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Delaying Treatment to Protect Ovarian Cancer Patients from COVID Has Benefits and Risks

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September 8, 2020

The virus has led to more careful consideration about which treatments to implement right away

  • Hospitals with large numbers of COVID patients have delayed cancer surgeries
  • Many in-person cancer visits have been moved to telehealth appointments
  • Virtual visits may not provide all the information doctors need to make decisions
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Determining the most appropriate cancer treatment for patients usually involves finding a delicate balance between the risks and benefits. How effective will the treatment be? Can a patient tolerate it? “With COVID, it’s just adding one more factor into the equation,” NYU Langone Health gynecologic oncologist, Dr. Douglas A. Levine, says at SurvivorNet Connect’s virtual conference on ovarian cancer treatment in the time of COVID.

You now have to determine whether the need to treat the cancer outweighs the risk of already vulnerable patients catching the virus. In the early days of the pandemic, when hospitals were full of COVID patients, delaying surgery was a necessity. Once the situation had stabilized and the COVID burden was reduced, doctors resumed performing cytoreductive procedures, but judiciously. For example, they might have delayed in a patient with an early-stage endometrial cancer and several comorbidities, but performed surgery on someone with a later-stage cancer.

The virus has also made oncologists more thoughtful about their decision to bring patients into the office for care. Many have transitioned their patients to telephone and video visits, like Dr. Bobbie J. Rimel, an OB/GYN and oncologist at Cedars-Sinai Medical Center. “If they don’t need to physically be seen, they’re not having active symptoms, we’ve moved all of those to video visits,” she says.

Facilities outside of big cities, including Roswell Park Comprehensive Cancer Center, didn’t face a COVID rush, which gave them a chance to get ready for their cancer patients. “We had extra time to prepare to move our practice to virtual visits and to protect our patients and develop better screening mechanisms,” says gynecologic oncologist, Dr. Emese Zsiros.

When it comes to delivering care remotely, Stanford Medicine gynecologic oncologist, Dr. Oliver Dorigo, was more skeptical, saying doctors are “still on a learning curve.” “I do believe that they can be done, but they’re not as good as an in-person visit. We need clues that we can only get from a patient during an in-person visit.”