8·45). 920 (16·2%) of 5671 patients died within 30 days of a COVID-19 diagnosis, including 161 (6·8%) of 2365 standard-risk patients, 409 (18·5%) of 2217 intermediate-risk patients, and 350 (32·1%) of 1089 high-risk patients. High-risk patients had higher adjusted odds of 30-day mortality (adjusted OR 10·7; 95% CI 8·54-13·5) than standard-risk patients. INTERPRETATION The CCC19 geriatric risk index was strongly associated with COVID-19 severity and 30-day mortality. Our CCC19 geriatric risk index, based on readily available clinical factors, might provide clinicians with an easy-to-use risk stratification method to identify older adults most at risk for severe COVID-19 as well as mortality. FUNDING US National Institutes of Health National Cancer Institute Cancer Center.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Orestis A Panagiotou
- Department of Health Services Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | | | | | - Lisa Tachiki
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Ryan C Lynch
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Catherine Stratton
- Yale Cancer Center at Yale University School of Medicine, New Haven, CT, USA
| | - Rawad Elias
- Hartford Healthcare Cancer Institute, Hartford, CT, USA
| | - Gerald Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Anup Kasi
- The University of Kansas Medical Center, Kansas City, KS, USA
| | - Dimpy P Shah
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX, USA
| | | | - Angelo Cabal
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | | | | | | | | | - Stacy L Fry
- University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | - Punita Grover
- University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Shuchi Gulati
- University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Shilpa Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Clara Hwang
- Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Hina Khan
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Soo Jung Kim
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Elizabeth J Klein
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Rana R McKay
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | - Amanda Nizam
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | | | | | | | | | - Justin A Shaya
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | | | - Sarah Wall
- The Ohio State University, Columbus, OH, USA
| | | | | | - Sanjay Mishra
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Petros Grivas
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | | | | |
Collapse
|
25
|
Elucidating the effect of geriatric parameters on COVID-19 outcomes for older adults with cancer. THE LANCET. HEALTHY LONGEVITY 2022; 3:e122-e123. [PMID: 35187515 PMCID: PMC8843064 DOI: 10.1016/s2666-7568(22)00026-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
|
26
|
Martinez-Recio S, Perez-Wert JP, Martinez-Fdez S, Jimenez-Bou D, Ruiz-Gutierrez I, Peña J, Pertejo A, Espinosa E, Pinto A. COMPARISON OF 2-WEEKLY AND 3-WEEKLY DOSING OF DOCETAXEL IN METASTATIC PROSTATE CANCER. Clin Genitourin Cancer 2022; 20:363-370. [DOI: 10.1016/j.clgc.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/14/2022] [Accepted: 02/19/2022] [Indexed: 12/20/2022]
|
27
|
Aparicio T, Layese R, Hemery F, Tournigand C, Paillaud E, De Angelis N, Quero L, Ganne N, Prat F, Pachev A, Galula G, Benderra MA, Canouï-Poitrine F. Effect of lockdown on digestive system cancer care amongst older patients during the first wave of COVID-19: The CADIGCOVAGE multicentre cohort study. Dig Liver Dis 2022; 54:10-18. [PMID: 34654679 PMCID: PMC8487788 DOI: 10.1016/j.dld.2021.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and treatment. Most patients newly diagnosed with digestive system cancer are aged 65 and over. METHODS We performed a retrospective, observational, multicentre cohort study based on prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer between January 2018 until August 2020 were enroled. RESULTS Data on 7882 patients were analysed. The first COVID-19 lockdown period led to a 42.4% decrease in newly treated digestive system cancers, and the post-lockdown period was associated with a 17% decrease. The decrease in newly treated digestive system cancer did not differ as a function of age, sex, comorbidities, primary tumour site, and disease stage. The proportion of patients admitted to an emergency department increased during the lockdown period. We do not observe a higher 3-month mortality rate in 2020, relative to the corresponding calendar periods in 2018 and 2019. CONCLUSION To avoid a decrease in newly treated cancers during future lockdown periods, access to healthcare will have to be modified. Although 3-month mortality did not increase in any of the patient subgroups, the 2020 cohort must be followed up for long-term mortality.
