Ecancermedicalscience
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Ecancermedicalscience · Jan 2020
EditorialAdditional challenges faced by cancer patients in Gaza due to COVID-19.
Cancer patients in conflict settings experience significant barriers in accessing chemotherapy and radiotherapy as well as palliative care and psychosocial support. Now they face an additional possible risk of infection by SARS-CoV-2 novel coronavirus and the indirect impact of the COVID-19 pandemic on movement restrictions and their access to care. In this commentary, we highlight that despite the low COVID-19 burden in conflict settings like Gaza, COVID-19 could lead to further inequity in cancer care and poorer outcomes for Palestinians with cancer. This is due to the pre-existing shortage in cancer resources as well as the lack of context-specific guidelines to prepare for COVID-19 in war-torn settings.
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Ecancermedicalscience · Jan 2020
Medical oncology care amidst the COVID-19 pandemic at the National University Hospital in the Philippines.
COVID-19 has abruptly and radically changed the landscape of cancer care delivery throughout the world, including the Philippines. The Philippine General Hospital is the academic hospital of the University of the Philippines. ⋯ As the global pandemic challenges healthcare delivery, centres are forced to rethink how to care for their patients. This paper discusses how a national, academic, referral cancer institute in a low-middle income country is trying to meet the challenges of COVID-19.
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Ecancermedicalscience · Jan 2020
Should cancer treatment be continued during the COVID-19 pandemic? A single Egyptian institution experience.
The first confirmed case of coronavirus disease 2019 (COVID-19) in Egypt was reported on 14 February, 2020. Menoufia Clinical Oncology Centre is at the forefront of delivering care to patients with cancer during this public health crisis in Menoufia Governorate, Egypt. This article highlights the unique circumstances and challenges of cancer treatment during this global pandemic and the importance of organisational structure, preparation and a shared vision for continuing to provide cancer treatment to patients in the face of uncertainty and rapid change.
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Ecancermedicalscience · Jan 2020
ReviewAssociations between immune-suppressive and stimulating drugs and novel COVID-19-a systematic review of current evidence.
Cancer and transplant patients with COVID-19 have a higher risk of developing severe and even fatal respiratory diseases, especially as they may be treated with immune-suppressive or immune-stimulating drugs. This review focuses on the effects of these drugs on host immunity against COVID-19. ⋯ The COVID-19 pandemic has led to challenging decision-making about treatment of critically unwell patients. Low-dose prednisolone and tacrolimus may have beneficial impacts on COVID-19. The mycophenolate mofetil picture is less clear, with conflicting data from pre-clinical studies. There is no definitive evidence that specific cytotoxic drugs, low-dose methotrexate for auto-immune disease, NSAIDs, JAK kinase inhibitors or anti-TNFα agents are contraindicated. There is clear evidence that IL-6 peak levels are associated with severity of pulmonary complications.
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Ecancermedicalscience · Jan 2020
ReviewEvidence-based recommendations for gastrointestinal cancers during the COVID-19 pandemic by the Brazilian Gastrointestinal Tumours Group.
As of 2020, the world is facing the great challenge of the COVID-19 (Coronavirus disease 2019) pandemic, caused by the SARS-CoV-2 virus. While the overall mortality is low, the virus is highly virulent and may infect millions of people worldwide. This will consequently burden health systems, particularly by those individuals considered to be at high risk of severe complications from COVID-19. Such risk factors include advanced age, cardiovascular and pulmonary diseases, diabetes and cancer. However, few data on the outcomes of cancer patients infected by SARS CoV-2 exist. Therefore, there is a lack of guidance on how to manage cancer patients during the pandemic. We sought to propose specific recommendations about the management of patients with gastrointestinal malignancies. ⋯ Our recommendations emphasise the importance of treating cancer patients, using the best evidence available, while simultaneously taking into consideration the world-wide health resource hyperutilisation to treat non-cancer COVID-19 patients.