COVID-19 Changed Cancer Treatment — For Better

Beyond the additional difficulty of accessing care, many treatments for cancer endanger the immune system, making it easier for patients to catch the infectious respiratory virus and driving many to extreme isolation.Recent studies published in JAMA Oncology Patients recently diagnosed with cancer, especially African Americans, have been found to have a significantly increased risk of COVID-19 infection and its adverse consequences.

In addition to the physical aspects Survey by the American Cancer Society Almost half of all patients reported that their experience as a cancer survivor during the COVID-19 pandemic affected their mental and / or emotional well-being. Twenty-four percent (24%) said the outbreak made it more difficult to contact the provider about their survivor needs.

The pandemic has forced oncologists to completely rethink their interactions with patients. From finding creative ways to overcome the clinical challenges associated with providing remote care, to getting more in touch with and better supporting the emotional health of patients. Although difficult this year, many of the changes that have emerged, such as accelerating telemedicine, rethinking patient experience, and adjusting treatment, will be a lasting tool for improving patient care and outcomes over the next few years. think.

Acceleration of telemedicine

As in other areas of practice, telemedicine services have grown rapidly in oncology. While some forms of cancer treatment require direct visits such as infusions, the team has identified remote opportunities along the care journey, such as performing symptom checks. The truth is, with the exception of face-to-face testing and treatment, the ability to check in, monitor, and manage patient care is as effective as face-to-face, but more convenient and comfortable for the patient.

Today, many patients are virtually met with oncologists to discuss treatment plans, progress, questions, and concerns before being referred to an office near their home for laboratory work or other necessary tests, and travel time. And can reduce exposure.

As we have seen the benefits of telemedicine for patients, doctors and care teams are beginning to discuss ways to further extend home and telemedicine care, such as providing home infusions. We are not there yet, but we have opened up new possibilities for providing quality care that is more accessible, efficient, safe and quality for patients.

Rethink the patient’s experience

For many cancer patients, the physical and mental support of family and friends is important when they are diagnosed and treated. However, due to the limited number of people in hospitals and offices, most patients face pre-pandemic friendships that are often part of IVs, waiting rooms, and cafeterias, as well as having no family. Today, face-to-face visits aren’t about connectivity or support, but about speed and risk mitigation or elimination.

And this is not only difficult for patients. Oncology is not a medical field where doctors distance themselves from patients. The exact opposite. Prior to being infected with COVID-19, he shook hands regularly to hug the patient. In reality, the news I deliver is often devastating and, as a human being, requires a level of empathy and compassion through touch. It’s hard to do it behind the mask from the other side of the room. This new reality challenges and continues to challenge us to find new ways to connect.

One way to find out that your team can provide this important support piece is to use the smartphone app. The smartphone app allows patients to find all the resources they need, including access to nurses and advocates who can answer questions, talk about concerns, and provide additional resources as needed. .. The other is to help them in the “small” ways that friends and family used to do, such as helping them take notes when booking. The care team is currently playing these roles. Pause more often to allow for mental processing, ensure understanding of patient-provided information, proactively answer frequently asked questions, and fill in as a note-taker and paper organizer ..

Treatment adjustment

In addition to How We have provided care and support to our patients and there have been changes in treatment. For example, the FDA has approved some immunotherapy changes and is extending the amount of prescription allowed to limit the number of visits patients need for follow-up and replacement.

For many patients, clinical trials are part of their treatment strategy. However, like everything else, enrollment in those exams is declining.The· The main reason for failing to meet the clinical trial deadline is the patient recruitment process., Occupy an estimated 30% of the clinical timeline. Prior to the pandemic, only 3-5% of oncology patients participated in clinical trials, which is still too low. Now that patients are delaying screening and care, their numbers are even smaller. This reduction in study enrollment can have a significant impact on overall treatment outcomes.

It brings us to another terrifying reality we are facing: Delayed diagnosis. Investigated by UnitedHealth Group California insists on data And by the second week of April, we found that screening for mammograms and colorectal cancer in asymptomatic individuals had decreased by more than 90%. One Oncology Practice Publication Since the pandemic began, new cancer diagnoses have been reported to have declined by 37%. Problem: Lower screening also reduces the chances of finding cancer at a faster and more treatable stage.

We are at risk of seeing people with late-stage cancer who need a more aggressive treatment plan. It is important to be careful in preparation for the coming months and years, for future changes, and for future changes.

Get ready for telemedicine to stay

According to MJH Life Sciences survey results Status of doctor surveyMore than half (54%) of the physicians surveyed say they continue to use telemedicine frequently to serve their patients after the pandemic is over.

It is clear that telemedicine will never go away. Therefore, clinics need to design strategies that serve their own patient community. How can telemedicine enhance the care it provides and improve the patient’s experience? As part of that strategy, we need to tell patients where telemedicine fits into their care plans. This allows patients to know how to receive the care and support they need throughout the journey.

Improve patient experience

In line with those same policies, the patient’s experience needs to be thoughtfully designed and implemented. Clinics need to go beyond the band-aid approach implemented during COVID-19. 24×7 virtual support and seamlessly provided resources are critical to improving the experience of patient care and the teams that deliver it.

Behind the scenes, clinics need to reassess their integration with electronic health records (EHRs) to enable quality care, whether delivered face-to-face or virtually. ..

Planning a diagnosis and treatment plan for late-stage cancer

Patients with a late diagnosis need treatment and support plans to meet them where they are ill. They need to connect with the right support team as soon as possible, access resources to help them make the necessary decisions about treatment planning, and be able to start their regimen without delay.

Clinic and care teams need to consider ways to speed up care delivery right now so that when a patient has advanced cancer, treatment time is reduced, streamlined, and efficient. There is.

Like many others, cancer treatment has changed dramatically over the past year. These changes have been forced on us by the pandemic, but many of them have improved the quality of care we provide and the patient experience. Once under the control of COVID-19, you may revert to previous versions, such as support groups and waiting room friendships. However, there are also improvements and enhancements to these features, such as 24×7 access to the support team via smartphone apps that act as both treatment management and support tools.

Our job as a doctor is to ensure that patients receive the highest quality care available, and we now believe that there is a new way to do just that.

Ankur Parikh, MD, is a hematologist, oncologist, Ora oncology..