Impact of COVID-19 Pandemic on Gynecological Oncology Care: Glimpse into Association of Gynecological Oncologists of India (AGOI) Perspective

Abstract

Purpose The notorious COVID 19 pandemic has caused rapid and drastic changes in cancer care worldwide in 2020. This online survey aims to assess the extent to which the pandemic has affected cancer care in gynecological oncology amongst members of the Association of Gynecological Oncologists of India (AGOI), a registered professional society founded in 1991. Methods We developed and administered a cross-sectional, flash survey to members of AGOI in the first week of April 2020. Data were analyzed using Microsoft Office Excel 2016. Results were expressed as percentages of total responses excluding blank or unattended response. Overall theme-specific responses were described as a spectrum of findings, and related inferences were drawn. Results Among approached practitioners, 90 responded to the survey, more than 80% were practicing consultants, and more than 50% from academic institutions. The results of the study showed that the ongoing pandemic had severely affected gynecological oncology practice and care amongst all respondents. There were modifications in diagnostic pathways, interventions, and follow-ups across all organ sites. There was a near-unanimous opinion on the use of general safety measures to combat the virus and to use complete PPEs in a high-risk situation. There were mixed responses to alternative educational activities, especially using electronic technology and distant learning methods. There was optimism among respondents with regards to the current situation normalizing in 3-6 months. Conclusion This study documents the pandemic affected scenario of gynecological cancer care and perceptions of Gynecological Oncologists in India. A significant effect on all aspects of cancer care was observed. Technological learning methods, both for patient care and educational activities, were being adopted by many respondents.

Psychosocial perspective of patients with gynecological cancer towards medical services during the coronavirus disease pandemic at RSUD Dr. Soetomo, Surabaya, Indonesia

“…Gultekin et al (2021) also reported that patients worried about their disease progression if their treatment or follow-up was delayed (Gultekin et al 2021). An article stated that restrictions/lockdowns disrupt patient access to health facilities, which causes delays in treatment (Bhandoria et al 2020). In this study, 61.7% of patients stated that there was no effect of government restrictions on accessing and delaying their treatment.…”

Management of Gynecologic Cancer During COVID-19 Pandemic: South Asian Perspective

“…This needs to be discussed with the patient, before, making any decision. 12 For follow-up of gynecological malignancy cases, oncologists and their patients need to discuss the necessity of avoiding clinic visits, due to higher risk of morbidity and mortality from COVID-19 and choose telemedicine facility instead if applicable. Another issue of significance is the tough decision for both patients and oncologists to continue immuno-suppressive treatments during this COVID-19 crisis.…”

“…In an online survey conducted amongst gynecologists, gynecologic oncologists, surgical oncologists, radiation oncologists, and medical oncologists of Association of Gynecological Oncologists of India (AGOI), 54% respondents felt that alternative learning methods like virtual conferences, online reading material through professional society websites, and limited gathering were necessary to inform medical practices, but expressed concern that there would be few opportunities for professional interaction and networking. 12…”

Gynecologic radiation therapy in low and middle income countries during the COVID-19 pandemic

“…Early in the pandemic, in June 2020, an online survey of the Association of Gynecologic Oncologists of India was distributed to assess the response to changes in gynecologic cancer treatment. At that time, cervical cancer was managed with standard optimal therapy (surgery or definitive chemoradiation, depending on stage) for two-thirds of patients whereas in about a third of patients, neoadjuvant chemotherapy was used to delay surgery, a proven alternative in a limited resource setting 15…”

“…At that time, cervical cancer was managed with standard optimal therapy (surgery or definitive chemoradiation, depending on stage) for twothirds of patients whereas in about a third of patients, neoadjuvant chemotherapy was used to delay surgery, a proven alternative in a limited resource setting. 15 At Tata Memorial Hospital in Mumbai, Indian, physicians documented their procedural changes for gynecologic cancer during the lockdown period between March 23 and June 30, 2020. These included: suspension of all concurrent chemotherapy for cervical, endometrial, and vulvo-vaginal cancers during radiation, given that most of their patient populations were from geographic locations with high rates of COVID-19; preferential use of hypofractionated external beam treatment for elderly patients (age >75 years) to minimize the need for travel; and preferential use of single application with multiple fractions of intracavitary interstitial brachytherapy or multiple applications with reduced time interval to prevent inpatient admissions and procedures.…”