Cancer, COVID-19 and the precautionary principle: prioritizing treatment during a global pandemic

Cancer patients and research during COVID-19 pandemic: A systematic review of current evidence

“…The urgent need for guidelines implementation to protect cancer patients from acquiring a COVID-19 without harming them is discussed by many authors in the literature. In the absence of universal guidelines, most of the strategies adopted involve prioritizing urgent situations such as acute leukemia, curative treatments for aggressive diseases, and adjuvant and neoadjuvant therapies while withholding or postponing palliative therapies for poor prognosis patients (37).…”

The Need for Prioritizing Cancer Surgeries Amidst the COVID-19 Pandemic

“…Further, there are clear evidences to suggest that older patients and also patients with increased comorbidities tend to have poorer outcomes with COVID 19 infection [5]; these issues assume greater significance while managing an elderly cancer patient with comorbidities. The lower case fatality rate of COVID-19 logically seems to suggest that the benefits of treating selected cancer patients (who are otherwise fit and healthy) may far outweigh the risks of dying from COVID-19 [6]. It is vitally important for the treating oncologists to clearly explain the above evidences to cancer patients during the process of informed consenting.…”

“…Treating surgical oncologists as well as treating oncology institutions must ideally develop their own multidisciplinary protocols for prioritizing cancer treatments after taking into account all the ground realities amidst the pandemic [6,7]. All patients scheduled for cancer surgeries should be managed with all the due precautions (Universal and Respiratory) in dedicated health care settings and by trained and well informed (by ensuring periodic training of the protocols) health care workers.…”

“…Certain broad surgical considerations, commonly seen across among the various guidelines include [6,7] Finally the treating oncologists must be aware and must fully abide by the protocols as laid down by the Government, knowing fully well that in case of a conflict, the Governmental protocols supersede all the other guidelines. The decision for starting or delaying a cancer surgery should ideally be made by a shared decision making process and should be individualized for each patient.…”

Managing cancer during a pandemic

“…In a Comment in Nature Reviews Clinical Oncology, Hanna et al 3 discuss the competing risks faced by patients with cancer risking exposure to SARS-CoV-2 in order to receive treatment. With precaution as a driving principle, these investigators propose a framework to minimize exposure while providing optimal care in three scenarios defined according to the severity of the crisis at a given health-care facility 3 .…”