Collapse
Affiliation(s)
- Thomas Aparicio
- AP-HP, Gastroenterology and Digestive Oncology Department, Saint Louis Hospital, 1 avenue Claude Vellefaux, Paris F-75010, France,Université de Paris, Paris F-75010, France,Corresponding author at: AP-HP, Gastroenterology and Digestive Oncology Department, Saint Louis Hospital, 1 avenue Claude Vellefaux, Paris F-75010, France
| | - Richard Layese
- AP-HP, Public Health and Clinical Research Department, Henri-Mondor Hospital, Créteil F-94010, France,INSERM, IMRB U955, CEpiA Team, University Paris-Est Créteil, Créteil F-94000, France
| | - François Hemery
- AP-HP, Medical Information Department, Henri-Mondor Hospital, Créteil F-94010, France
| | | | - Elena Paillaud
- INSERM, IMRB U955, CEpiA Team, University Paris-Est Créteil, Créteil F-94000, France,AP-HP, Georges Pompidou Hospital, Geriatric Department, Paris Cancer Institute CARPEM, Paris F-75015, France
| | - Nicola De Angelis
- AP-HP, Henri-Mondor Hospital, Digestive Surgery, Créteil F-94010, France
| | - Laurent Quero
- Université de Paris, Paris F-75010, France,AP-HP, Radiotherapy Department, Saint Louis Hospital, Paris F-75010, France
| | - Nathalie Ganne
- AP-HP, Hepatology Department, Avicenne Hospital, Bobigny F-93000, France
| | - Fredéric Prat
- Université de Paris, Paris F-75010, France,AP-HP, Endoscopy Department, Beaujon Hospital, Clichy F-92110, France
| | - Atanas Pachev
- AP-HP, Radiology Department, Saint Louis Hospital, Paris F-75010, France
| | - Gilles Galula
- AP-HP, Medical Oncology, Tenon Hospital, Paris F-75020, France
| | | | - Florence Canouï-Poitrine
- AP-HP, Public Health and Clinical Research Department, Henri-Mondor Hospital, Créteil F-94010, France,INSERM, IMRB U955, CEpiA Team, University Paris-Est Créteil, Créteil F-94000, France
| | | |
Collapse
|
28
|
Golbach AP, McCullough KB, Soefje SA, Mara KC, Shanafelt TD, Merten JA. Evaluation of Burnout in a National Sample of Hematology-Oncology Pharmacists. JCO Oncol Pract 2021; 18:e1278-e1288. [PMID: 34793242 DOI: 10.1200/op.21.00471] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To evaluate the prevalence of burnout among hematology-oncology pharmacists and factors associated with an increased risk of high burnout. METHODS Between October and November 2020, members of the Hematology/Oncology Pharmacy Association were invited to complete an anonymous survey. Questions included the Maslach Burnout Inventory (MBI), Well-Being Index, and sociodemographic and occupational factors linked with burnout. RESULTS Of 3,024 pharmacists contacted, 614 pharmacists (20.3%) responded to an online survey and 550 (18.2% of overall sample) completed the MBI and were included for analysis. Overall, high levels of burnout were observed in 61.8% of respondents based on the MBI, with 57.9% of respondents scoring high on the emotional exhaustion domain and 31.3% high in the depersonalization domain. Pharmacists with burnout worked on average 48.6 (±9.6) hours per week compared with 44.5 (±9.6) hours per week for those without high burnout and spent more time on administrative tasks per week (7.5 hours v 4.3 hours; all P < .001). Pharmacists reporting high burnout were more likely to report concern they had made a major medication error within the past 3 months (27.6% v 8.1%; P < .001) and greater intent to leave their current job within 2 years (60.3% v 19.0%; P < .001). CONCLUSION Burnout is prevalent among hematology-oncology pharmacists and may affect both patient safety and the adequacy of the workforce. Risk factors for burnout among hematology-oncology pharmacists in this study may be targets for burnout mitigation and prevention strategies to reduce the impact on pharmacists and improve cancer care for patients.
Collapse
|
29
|
Kilgour HM, Galica J, Oliffe JL, Haase KR. The Needs of Older Adult Cancer Survivors During COVID-19: Implications for Oncology Nursing. Semin Oncol Nurs 2021; 37:151229. [PMID: 34776292 PMCID: PMC8502729 DOI: 10.1016/j.soncn.2021.151229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Older adults living with cancer have been described as more susceptible to coronavirus disease 2019 (COVID-19) and in need of special attention during the COVID-19 pandemic. For cancer survivors, the first year post-treatment is a critical time because many individuals transition back to their primary care provider and adjust to physical and psychosocial changes that occurred during their cancer treatment. In this longitudinal qualitative study, we followed a cohort of older adult cancer survivors through the first three waves of the pandemic to describe their experiences as a means for providing recommendations for how oncology nurses can tailor support to this unique population. DATA SOURCES We conducted individual, semi-structured qualitative interviews with 24 older adults at three time points during the pandemic. Data were analyzed drawing from interpretive descriptive methodologies. CONCLUSION Older adult cancer survivors' needs shifted during the pandemic from feeling confident and self-assured during the early days of COVID-19 to growing uncertainty and unease about their health and well-being. The main survivorship concerns included a preference for in-person appointments (as opposed to virtual), barriers to caregiver attendance at appointments, and diminished access to health care services. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses play a critical role providing care to older adult cancer survivors and are most familiar with unique patient needs and the gaps in services they face. We provide recommendations for oncology nursing practice that consider the shifting needs of older adult cancer survivors during COVID-19 and beyond.
Collapse
Affiliation(s)
- Heather M Kilgour
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada; Department of Nursing, University of Melbourne, Carlton, VIC, Australia
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
30
|
Ng ZX, Zheng H, Chen MZ, Soon YY, Ho F. Comprehensive Geriatric Assessment guided treatment versus usual care for older adults aged 60 years and above with cancer. Hippokratia 2021. [DOI: 10.1002/14651858.cd014875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Zhi Xuan Ng
- National University Hospital Singapore; Singapore Singapore
| | - Huili Zheng
- National Registry of Diseases Office; Health Promotion Board; Singapore Singapore
| | | | - Yu Yang Soon
- Department of Radiation Oncology; National University Cancer Institute; Singapore Singapore
| | - Francis Ho
- Department of Radiation Oncology; National University Cancer Institute; Singapore Singapore
| |
Collapse
|
31
|
Tuch G, Soo WK, Luo KY, Frearson K, Oh EL, Phillips JL, Agar M, Lane H. Cognitive Assessment Tools Recommended in Geriatric Oncology Guidelines: A Rapid Review. Curr Oncol 2021; 28:3987-4003. [PMID: 34677257 PMCID: PMC8534877 DOI: 10.3390/curroncol28050339] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 12/26/2022] Open
Abstract
Cognitive assessment is a cornerstone of geriatric care. Cognitive impairment has the potential to significantly impact multiple phases of a person's cancer care experience. Accurately identifying this vulnerability is a challenge for many cancer care clinicians, thus the use of validated cognitive assessment tools are recommended. As international cancer guidelines for older adults recommend Geriatric Assessment (GA) which includes an evaluation of cognition, clinicians need to be familiar with the overall interpretation of the commonly used cognitive assessment tools. This rapid review investigated the cognitive assessment tools that were most frequently recommended by Geriatric Oncology guidelines: Blessed Orientation-Memory-Concentration test (BOMC), Clock Drawing Test (CDT), Mini-Cog, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Short Portable Mental Status Questionnaire (SPMSQ). A detailed appraisal of the strengths and limitations of each tool was conducted, with a focus on practical aspects of implementing cognitive assessment tools into real-world clinical settings. Finally, recommendations on choosing an assessment tool and the additional considerations beyond screening are discussed.
