What COVID-19 May Have Changed Forever About Multiple Myeloma Care — Telemedicine

The Pandemic Has Put a New Emphasis on Telemedicine and Oral Therapies

• COVID-19 has made multiple myeloma providers rely on telemedicine
• Oncologists have also shifted to oral therapies and deferred elective procedures
• Doctors haven’t stopped chemotherapy because the need to control multiple myeloma still takes precedence

New York City was a major epicenter of the COVID-19 pandemic, and in April, Mount Sinai Hospital reached its peak caseload, with over 2,200 admissions. COVID made oncologists like Dr. Joshua Richter rethink how to deliver care to their multiple myeloma patients, who are already at higher risk for infection. Providers increasingly shifted to telemedicine, and quickly realized its long-term benefits — particularly for patients living far from major cancer centers.

“If patients at one time in their myeloma journey interact with a myeloma center, their outcome is improved,” Dr. Richter says during a SurvivorNet Connect panel discussion. Those who are treated by multiple myeloma specialists at high-volume centers have a lower mortality risk than patients treated by community oncologists, research finds.

“What this has taught me is that patient access should be the same for everybody,” adds Dr. Nina Shah of UCSF Medical Center. “There’s no reason why somebody in one state or one county should not be able to get access to a myeloma expert, just because of where he or she lives.”

Dana-Farber medical oncologist, Dr. Paul Richardson, says the pandemic has been “completely transformative” for his practice. To protect patients’ safety, he and his colleagues shifted to oral therapies and deferred elective procedures such as autologous stem cell transplantation. “We’ve been fortunate in multiple myeloma that we have 11 new drugs approved,” he says. “That armamentarium has allowed us the flexibility to manage patients in a very tailored fashion.”

At Mayo Clinic, Dr. Vincent Rajkumar had to grapple with the question of whether to take patients off chemotherapy, even in the maintenance setting, due to concerns that this treatment might increase the risk of severe illness from COVID-19. Ultimately, the need to manage the cancer took precedence. “We’ve been telling patients that controlling multiple myeloma is more important than anything else, and to stay on their treatment,” he says.