A practical approach to the management of colorectal cancer during the COVID-19 crisis in the reference cancer treatment center in Tunisia

Letaief, Feriel; Gharbi, Imen; Hamdi, Adel; Yahyaoui, Yosra; Ayadi, Mohamed; Blousa, Imen; Mézlini, Amel

doi:10.1177/1078155220961139

Cited by 2 publications

(8 citation statements)

References 3 publications

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“…The National Cancer Grid of India meanwhile appears to be finalising a set of official guidelines for cancer management during the COVID-19 outbreak [ 20 ]. Published literature from the African region were generally scanty, with mostly covering institutional responses to COVID-19 [ 21 – 22 ]. Country-specific recommendations also appear limited in the LMICs in Europe.…”

Section: Resultsmentioning

confidence: 99%

Contingency planning for cancer care in low- and middle-income countries during the COVID-19 pandemic: a rapid assessment for future disaster resilience

Teoh¹,

Hoo²,

Murillo³

et al. 2022

ecancer

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Background: Many countries appear to be ill-prepared in their emergency responses towards the Corona Virus Disease 2019 (COVID-19) pandemic, particularly in managing chronic diseases such as cancer. We aimed to gain insight on the preparedness of health systems within low-and middle-income countries (LMICs) in maintaining delivery of cancer care amid the pandemic. Methods:We performed a rapid review of publications focusing on emergency contingency plans for cancer care during the pandemic in LMICs. An online desk research was conducted to identify relevant policy documents, guidelines or scientific publications.Results: Very few LMICs had readily accessible documents to ensure continuity in delivery of cancer care during the pandemic. A majority of publications were focused on delivery of cancer treatment whereas early detection, diagnosis and delivery of supportive and survivorship care received very little attention. Far fewer of the published guidelines appear to have been formulated at the national level by governmental agencies. A vast majority of publications constituted consensus guidelines from professional societies, followed by sharing of best practices from local institutions. Overall, three main strategies have been recommended to maintain delivery of cancer care amid the pandemic in LMICs: 1) Modification of cancer treatment regimens, 2) Changes in methods of administration of curative and supportive cancer care and 3) Implementation of generic measures to reduce the risk of COVID-19 infection in healthcare settings. Conclusion:All LMICs should consider collating best practices from the current pandemic and translating them into an explicit cancer preparedness plan, which can be escalated during future disasters.

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Section: Resultsmentioning

confidence: 99%

Contingency planning for cancer care in low- and middle-income countries during the COVID-19 pandemic: a rapid assessment for future disaster resilience

Teoh¹,

Hoo²,

Murillo³

et al. 2022

ecancer

View full text Add to dashboard Cite

show abstract

“…For patients on regimens with high risk of neutropenia, they were given G-CSF with possibility of maintenance therapy or break in therapy if they lived far from the hospital. 102 Single oral capecitabine was the preferred approach in patients with significant comorbidities. 102 In China, changes in management of CRC were also implemented at the start of the COVID-19 pandemic (Table 2).…”

Section: Colorectal Cancer Management In Other Countriesmentioning

confidence: 99%

“…102 Single oral capecitabine was the preferred approach in patients with significant comorbidities. 102 In China, changes in management of CRC were also implemented at the start of the COVID-19 pandemic (Table 2). 103…”

Section: Colorectal Cancer Management In Other Countriesmentioning

confidence: 99%

“…101 In Tunisia, management of CRC was adapted to decrease infection risk and treatment was done only when benefit outweighed the risk of death from COVID-19. 102 Localized colon cancer was surgically treated in the same timeframe as before the COVID-19 pandemic. For adjuvant chemotherapy, protocols with oral chemotherapy were preferred such as CAPOX instead of FOLFOX to decrease hospital admission duration and hospital visits as compared to infusional 5-FUbased regimens.…”

Section: Colorectal Cancer Management In Other Countriesmentioning

confidence: 99%

“…Management of stage III colon cancer involved eight cycles of CAPOX, while high-risk stage II patients received eight cycles of oral capecitabine only. 102 In locally advanced cases, NAT with the CAPOX regimen instead of FOLFOX was favored, with a delay in surgery until after the pandemic period. 102 For rectal cancer, a pre-operative short course radiotherapy without chemotherapy followed by four cycles of CAPOX and a delayed surgery were the preferred approach as to reduce the number of hospital visits.…”

Section: Colorectal Cancer Management In Other Countriesmentioning

confidence: 99%

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Management of colorectal cancer in the era of COVID-19: Challenges and suggestions

et al. 2021

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The Coronavirus (COVID-19) pandemic had a huge impact on all sectors around the world. In particular, the healthcare system has been subject to an enormous pressure that has surpassed its ability in many instances. Additionally, the pandemic has called for a review of our daily medical practices, including our approach to colorectal cancer management where treatment puts patients at high risk of virus exposure. Given their higher median age, patients are at an increased risk for severe symptoms and complications in cases of infection, especially in the setting of immunosuppression. Therefore, a review of the routine colorectal cancer practices is needed to minimize risk of exposure. Oncologists should weigh risk of exposure versus the patient’s oncologic benefits when approaching management. In addition, treatment protocols should be modified to minimize hospital visits and admissions while maintaining the same treatment efficacy. In this review, we will focus on challenges that colorectal cancer patients face during the pandemic, while highlighting the priority in each case. We will also discuss the evidence for potential modifications to existing treatment plans that could reduce infectious exposure without compromising care. Finally, we will discuss the impact of the socio-economic difficulties faced by Lebanese patients due to a poor economy toppled by an unexpected pandemic.

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A practical approach to the management of colorectal cancer during the COVID-19 crisis in the reference cancer treatment center in Tunisia

Cited by 2 publications

References 3 publications

Contingency planning for cancer care in low- and middle-income countries during the COVID-19 pandemic: a rapid assessment for future disaster resilience

Contingency planning for cancer care in low- and middle-income countries during the COVID-19 pandemic: a rapid assessment for future disaster resilience

Management of colorectal cancer in the era of COVID-19: Challenges and suggestions

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