Collapse
Affiliation(s)
- Gina Tuch
- Department of Geriatric Medicine, Alfred Health, Melbourne, VIC 3004, Australia
| | - Wee Kheng Soo
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia;
- Cancer Services, Eastern Health, Box Hill, VIC 3128, Australia
- Aged Medicine Program, Eastern Health, Box Hill, VIC 3128, Australia
| | - Ki-Yung Luo
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| | - Kinglsey Frearson
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| | - Ek Leone Oh
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| | - Jane L. Phillips
- Queensland University of Technology, Brisbane City, QLD 4000, Australia;
| | - Meera Agar
- University of Technology Sydney, Ultimo, NSW 2007, Australia;
| | - Heather Lane
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (K.-Y.L.); (K.F.); (E.L.O.); (H.L.)
| |
Collapse
|
32
|
Abstract
In this article, the authors review manifestations of COVID-19 in older adults, normal physiologic changes and frequent comorbidities of aging that increase pathogenicity, factors contributing to overwhelming viral spread among seniors, negative effects on health and well-being resulting from measures to control the virus, and health-system improvements necessary to protect and care for this vulnerable population.
Collapse
Affiliation(s)
- Sophie Lin
- New York Medical College, Metropolitan Hospital Center, 1901 First Avenue, New York, NY, 10029, USA
| | - Rachael Kantor
- Medical School of International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | |
Collapse
|
33
|
Marshall VK, Chavez M, Mason TM, Martinez‐Tyson D. Emergency preparedness during the COVID-19 pandemic: Perceptions of oncology professionals and implications for nursing management from a qualitative study. J Nurs Manag 2021; 29:1375-1384. [PMID: 34174005 PMCID: PMC8420290 DOI: 10.1111/jonm.13399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/05/2021] [Accepted: 06/22/2021] [Indexed: 01/09/2023]
Abstract
AIM To explore oncology health care professionals' perceptions of the COVID-19 pandemic response. BACKGROUND The pandemic has created health care delivery challenges globally and many countries have exhibited low readiness and emergency preparedness. METHODS A descriptive design using a qualitative approach was employed. Semi-structured interviews, which were completed via telephone, were audio recorded and transcribed verbatim. A thematic analysis was conducted. RESULTS Participants (N = 30) were mostly registered nurses (70%). Three themes emerged: (1) ability to adapt and operationalize disaster planning, training and restructure nursing models (subtheme: reactive vs. proactive approach to emergency preparedness); (2) COVID-19 task forces and professional organisations were critical for valid information surrounding the pandemic; and (3) recommendations for emergency preparedness/planning for future pandemics. CONCLUSION Oncology organisations adapted during the pandemic, but policies and procedures were perceived as reactive and not proactive. Recommendations for planning for future pandemics included (1) adequate personal protective equipment, (2) developing cancer-specific guidelines/algorithms and (3) telehealth training related to billing/reimbursement. Professional organisations were reliable resources of information during the pandemic, but oncology professionals ultimately trusted employers and administration to distribute information needed for safe patient care. IMPLICATIONS FOR NURSING MANAGEMENT Frontline nurses should hold positions on task forces to develop future emergency preparedness.
Collapse
Affiliation(s)
| | - Melody Chavez
- College of Public HealthUniversity of South FloridaTampaFloridaUSA
| | - Tina M. Mason
- H. Lee Moffitt Cancer Center and Research InstituteTampaFloridaUSA
| | | |
Collapse
|
34
|
Palumbo I, Borghesi S, Gregucci F, Falivene S, Fontana A, Aristei C, Ciabattoni A. Omission of adjuvant radiotherapy for older adults with early-stage breast cancer particularly in the COVID era: A literature review (on the behalf of Italian Association of Radiotherapy and Clinical Oncology). J Geriatr Oncol 2021; 12:1130-1135. [PMID: 34020908 PMCID: PMC8131185 DOI: 10.1016/j.jgo.2021.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/21/2021] [Accepted: 05/07/2021] [Indexed: 12/25/2022]
Abstract
This review is aimed at evaluating whether radiation therapy (RT) can be omitted in older adult early-stage low-risk breast cancer (BC) patients. The published data are particularly relevant at present, during the COVID-19 pandemic emergency, to define a treatment strategy and to prioritize essential therapy. Cochrane Database of Systematic Reviews and PubMED were systematically researched from outset through April 2020 using Mesh terms. Only randomized controlled trials (RCT), with one arm without adjuvant whole-breast irradiation (WBI), were included in the analysis. Recent literature regarding the COVID pandemic and BC RT was assessed. The reported RCTs identified a group of BC patients (pT1-2N0M0 R0, grade 1-2, estrogen receptor (ER) positive, human epidermal growth factor receptor 2 (HER2) negative tumours) in which the absolute risk of local recurrence (LR) was considered low enough to omit RT. The most common risk factors were tumor diameter, nodal and receptor status. Adjuvant RT had a significant impact on LR but not on distant metastasis (DM) or death. During the COVID 19 pandemic, results from RTCs were re-considered to define treatment recommendations for BC patients. International scientific societies and radiation oncology experts suggested RT omission, whenever possible, in older adult early-stage BC patients. Adjuvant RT might be omitted in a highly selected group of older adult early-stage BC patients with favourable prognostic factors. Hypofractionated regimens should be the standard. RT omission, partial breast irradiation (PBI), and ultra- hypofractionated regimens could be considered in selected cases due to the pandemic.
