COVID-19 & Cancer: Crowdsourced Q&A from theMednet Community of Oncologists

news Mar 17, 2020

COVID-19 information is evolving at a rapid pace. We all have pressing questions about this pandemic, and this is especially the case for physicians. Oncologists need to know how to protect patients and staff and be able to effectively deliver care to cancer patients.

That's why theMednet is focusing our efforts on national collaboration in the oncology community to share knowledge and best practices from oncology departments around the country.

Join us on this page as we continuously provide questions and answers to the world of oncology in these uncertain times. Below you'll find the most up to date questions on COVID-19 and oncology protocol within theMednet community.


Radiation Oncology

What are best practices for radiation oncology patient and staff precautions with the COVID-19 pandemic?

Should we delay adjuvant breast radiotherapy for early stage breast cancers as the COVID-19 situation evolves?

How should you manage a coronavirus infected/suspected patient who is receiving radiotherapy and cannot interrupt or delay their cancer treatment?

How should radiation oncology departments prepare for significant resource depletion and/or staff shortages with the COVID-19 outbreak?

How would you boost a high-risk prostate cancer patient who received standard fractionation treatment and is not able to get LDR boost given COVID-19?

In the wake of the COVID-19 pandemic, are there any hypofractionated regimens (without concurrent chemotherapy) that could be utilized for head / neck cancer in a post operative setting?

Would you consider modifying T&O fractionation during the COVID-19 pandemic?

What is your treatment paradigm for rectal cancer in the setting of COVID-19?

What is the longest acceptable interval between hysterectomy and VCBT for HIR EMCA in the age of COVID-19?

Will patients who receive radiation to a large mediastinal nodal field have an increased susceptibility to COVID-19?

How long can you delay the start of radiation in a patient who has received adjuvant chemotherapy after lumpectomy/mastectomy?


Medical Oncology

Is your approach to managing immune related adverse events altered at all in light of COVID-19?

Should we be utilizing prophylactic G-CSF in our patients with intermediate risk of febrile neutropenia due to the COVID-19 pandemic?

What scenarios, if any, are you delaying adjuvant chemotherapy in light of the COVID-19 outbreak?

Are there scenarios that new visits/consults with patients with breast and colon cancers can be done virtually amidst the COVID-19 outbreak?

Should we be stopping new starts of patients who can be triaged for 2-3 months like prostate cancers on ADT when significant community spread of COVID-19 is detectable in our area?

Have your treatment recommendations for urothelial cancer patients changed given the ongoing COVID19 pandemic?

How should you manage a COVID-19 infected/suspected patient who is receiving chemotherapy and cannot interrupt or delay their cancer treatment?

Should we consider deferring adjuvant chemotherapy for resected early-stage NSCLC in light of COVID-19?

How would you approach missed doses of fulvestrant due to COVID-19?


Pediatric Oncology

Should extra precautions be taken for pediatric oncology patients in light of the recent COVID-19 outbreak?

How should you manage a pediatric oncology patient who has an ANC > 500 and a normal chest x-ray but is confirmed to be infected with COVID-19 and is immunosuppressed from chemotherapy?


General

How will your management of head and neck cancers change with the COVID-19 pandemic?

Is there any consensus or guidance on how to manage germ cell tumor patients in the COVID-19 era?

What measures should we take regarding routine follow-up visits for well patients in surveillance during the coronavirus pandemic?

What are best practices for taking care of lung cancer patients during the COVID-19 pandemic?

What are the current official guidelines regarding managing patients during COVID-19?

How has COVID-19 altered your recommendations for invasive mediastinal staging for NSCLC?

Are there scenarios that new visits/consults with patients can be done virtually amidst the COVID-19 outbreak?

In light of promising results of hydroxychloroquine in COVID-19, should we consider using it prophylactically in cancer patients, especially if immunocompromised?

How should our selection for neoadjuvant chemotherapy for breast cancer change in light of COVID-19?

What is the longest acceptable interval between radical orchiectomy and adjuvant BEP for Stage IIB/III pure seminoma in the age of COVID-19?

Nadine Housri

Among with Brendan Bense

Dr. Nadine Housri is the co-founder of theMednet and an Assistant Professor of Radiation Oncology at Yale.