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Table of Contents
LETTER TO EDITOR
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 611-612

Challenges in the diagnosis and treatment of gynecological cancers during the COVID-19 pandemic


1 Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh, India
2 Department of Pediatrics, AIIMS, Mangalagiri, Andhra Pradesh, India

Date of Submission10-Aug-2020
Date of Decision15-Aug-2020
Date of Acceptance16-Aug-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Vijayan Sharmila
Department of OBG, AIIMS, Mangalagiri, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_273_20

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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 30];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.[1] 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.[2] Telemedicine has revolutionized the field of healthcare during this pandemic, and outpatient visits have transformed into virtual visits through telephone and video consultations.[3] 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.”[4] This can also indirectly encourage patients to seek treatment from practitioners of other non-allopathic streams of medicine.[5] 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.[6],[7],[8] Decisions regarding performing cancer surgery during the pandemic are particularly important, as COVID-19 is associated with higher surgical morbidity and mortality.[9] 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.[3] 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.[10] It is estimated that several cancer surgeries have been deferred worldwide due to COVID-19 leading to a backlog of cases.[11],[12] As the pandemic is still evolving, most of the available guidelines on the management of cancers during this pandemic lack robust scientific evidence.[13],[14],[15] 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

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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