Collapse
Affiliation(s)
- Isabella Palumbo
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy
| | - Simona Borghesi
- Radiation Oncology Department, Arezzo-Valdarno, Azienda USL Toscana Sud Est, Arezzo, Italy
| | - Fabiana Gregucci
- Radiation Oncology Division, Miulli-Felli Hospital, Acquaviva delle Fonti, Bari, Italy
| | - Sara Falivene
- Radiation Oncology Division, Ospedale del Mare, Asl Napoli 1 centro, Napoli, Italy
| | - Antonella Fontana
- Radiation Oncology Division, Santa Maria Goretti Hospital, Latina, Italy
| | - Cynthia Aristei
- Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy,Corresponding author at: Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, Perugia General Hospital, Sant'Andrea delle Fratte, 06156 Perugia, Italy
| | - Antonella Ciabattoni
- Radiation Oncology Division, San Filippo Neri, Hospital, ASL Roma 1, Roma, Italy
| |
Collapse
|
35
|
Hingmire S, Wategaonkar R, Hegde S, Mekha M, Kulkarni R, Rajbhoj A, Deshmukh C, Kulkarni P, Patil T, Kanitkar G, Wanjarkhedkar P, Mane A, Bokil K, Parasnis A, Gawande J, Bhatia J, Khaladkar B, Sirsath N, Melinkeri S, Kashyapi B, Agrawal RK, Prabhakaran A, Desai I, Kelkar D. Outcome of COVID-19 Infection in Cancer Patients in Pune. South Asian J Cancer 2021; 10:23-27. [PMID: 34430515 PMCID: PMC8380150 DOI: 10.1055/s-0041-1731910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction
We document our data on the course of the coronavirus disease 2019 (COVID-19) infection in cancer patients in an attempt to help optimize their management in India and globally.
Material and Methods
Between February 2020 and January 2021, participating oncologists from Pune (members of the Oncology Group of Pune) documented effect of COVID-19 infection in their cancer patients. Binomial logistic regression analysis as well as correlation analysis was done using Pearson Chi-square test to determine significance of clinical factors.
Results
A total of 29 oncologists from 20 hospitals contributed their data involving 147 cancer patients who developed COVID-19 infections. COVID-19 infection resulted in higher deaths (likelihood ratio of 4.4) amongst patients with hematological malignancies (12/44 = 27.2%) as compared with those with solid tumors (13/90 = 14.4%,
p
= 0.030). Patients with uncontrolled or progressive cancer (11/34 = 32.4%) when they got infected with COVID-19 had higher mortality as compared with patients whose cancer was under control (14/113 = 12.4%;
p
= 0.020). Complication of thromboembolic episodes (seen in eight patients; 5.4% cases) was associated with higher risk (25.6 times) of death (five-eighths; 62.5%) as compared with those who did not develop it (20/139;14.4%;
p
<0.001).
Discussion
Patients with cancer should be advised to take strict precautions to reduce the risk of being infected with COVID-19. They should also be given priority for COVID-19 vaccination. If infected with COVID-19, patients with hematological malignancy and uncontrolled cancer are at higher risk of morbidity and mortality. When they are being treated (OPD or inpatient basis), additional precautions are necessary to ensure their exposure to potential COVID-19 virus is minimized. If they get infected with COVID-19, they should be given aggressive treatment to prevent complications, especially thromboembolic episodes. If they develop any thromboembolic complication, their risk of dying are significantly higher, and management should be modified accordingly.
Collapse
Affiliation(s)
- Sachin Hingmire
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | | | - Sujai Hegde
- Department of Oncology, Ruby Hall Clinic, Pune, Maharashtra, India
| | - Mangesh Mekha
- Department of Oncology, Jehangir Hospital, Pune, Maharashtra, India
| | - Rahul Kulkarni
- Department of Oncology, Sahyadri Superspecialty Hospital, Pune, Maharashtra, India
| | - Ashwin Rajbhoj
- Department of Oncology, KEM Hospital, Pune, Maharashtra, India
| | - Chetan Deshmukh
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Padmaj Kulkarni
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Tushar Patil
- Department of Oncology, Sahyadri Superspecialty Hospital, Pune, Maharashtra, India
| | - Gajanan Kanitkar
- Department of Oncology, Ruby Hall Clinic, Pune, Maharashtra, India
| | - Pankaj Wanjarkhedkar
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Anupama Mane
- Department of Oncology, Jehangir Hospital, Pune, Maharashtra, India
| | | | - Amit Parasnis
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Jayant Gawande
- Department of Oncology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
| | - Jatin Bhatia
- Department of Oncology, Jupiter Hospital, Pune, Maharashtra, India
| | - Bhagyashree Khaladkar
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Nagesh Sirsath
- Department of Oncology, Inlaks & Budhrani Hospital, Pune, Maharashtra, India
| | - Sameer Melinkeri
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Bhalchandra Kashyapi
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Rakesh Kumar Agrawal
- Department of Oncology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
| | - Anushree Prabhakaran
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Isha Desai
- Department of Medicine, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| | - Dhananjay Kelkar
- Department of Oncology, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India
| |
Collapse
|
36
|
Mo A, Chung J, Eichler J, Yukelis S, Feldman S, Fox J, Garg M, Kalnicki S, Ohri N, Sparano JA, Klein J. Breast cancer survivorship care during the COVID-19 pandemic within an urban New York Hospital System. Breast 2021; 59:301-307. [PMID: 34385028 PMCID: PMC8334511 DOI: 10.1016/j.breast.2021.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To examine clinicodemographic determinants associated with breast cancer survivorship follow-up during COVID-19. Methods We performed a retrospective, population-based cohort study including early stage (Stage I-II) breast cancer patients who underwent resection between 2006 and 2018 in a New York City hospital system. The primary outcome was oncologic follow-up prior to and during the COVID-19 pandemic. Secondary analyses compared differences in follow-up by COVID-19 case rates stratified by ZIP code. Results A total of 2942 patients with early-stage breast cancer were available for analysis. 1588 (54%) of patients had attended follow-up in the year prior to the COVID-19 period but failed to continue to follow-up during the pandemic, either in-person or via telemedicine. 1242 (42%) patients attended a follow-up appointment during the COVID-19 pandemic. Compared with patients who did not present for follow-up during COVID-19, patients who continued their oncologic follow-up during the pandemic were younger (p = 0.049) more likely to have received adjuvant radiation therapy (p = 0.025), and have lower household income (p = 0.031) on multivariate modeling. When patients who live in Bronx, New York, were stratified by ZIP code, there was a modest negative association (r = −0.56) between COVID-19 cases and proportion of patients who continued to follow-up during the COVID-19 period. Conclusion We observed a dramatic disruption in routine breast cancer follow-up during the COVID-19 pandemic. Providers and health systems should emphasize reintegrating patients who missed appointments during COVID-19 back into regular surveillance programs to avoid significant morbidity and mortality from missed breast cancer recurrences. A dramatic disruption in routine oncologic follow-up was observed during the COVID-19 period. Over half of patients with breast cancer at our center did not attend routine oncologic follow-up during COVID-19. Patients who were younger, had lower SES, and who received radiotherapy were more likely to follow-up during the pandemic. A modest negative association was observed between local ZIP code COVID-19 infection rates and follow-up attendance rate.
