Comprehensively adapting cancer care and clinical cancer research to the COVID-19 pandemic is a necessity, researchers and doctors at Karolinska Institutet and Karolinska University Hospital write in a paper published in the journal Nature Medicine. In it, seven top European cancer centres propose adaptations to protect patients.
“Cancer patients are particularly vulnerable to complications if they get infected by the new coronavirus,” says Jonas Bergh, chair of Cancer Research KI, professor at the Department of Oncology-Pathology at Karolinska Institutet and consultant at Karolinska University Hospital. “We must therefore protect them from the virus without compromising continuity of care.”
The article has been written by representatives of the seven centres that make up Cancer Core Europe, which together conduct extensive clinical research and treat 70,000 new cancer patients a year. The centres in Milan, Barcelona, Cambridge, Paris, Amsterdam and Heidelberg are, like Karolinska Institutet, facing very difficult challenges imposed by the pandemic.
Several changes made
“Our aim is to quickly communicate our experiences from the first months of the pandemic and give general advice and guidelines to other cancer clinics,” says Ingemar Ernberg, chair of Karolinska Institutet’s Personalised Cancer Medicine (PCM) programme and professor at the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet. “We’re in an earlier essentially unknown medical and ethical reality, which means that caregivers have to muster all their knowhow and experience to make vital clinical decisions.”
Treatments have had to be postponed or modified to protect the patients’ immune systems and many more patient follow-ups are performed remotely. Some clinical research studies have been rescheduled or even put on hold if they are judged to expose patients to extra risk.
“We and other cancer centres around the world will continue to compile and report new data on the impact that the pandemic is having on cancer care to provide a solid foundation for future choices and decisions,” says Luigi De Petris, oncologist at the Cancer Theme, Karolinska University Hospital and researcher at the Department of Oncology-Pathology, Karolinska Institutet. “This will be a dynamic and swift process in which we hope that our combined experiences will come to benefit others.”
The article gives examples of what needs to be considered and possibly changed in order to create continuity in cancer care during the pandemic:
- Adaptation of clinical activities to keep centres infection-free, of treatment regimens, and of treatment protocols for safety reasons
- High ambitions for patient information and psychosocial care
- Make sure that the maximum possible number of qualified caregivers can continue to work, through aggressive and quick COVID-19-testing
- Take into consideration opportunities for alternative therapies, such as radiotherapy and/or systemic therapies, delaying elective surgery and expediting treatment when there is the ability and capacity to do so
- Greater regional and national collaboration to collectively share the burden of care for patients with cancer
The research was part-financed with a grant from the Cancer Research Funds of Radiumhemmet.
“Caring for patients with cancer in the COVID-19 era”. Joris van de Haar, Louisa R. Hoes, Charlotte E. Coles, Kenneth Seamon, Stefan Fröhling, Dirk Jäger, Franco Valenza, Filippo de Braud, Luigi De Petris, Jonas Bergh, Ingemar Ernberg, Benjamin Besse, Fabrice Barlesi, Elena Garralda, Alejandro Piris-Giménez, Michael Baumann, Giovanni Apolone, Jean Charles Soria, Josep Tabernero , Carlos Caldas , Emile E. Voest. Nature Medicine, online 16 April 2020, doi: 10.1038/s41591-020-0874-8.
This article was first published on 29 April by Karolinska Institutet.