|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 3 | Page : 611-612
Challenges in the diagnosis and treatment of gynecological cancers during the COVID-19 pandemic
Vijayan Sharmila1, Thirunavukkarasu Arun Babu2
1 Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh, India
2 Department of Pediatrics, AIIMS, Mangalagiri, Andhra Pradesh, India
|Date of Submission||10-Aug-2020|
|Date of Decision||15-Aug-2020|
|Date of Acceptance||16-Aug-2020|
|Date of Web Publication||19-Sep-2020|
Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharmila V, Babu TA. Challenges in the diagnosis and treatment of gynecological cancers during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3:611-2
|How to cite this URL:|
Sharmila V, Babu TA. Challenges in the diagnosis and treatment of gynecological cancers during the COVID-19 pandemic. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Oct 25];3:611-2. Available from: https://www.crstonline.com/text.asp?2020/3/3/611/295516
The coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization on March 11, 2020. In an attempt to contain the spread of SARS-CoV-2, several countries imposed restrictions and repeated lockdowns that led to reduced access to health-care services. Globally, the health-care facilities are currently focusing on limiting the physical interaction between the patients and physicians to avoid the risk of infection. Telemedicine has revolutionized the field of healthcare during this pandemic, and outpatient visits have transformed into virtual visits through telephone and video consultations. Most of the existing human and health-care resources have been allocated to deal with COVID-19. This has also led to fewer non-COVID patients visiting the hospitals.
Health-care providers have limited the physical examination component of evaluation due to the risk of spreading infection. Diagnosis and assessment of the clinical condition are now heavily dependent on a standard set of investigations. Malignancies of the genital tract, such as carcinomas of the cervix, vulva, and vagina, and endometrial and ovarian cancers, require mandatory physical examination of the abdomen, per-speculum vaginal examination, and bimanual and rectal examinations for clinical diagnosis and staging. Restricting the “in-person” visits and physical examinations could lead to delays and misdiagnoses, thereby causing clinicians to miss out on the critical “treatment window.” This can also indirectly encourage patients to seek treatment from practitioners of other non-allopathic streams of medicine. All these factors can lead to grave consequences in patients with gynecological cancers. During this pandemic, several difficult and unique decisions need to be made for the management of patients with gynecological cancers. These can be pertaining to the standard of care to be provided to these patients, modifications in the standard of care due to the pandemic, whether to defer therapy and surgery, surgical prioritization of cases, initiation and continuation of chemotherapy and radiotherapy, follow-up protocols of treated patients, and recruitment of patients for cancer clinical trials.,, Decisions regarding performing cancer surgery during the pandemic are particularly important, as COVID-19 is associated with higher surgical morbidity and mortality. In addition, there is an acute shortage of the number of in-patient beds and intensive care unit beds, which may be required following surgery. For patients with metastatic disease, treatment delays may lead to worsening of the performance status. A recent study noted that patients with cancer feared cancer progression (70.9%) more than acquiring COVID-19 and were anxious that the pandemic would lead to a change in the planned course of cancer treatment. It is estimated that several cancer surgeries have been deferred worldwide due to COVID-19 leading to a backlog of cases., As the pandemic is still evolving, most of the available guidelines on the management of cancers during this pandemic lack robust scientific evidence.,, Hence, there is an emergent need to understand the impact of the prevailing hostile environment due to the pandemic on the diagnosis and treatment of gynecological cancers, which only time can reveal.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Pande P, Sharma P, Goyal D, Kulkarni T, Rane S, Mahajan A. COVID-19: A review of the ongoing pandemic. Cancer Res Stat Treat 2020;3:221-32. [Full text]
Bansal N, Ghafur A. COVID-19 in oncology settings. Cancer Res Stat Treat 2020;3 Suppl 1:13-4.
Di Marzo F, Sartelli M, Cennamo R, Toccafondi G, Coccolini F, La Torre G, et al
. Recommendations for general surgery activities in a pandemic scenario (SARS-CoV-2). Br J Surg 2020;107:1104-6.
Arun Babu T, Sharmila V. COVID-19 pandemic: Another nail in the coffin of the 'dying art' of physical examination. Cancer Res Stat Treat 2020;3:610.
Ueda M, Martins R, Hendrie PC, McDonnell T, Crews JR, Wong TL, et al
. Managing cancer care during the COVID-19 pandemic: Agility and collaboration toward a common goal. J Natl Compr Canc Netw 2020;18:366-9.
Dessai S, Nachankar A, Kataria P, Abyankar A. Management of patients with gynecological cancers during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3 Suppl 1:40-8.
Goel A. Management of cancer during the COVID pandemic: Treatment of gynecological malignancies. Cancer Res Stat Treat 2020;3 Suppl 1:106-9.
Mathrudev V, Goud S, More S, Jain S. Impact of COVID-19 on oncology clinical trials: A “novel” challenge. Cancer Res Stat Treat 2020;3 Suppl 1:133-5.
Thomakos N, Pandraklakis A, Bisch SP, Rodolakis A, Nelson G. ERAS protocols in gynecologic oncology during COVID-19 pandemic. Int J Gynecol Cancer 2020;30:728-9.
COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans. Br J Surg 2020;May 12 [Epub ahead of print] doi: 10.1002/bjs.11746.
Prem A, Patel S, Pai E, Pandey D. Surgical management of cancer during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3 Suppl 1:119-22.
Pinninti R. Management of geriatric cancer patients during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3 Suppl 1:71-5.
Karpe A, Nagvekar-Karpe S. Management of hematological malignancies during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3 Suppl 1:54-8.
Patil V, Noronha V, Chaturvedi P, Talapatra K, Joshi A, Menon N, et al
. COVID-19 and head and neck cancer treatment. Cancer Res Stat Treat 2020;3 Suppl 1:15-28..