Collapse
Affiliation(s)
- Allen Mo
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Julie Chung
- Health Information Management, Cancer Registry, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeremy Eichler
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Sarah Yukelis
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Sheldon Feldman
- Department of Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Jana Fox
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Madhur Garg
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Shalom Kalnicki
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Nitin Ohri
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Joseph A Sparano
- Department of Medical Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Jonathan Klein
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
| |
Collapse
|
37
|
Kent EE, Park EM, Wood WA, Bryant AL, Mollica MA. Survivorship Care of Older Adults With Cancer: Priority Areas for Clinical Practice, Training, Research, and Policy. J Clin Oncol 2021; 39:2175-2184. [PMID: 34043450 PMCID: PMC8260922 DOI: 10.1200/jco.21.00226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/09/2021] [Accepted: 03/23/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- Erin E. Kent
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Eliza M. Park
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - William A. Wood
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Ashley Leak Bryant
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | |
Collapse
|
38
|
Siavashpour Z, Goharpey N, Mobasheri M. Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines. Crit Rev Oncol Hematol 2021; 164:103402. [PMID: 34214608 PMCID: PMC8242203 DOI: 10.1016/j.critrevonc.2021.103402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/17/2021] [Accepted: 06/18/2021] [Indexed: 01/18/2023] Open
Abstract
Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palliative indications, (2) delaying radiotherapy for several weeks or until pandemic over, (3) omitting radiotherapy by replacement of alternative therapies or active surveillance, (4) applying safer patients' setup and preparation protocols, (5) developing telemedicine/telehealth service. To conclude, it is essential to carefully weigh the risk of exposure to COVID-19 infection and the benefit of treating cancer patients during the pandemic. Trying to have a global guideline facing this or any other probable crisis is crucial for health care service.
Collapse
Affiliation(s)
- Zahra Siavashpour
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Neda Goharpey
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Tehran, Iran.
| | | |
Collapse
|
39
|
Iacono D, Cerbone L, Palombi L, Cavalieri E, Sperduti I, Cocchiara RA, Mariani B, Parisi G, Garufi C. Serological response to COVID-19 vaccination in patients with cancer older than 80 years. J Geriatr Oncol 2021; 12:1253-1255. [PMID: 34175246 PMCID: PMC8192957 DOI: 10.1016/j.jgo.2021.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/15/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022]
Abstract
Central studies carried out on vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-COV2) excluded patients receiving immunosuppressive therapy and those diagnosed with an immunosuppressive condition. Moreover, there are no data on vaccine efficacy regarding older patients with cancer. Objectives The primary objective was to evaluate the seroprevalence of the SARS-CoV2 IgG in older patients (aged ≥80 years) diagnosed with solid or hematological malignancies, one month after administering the second dose of the BNT162b2 vaccine. Materials and methods We screened 74 older patients with cancer, 45 of them accepted to receive the vaccination and collected serum samples from 36 patients; a group of medical doctors and nurses from our hospital was used as a control in a 1:2 ratio. Results The median age was 82 years (range 80–89). Median serum IgG were 2396,10 AU/ml (range 0–32,763,00) in patients with cancer and 8737,49 AU/ml (398.90–976,280,00) in the control group, p < 0.0001. Additional subgroup analyses were performed comparing males and females, patients treated with chemotherapy versus other therapies (immunotherapy, targeted therapy), solid tumors versus hematological malignancies, early (I-II) versus advanced (III-IV) stage of disease, continuative corticosteroid use or not. None of them reached statistical significance. Conclusion Our study shows for the first time that patients with cancer aged ≥80 years can have a serological response to the BNT162b2 COVID-19 vaccine one month after vaccination and consequently support the vaccination campaign currently underway in this frail population.
