Palliative care provision at a tertiary cancer center during a global pandemic

Abstract

COVID-19 was first reported in Wuhan, China, in December 2019; it rapidly spread around the world and was declared a global pandemic by the World Health Organization in March 2020. The palliative care program at the Princess Margaret Cancer Centre, Toronto, Canada, provides comprehensive care to patients with advanced cancer and their families, through services including an acute palliative care unit, an inpatient consultation service, and an ambulatory palliative care clinic. In the face of a global pandemic, palliative care teams are uniquely placed to support patients with cancer who also have COVID-19. This may include managing severe symptoms such as dyspnea and agitation, as well as guiding advance care planning and goals of care conversations. In tandem, there is a need for palliative care teams to continue to provide care to patients with advanced cancer who are COVID-negative but who are at higher risk of infection and adverse outcomes related to COVID-19. This paper highlights the unique challenges faced by a palliative care team in terms of scaling up services in response to a global pandemic while simultaneously providing ongoing support to their patients with advanced cancer at a tertiary cancer center.

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

“…Several groups have shared their experiences with establishing a telemedicine-based palliative care program [ 28 , 37 – 39 , 40 ▪▪ , 41 , 42 ]. Chavarri-Guerra et al [ 40 ▪▪ ] describe the feasibility of providing supportive and palliative care using telemedicine to patients with advanced cancer in Mexico, despite low availability of resources and patients with significant symptom burden.…”

Palliative care interventions for people who use substances during communicable disease outbreaks: a scoping review

“…This review identified a knowledge gap about how palliative care interventions for people who use substances should be provided in communicable disease outbreaks other than HIV. Though the knowledge identified in our scoping review is generally applicable to other life-limiting illnesses and communicable disease outbreaks, novel models of care (eg, virtual care) are likely required to deliver high-quality, equitable palliative care for people who use substances that prevents and minimises risk of transmission of infectious diseases other than HIV 49 50…”

Health Professionals’ Perspectives of the Role of Palliative Care During COVID-19: Content Analysis of Articles and Blogs Posted on Twitter

“…Palliative care educational endeavors should prioritize the development and dissemination of resources for non-specialist palliative care teams around communication skills. 31 …”