Cancer Care Management During the COVID-19 Pandemic

By Phoebe Ho

 CEO, Integrated Oncology Centres (IOC)

In South East Asia, research has shown that over 2 million people were diagnosed with cancer in the year of 2020[1]. With the emergence of COVID-19, all eyes have been focused on managing the public healthcare crisis at hand, that the silent struggle of the community facing cancer may have been overlooked.

Based on research, those with pre-existing co-morbid conditions are most likely to experience COVID-19 more severely. That said, cancer patients are estimated to have a twofold risk of contracting  the virus as compared to the general population.[2]. Cancer patients regularly go through treatment for their cancer, and this may render them more immunocompromised, exposing them to a higher risk of infection.

Further complicating things for patients is their treatment routine. What was seemingly easy and ordinary before becomes a challenge because this aspect is greatly affected as healthcare providers need to implement numerous protective measures such as swab tests and social distancing,

Furthermore, cancer patients as a whole may need to make alterations or postponements to their treatments such as surgery, radiotherapy, chemotherapy or immunotherapy in order to minimize their risk of contracting COVID-19. Unfortunately, the necessary adherence to such SOPs will lead to interruptions of their treatment plans. This will create a feeling of anxiety and frustration – none of which are conducive to their well-being.

The standard operating procedures (SOP) set in place to help contain the virus are necessary but may be too much to handle for the patients. Still, while there pandemic may be a challenge, it does not mean that the quality of care should be sacrifice. IOC’s centre in Philippines, Central Luzon Integrated Centre (CLIOC) created a unique algorithm to help triage patients for them to safely receive treatment even with the SOP’s in place, under the directives of Dr Misael Cruz, Medical Director, CLIOC.  Due to this method being effective, other cancer centres in Central Luzon and IOC have incorporated the same system as well.

According to Dr Misael Cruz, some important preventive measures in triaging of patients include[3]:

Use of rapid antigen or ECLIA covid test prior consultation

Appointment and scheduling system done via online or telephone for patients

Creation of our own screening data sheet to be accomplished by patients/relatives

Strict adherence to minimal health measures: hand washing/sanitizing, physical distancing, wearing of mask

Enforcing a no relative policy or if needed at most 1:1 relative and patient ratio

Wearing of personal protective equipment by the staff

This system proved to be successful as the entire team of doctors and staff were well-prepped and aligned with the strategies, which also resulted in a better work-flow structure. Furthermore, using our very own screening data form helped us keep better track of patients.

Cancer care and treatment requires full involvement of a multi-disciplinary teams throughout the trajectory from diagnosis to rehabilitation. Patients will receive a collaborative assessment from different clinicians and undergo necessary/appropriate laboratory or imaging tests for diagnosis, staging and monitoring of treatment efficacy. During this pandemic, it is important that healthcare providers take the best treatment measures/approaches while minimizing the risks that stem from COVID-19. They must also weigh the pros and cons of continuing anticancer therapy.

Taking all these into consideration, when it comes to cancer care, we must adopt a patient-centric mindset in terms of addressing the impact of the pandemic on cancer patients. They go through quite a journey and we need to provide the necessary support when it comes to resource allocation, clinical care, and the consent process.

Phoebe Ho is the CEO of Integrated Oncology Centres (IOC). A pharmacist by training, Phoebe has over 20 years of experience in healthcare and has served in various senior executive  positions with Fortune 500 pharmaceutical companies.

As CEO of IOC, Phoebe now provides strategic leadership and direction to seven oncology centres across Asia including Hong Kong, Indonesia, Philippines and Vietnam and her role is pivotal in strengthening the clinical partnership between doctors and health professionals within the IOC regional network.

Phoebe holds a Bachelor in Science degree from the University of Alberta, Canada.

[1] https://gco.iarc.fr/today/data/factsheets/populations/995-who-south-east-asia-region-searo-fact-sheets.pdf

[2] [Full text] Cancer Care Management During the COVID-19 Pandemic | RMHP (dovepress.com)

[3] https://www.thegreenjournal.com/article/S0167-8140(20)30331-5/pdf