Collapse
Affiliation(s)
- Daniela Iacono
- Medical Oncology, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Linda Cerbone
- Medical Oncology, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Lucia Palombi
- Breast Unit, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Elena Cavalieri
- UOC Haematology & Stem Cell Transplant Unit, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Isabella Sperduti
- Biostatistical Unit - Clinical Trials Center IRCCS Istituto Nazionale Tumori Regina Elena, U.O. di Biostatistica e Bioinformatica - Direzione Scientifica, Via Elio Chianesi 53, 00144 Rome, Italy
| | - Rosario Andrea Cocchiara
- Department of Oncology, Health Direction Department San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Bruno Mariani
- Microbiology and Virology Unit, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Gabriella Parisi
- Microbiology and Virology Unit, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy
| | - Carlo Garufi
- Medical Oncology, San Camillo - Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy.
| |
Collapse
|
40
|
Galica J, Liu Z, Kain D, Merchant S, Booth C, Koven R, Brundage M, Haase KR. Coping during COVID-19: a mixed methods study of older cancer survivors. Support Care Cancer 2021; 29:3389-3398. [PMID: 33404813 PMCID: PMC7786158 DOI: 10.1007/s00520-020-05929-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Older cancer survivors are among the most vulnerable to the negative effects of COVID-19 and may need specific survivorship supports that are unavailable/restricted during the pandemic. The objective of this study was to explore how older adults (≥ 60 years) who were recently (≤ 12 months) discharged from the care of their cancer team were coping during the pandemic. METHODS We used a convergent mixed method design (QUAL+quan). Quantitative data were collected using the Brief-COPE questionnaire. Qualitative data were collected using telephone interviews to explore experiences and strategies for coping with cancer-related concerns. RESULTS The mean sample age (n = 30) was 72.1 years (SD 5.8, range 63-83) of whom 57% identified as female. Participants' Brief-COPE responses indicated that they commonly used acceptance (n = 29, 96.7%), self-distraction (n = 28, 93.3%), and taking action (n = 28, 93.3%) coping strategies. Through our descriptive thematic analysis, we identified three themes: (1) drawing on lived experiences, (2) redeploying coping strategies, and (3) complications of cancer survivorship in a pandemic. Participants' coping strategies were rooted in experiences with cancer, other illnesses, life, and work. Using these strategies during the pandemic was not new-they were redeployed and repurposed-although using them during the pandemic was sometimes complicated. These data were converged to maximize interpretation of the findings. CONCLUSIONS Study findings may inform the development or enhancement of cancer and non-cancer resources to support coping, particularly using remote delivery methods within and beyond the pandemic. Clinicians can engage a strengths-based approach to support older cancer survivors as they draw from their experiences, which contain a repository of potential coping skills.
Collapse
Affiliation(s)
- Jacqueline Galica
- School of Nursing, Queen's University, Kingston, Canada.
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada.
| | - Ziwei Liu
- School of Nursing, Queen's University, Kingston, Canada
| | - Danielle Kain
- Division of Palliative Medicine, Departments of Medicine and Oncology, School of Medicine, Queen's University, Kingston, Canada
| | - Shaila Merchant
- Division of General Surgery and Surgical Oncology, Queen's University, Kingston, Canada
| | - Christopher Booth
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
- Cancer Centre of Southeastern Ontario, Kingston, Canada
- Department of Oncology, School of Medicine, Queen's University, Kingston, Canada
| | - Rachel Koven
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
| | - Michael Brundage
- Division of Cancer Care & Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
- Cancer Centre of Southeastern Ontario, Kingston, Canada
- Department of Oncology, School of Medicine, Queen's University, Kingston, Canada
- Department of Public Health Sciences, School of Medicine, Queen's University, Kingston, Canada
| | - Kristen R Haase
- School of Nursing, Faculty of Applied Science, The University of British Columbia, Vancouver, Canada
| |
Collapse
|
41
|
Chan ASW, Ho JMC, Li JSF, Tam HL, Tang PMK. Impacts of COVID-19 Pandemic on Psychological Well-Being of Older Chronic Kidney Disease Patients. Front Med (Lausanne) 2021; 8:666973. [PMID: 34124096 PMCID: PMC8187602 DOI: 10.3389/fmed.2021.666973] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022] Open
Abstract
COVID-19 pandemic has been a major global issue, its eventual influences on the population welfare, global markets, public security, and everyday activities remain uncertain. Indeed, the pandemic has arisen a significant global threat. Its psychological impact is predicted to be severe and enduring, but the absolute magnitude is still largely unclear. Chronic kidney disease (CKD) is a complication markedly contributes to the mortality of COVID-19 cases, meanwhile several studies have demonstrated the high frequency and seriousness of the COVID-19 in CKD patients receiving dialysis. Importantly, the influence of COVID-19 among CKD patients without dialysis is still largely unexplored. Thus, we systemically summarized how mental health affects the spreading of COVID-19 to virtually worldwide, covering perspectives from several countries across a wide range of fields and clinical contexts. This review aims to provide the latest details and reveal potential concerns on the public health including psychological well-being of the older patients with CKD.
Collapse
Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | | | - Jane Siu Fan Li
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - Hon Lon Tam
- Education Department, Kiang Wu Nursing College of Macau, Macao, China
| | - Patrick Ming Kuen Tang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
42
|
Koinig KA, Arnold C, Lehmann J, Giesinger J, Köck S, Willenbacher W, Weger R, Holzner B, Ganswindt U, Wolf D, Stauder R. The cancer patient's perspective of COVID-19-induced distress-A cross-sectional study and a longitudinal comparison of HRQOL assessed before and during the pandemic. Cancer Med 2021; 10:3928-3937. [PMID: 33973411 PMCID: PMC8209623 DOI: 10.1002/cam4.3950] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background To permit timely mitigation of adverse effects on overall clinical outcome, it is essential to understand how the pandemic influences distress and health‐related quality of life (HRQOL) in cancer patients during the coronavirus disease 2019 (COVID‐19) pandemic. Methods In this cross‐sectional study, adult cancer patients, without COVID‐19 symptoms, completed a 13‐item questionnaire about the pandemic's impacts on distress and everyday‐life; associations with age, sex, or impaired HRQOL were then assessed by binary logistic regressions. In a subsample of patients with HRQOL assessment available from both before and during the pandemic, we evaluated the pandemic's impact on longitudinal changes in HRQOL reported within 6 months before versus during the COVID‐19 lockdown using McNemar's test, and thresholds for clinical importance. Results We consecutively enrolled 240 patients with solid (50%) or hematological (50%) cancers. Median age was 67 years, 46% were females. The majority ranked heeding their health (80%) and keeping their appointment schedule in hospital (78%) as important. Being younger than 60, or aged 60–70 was independently associated with limitations in everyday life (OR = 3.57, p < 0.001; and 2.05, p = 0.038); female individuals and those with restricted emotional functioning were more distressed by the COVID‐19 situation (OR = 2.47, p = 0.040; and 3.17, p = 0.019); the latter group was also significantly more concerned about being a patient at risk (OR = 2.21, p = 0.029). Interestingly, in a subsample of patients (n = 47), longitudinal comparisons pre‐ versus during the pandemic revealed that HRQOL was not substantially affected by the pandemic. Conclusion Particularly younger and female cancer patients, and those with impaired emotional functioning are distressed by COVID‐19. During the first COVID‐19 lockdown, cancer patients remained predominantly resilient. This analysis highlights the need to mitigate distress situations in vulnerable patients and thereby enhance resilience during pandemics.
