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After the Pandemic: Oncology Adapts to Maintain Focus on Patients - TechiLive.in

After the Pandemic: Oncology Adapts to Maintain Focus on Patients

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For MedPage Today‘s “After the Pandemic” series, we asked our editorial board members to discuss what significant and lasting effects the COVID-19 pandemic will have on medicine and the delivery of healthcare.

Here, we interview Don Dizon, MD, head of women’s cancers at Lifespan Cancer Institute (LCI) and director of medical oncology at Rhode Island Hospital, both in Providence.

Check out some of our other articles in the series here.

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Can you share an anecdote about a patient of yours, de-identified of course, and how the pandemic influenced the situation? What was the outcome?

Dizon: I took care of a person with pretty advanced uterine cancer. She was quite sick and couldn’t go to the operating room, which would have been her best option for a cure. We decided to give her chemotherapy first to reduce her tumor burden and also to give her room to get stronger.

She did great during the chemotherapy; her cancer burden had gone down significantly and she felt so much better. However she all of a sudden got clinically worse, unable to eat or drink, was short of breath with small distances, and she lost her strength. We were so alarmed we admitted her to the hospital.

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Every test suggested her cancer was under control, and we couldn’t figure out why she had gotten so ill. That is, until we tested her for COVID-19, which came out positive. She continued to decline and in days was in a coma. She ultimately died of COVID-19, which was so heartbreaking.

Several studies have documented declines in routine cancer screening, coinciding with the COVID-19 pandemic. How do you talk to patients about the competing concerns of timely care (including screening exams) and avoiding coronavirus infection?

Dizon: We try to meet their concerns firsthand, discussing the things we are doing in the center to keep everyone safe and the things she can do to stay safe outside of the hospital: handwashing frequently, physical distancing, and wearing masks.

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We have also been strong proponents of vaccination, not only for the protection of our patients on an individual level, but also in order to extend that protection to their families, communities, and beyond.

I think that these kinds of very personal conversations between a doctor and the person under his or her care are so critical to not only understand the concerns and anxieties but also to provide the best evidence-informed answers that we can, in a language that is easily understood.

Has the pandemic resulted in any lasting changes or long-term impact on cancer care?

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Dizon: I do believe telehealth visits are here to stay. There are truly some circumstances where seeing someone on a screen is enough. Otherwise, transitioning patients to therapies that do not require long infusion times has become more important in the age of COVID-19. It’s likely something that we will continue to do even after the pandemic has passed.

You specialize in gynecologic cancers. Has COVID-19 posed any particular challenges for your specialty?

Dizon: There hasn’t been a particular challenge specific to people with gynecologic cancers per se. The challenge has been that people are undergoing treatment with limited in-person companionship by their caregivers.

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We used to welcome up to two people for each person to have with them during treatment. At the height of the pandemic, no one was allowed to accompany them, and now we only allow one person. I think this has been particularly tough.

Especially early in the pandemic, healthcare professionals might have been asked to provide support outside their specialty or normal duties. Were you or any colleagues ever in that situation? If so, what did you learn from the experience?

Dizon: Fortunately, I was never asked to do this. The provision of timely oncology care was a priority at Lifespan, even as the pandemic raged around us.

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Looking back at the oncology community’s response and adaptation to the pandemic, would you have done anything differently, either personally or as a community?

Dizon: I am quite proud of how LCI handled the pandemic. We really looked at the provision of safe and timely cancer care as an institution-wide priority. I am still appreciative of that.

  • Charles Bankhead is senior editor for oncology and also covers urology, dermatology, and ophthalmology. He joined MedPage Today in 2007. Follow

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