Collapse
Affiliation(s)
- Karin A Koinig
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Arnold
- Department of Radiation Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Jens Lehmann
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Johannes Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefan Köck
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Willenbacher
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Roman Weger
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria.,OncoTyrol-Center for Personalized Cancer Medicine, Innsbruck, Austria
| | - Bernhard Holzner
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ute Ganswindt
- Department of Radiation Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Dominik Wolf
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| | - Reinhard Stauder
- Department of Internal Medicine V, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
43
|
The SIOG COVID-19 working group recommendations on the rollout of COVID-19 vaccines among older adults with cancer. J Geriatr Oncol 2021; 12:848-850. [PMID: 33715995 PMCID: PMC7934668 DOI: 10.1016/j.jgo.2021.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/03/2021] [Indexed: 01/19/2023]
|
44
|
Doraiswamy S, Jithesh A, Mamtani R, Abraham A, Cheema S. Telehealth Use in Geriatrics Care during the COVID-19 Pandemic-A Scoping Review and Evidence Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1755. [PMID: 33670270 PMCID: PMC7918552 DOI: 10.3390/ijerph18041755] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022]
Abstract
Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of new literature on this topic during the pandemic, so we conducted a scoping review and evidence synthesis for telehealth use in geriatric care to summarize learning from these new data. Methods: We searched PubMed, Embase, and the World Health Organization's COVID-19 global research database for articles published between 1 January and 20 August 2020. We included 79 articles that met our inclusion criteria. The information collected has been synthesized and presented as descriptive statistics. Strengths, weaknesses, opportunities, and threats (SWOT) have also been discussed. Results: The articles included in our review provide some evidence of effective provision of preventive, curative, and rehabilitative telehealth services for older people, but they highlight a greater focus on curative services and are mostly concentrated in high-income countries. We identified convenience and affordability as the strengths of telehealth use in geriatric care. Weaknesses identified include the inability of telehealth to cater to the needs of older people with specific physical and cognitive limitations. While the threats of increasing inequity and the lack of standardization in the provision of age-friendly telehealth services remain, we identified opportunities for technologic advancements driven by simplicity and user-friendliness for older people. Conclusion: Telehealth offers futuristic promise for the provision of essential health care services for older people worldwide. However, the extent of these services via telehealth appears to be currently limited in low and low-middle income countries. Optimizing telehealth services that can be accessed by older people requires greater government investments and active engagement by broader participation of older people, their caregivers, physicians and other health care providers, technology experts, and health managers.
Collapse
Affiliation(s)
- Sathyanarayanan Doraiswamy
- Institute for Population Health, Weill Cornell Medicine-Qatar, P.O. Box 24144, Doha, Qatar; (A.J.); (R.M.); (A.A.); (S.C.)
| | | | | | | | | |
Collapse
|
45
|
Gualandi R, De Benedictis A, De Marinis MG, Tartaglini D. Managing the Journey of Patients under Chemotherapy in a Pandemic Era: A Nursing Perspective. Chemotherapy 2021; 65:1-4. [PMID: 33540409 PMCID: PMC7900452 DOI: 10.1159/000513140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/17/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, cancer patients' care needs to be reconsidered by integrating the patient's clinical pathway with the hospital patient journey and the family context in a safe and patient-centered way. So far, no systematic reports are available regarding the impact of the COVID-19 pandemic on cancer care. This work gives a first overview of patients' care needs undergoing chemotherapy treatment from a nursing perspective.
Collapse
Affiliation(s)
- Raffaella Gualandi
- Department of Nursing, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Anna De Benedictis
- Department of Nursing, Università Campus Bio-Medico di Roma, Rome, Italy,
| | | | - Daniela Tartaglini
- Department of Nursing, Università Campus Bio-Medico di Roma, Rome, Italy
| |
Collapse
|
46
|
Ben-Arye E, Keshet Y, Gressel O, Tapiro Y, Lavie O, Samuels N. Being in touch: narrative assessment of patients receiving online integrative oncology treatments during COVID-19. Support Care Cancer 2021; 29:4819-4825. [PMID: 33538895 PMCID: PMC7859467 DOI: 10.1007/s00520-021-06026-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/21/2021] [Indexed: 11/26/2022]
Abstract
Objective We examined the qualitative impact of an online integrative oncology (IO) treatment program, designed in response to the restrictions created by the current COVID-19 pandemic. Methods Patients undergoing chemotherapy were seen by an integrative physician (IP), together co-designing an IO treatment program of ≥ 6 weekly treatments to alleviate symptoms and improve quality of life (QoL). IO practitioners guided patients and their caregivers online in self-treatment with manual/touch, movement, and/or mind-body modalities. Narratives of both patients and IO practitioners were analyzed for systematic coding, identifying barriers and advantages of the online treatment program. Results Narratives obtained from 30 patients and eight IO-trained practitioners were examined. The patients had undergone 169 online IO sessions with a total of 327 IO interventions during the 3-month study period. Patient narratives included reflections on both non-specific effects (e.g., less of a “sense of isolation”) and specific QoL-related outcomes with the online intervention. IO practitioner narratives focused on barriers to providing manual-movement and mind-body modalities, suggesting practical recommendations on how to address specific QoL-related outcomes using the online IO “toolbox.” Conclusions Effective online IO practitioner-guided treatments are feasible and may induce both specific and non-specific QoL-related effects. Future research needs to explore online IO interventions for additional situations in which access to IO care is limited.
Collapse
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel.
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Yael Keshet
- Department of Sociology and Anthropology, Western Galilee Academic College, Galilee, Israel
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel
| | - Yehudit Tapiro
- Integrative Oncology Program, The Oncology Service, Lin, Carmel, and Zebulun Medical Centers, Clalit Health Services, 35 Rothschild St, Haifa, Israel
| | - Ofer Lavie
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Obstetrics and Gynecology Carmel Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| |
Collapse
|
47
|
Ben-Arye E, Gressel O, Ben-Arye E, Samuels N. Feasibility of an Online Integrative Oncology Treatment Program During COVID-19. J Pain Symptom Manage 2021; 61:e1-e3. [PMID: 33189855 PMCID: PMC7659922 DOI: 10.1016/j.jpainsymman.2020.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service; Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel.
| | - Eran Ben-Arye
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Israel; Faculty of Medicine, Tel-Aviv University, Israel
| |
Collapse
|
48
|
Lange M, Binarelli G, Joly F. Geriatric phone follow-up including validated cognitive assessment in older patients treated for cancer. J Geriatr Oncol 2021; 12:838-839. [PMID: 33500222 DOI: 10.1016/j.jgo.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Marie Lange
- Clinical Research Department, Centre François Baclesse, 14076 Caen, France; Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France; Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France.
| | | | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14076 Caen, France; Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France; Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France; University Hospital of Caen, 14000 Caen, France
| |
Collapse
|
49
|
Heymann D. The Elderly and the COVID 19 Crisis: A Chronicle of Deaths Foretold, in Isolation and Total Indifference. Front Public Health 2021; 8:602982. [PMID: 33490021 PMCID: PMC7820755 DOI: 10.3389/fpubh.2020.602982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/07/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Dominique Heymann
- Université de Nantes, Institut de Cancérologie de l'Ouest, Saint-Herblain, France.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| |
Collapse
|
50
|
Cherif MA, Loganadane G, Debbi K, Coraggio G, Ghith S, Hadhri A, Hassani W, Grellier N, To NH, Belkacemi Y. Radiation Therapy Delivery Challenges in Older Patients During Coronavirus Disease 2019 Pandemic. Adv Radiat Oncol 2020; 6:100626. [PMID: 33313442 PMCID: PMC7718104 DOI: 10.1016/j.adro.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose The management of older patients in radiation therapy (RT) departments has been challenging in the context of the Coronavirus Disease 2019 (COVID-19) outbreak. We report our experience of RT adapted schedules or strategy changes in older patients during the COVID-19 pandemic. Methods and Materials Patients aged ≥75 years were recruited during weekly chart rounds. All were potentially eligible for a specific intervention to reduce the frequency of patients' visits to the hospital. The effect of deferring radiation and hypofractionation of RT schedules was assessed in terms of the number of courses initially planned and replanned during the lockdown. Results Twenty patients were identified during the official lockdown in France (March 17 to May 11). Median age was 78 years (75-95 years). Most patients were male (n = 12, 60%) being treated in the postoperative setting (n = 17, 85%). RT was delayed in 11 cases (55%) with hormonal therapy prescribed in 10 cases (50%). Altered RT fractionation was proposed for 5 cases (25%); combinations of altered fractionation and deferral of radiation were applied in 3 cases (15%). The number of radiation courses initially planned and replanned according to the pandemic context: 563 and 197, respectively (-62%; P < .001). None presented recurrence when RT was initiated, and no patient developed symptomatic COVID-19 infection. Conclusions In the context of the COVID-19 outbreak, individual risk-based radiation therapy seems to be safe. Systematic screening of patients for COVID-19 before starting radiation therapy is mandatory. In our department the oncogeriatrics expertise availability for daily practice was of great use during the pandemic. Other prospective studies are needed to validate such strategies in case of resurgence of similar outbreaks.
Collapse
Affiliation(s)
- Mohamed Aziz Cherif
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
- Association of Radiation therapy and Oncology of the Mediterranean Area and Transatlantic Radiation Oncology Network
| | - Gokoulakrichenane Loganadane
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
| | - Kamel Debbi
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
| | - Gabriele Coraggio
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
- Association of Radiation therapy and Oncology of the Mediterranean Area and Transatlantic Radiation Oncology Network
| | - Sahar Ghith
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
| | - Asma Hadhri
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
| | - Wissal Hassani
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
| | - Noémie Grellier
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
- Association of Radiation therapy and Oncology of the Mediterranean Area and Transatlantic Radiation Oncology Network
| | - Nhu Hanh To
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
- INSERM Unit 955; Team 21, IMRB, University of Paris-Est (UPEC), Creteil, France
| | - Yazid Belkacemi
- AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, University of Paris-Est (UPEC), Creteil, France
- Association of Radiation therapy and Oncology of the Mediterranean Area and Transatlantic Radiation Oncology Network
- INSERM Unit 955; Team 21, IMRB, University of Paris-Est (UPEC), Creteil, France
- Corresponding author: Yacid Belkacemi MD, PhD
| |
Collapse
|