The impact of COVID‐19 on the management of neuroendocrine tumors (NETS): An international NET CONNECT survey of NET patients and healthcare professionals treating net patients

Abstract

The COVID-19 outbreak has added complexity in the management of patients with neuroendocrine tumors (NETs). Little information is currently available regarding the real impact of the pandemic in current practice. The present study aimed to capture patients' and healthcare professionals' experiences on how the NET management has changed during the pandemic and how it should be modified in a foreseeable postpandemic environment. Physicians and nurses working in ENETS Centers of Excellence or other hospitals with high volume of NET patients (n = 48), as well as NET patients residing worldwide (n = 353), were asked to respond to two online anonymous surveys addressing different aspects of NET care. Deferred diagnoses, delayed surveillance procedures and postponed elective surgeries were among the main negative consequences of the COVID-19 outbreak according to 40%, 54% and 46% of healthcare professionals (HPs) respectively. Somatostatin analogs were increasingly used as bridging strategy for delaying surgery based on the views of 31% of HPs and were self-injected or delivered by home care services more frequently than before the initiation of the pandemic (53% of patients during the pandemic vs. 44% before the pandemic). Multidisciplinary tumor boards kept their usual schedule according to 58% of HPs, but were held virtually in the 77% of cases. The contact with healthcare professionals was maintained by remote methods more often than in the past (69% of patients), but only 34% of patients (59% among subjects < 41 years) would prefer telemedicine to face-to-face consultations in the future. New health policy measures should guarantee the highest standard of treatment to NET patients, regardless of the trajectory followed by the COVID-19 pandemic in the next months. Pros and cons of telemedicine should be carefully weighted before systematic implementation.

Neuroendocrine neoplasms: Consensus on a patient care pathway

“…Challenges posed by personalised care: As care becomes increasingly personalised during follow‐up, the impact of language, literacy, financial and cultural barriers on care‐seeking behaviours, 39 mental health and, ultimately, clinical outcomes of people living with NENs is amplified. These challenges have been exacerbated by the COVID‐19 pandemic, which had adverse effects on the mental health of people living with NENs 55,124–128 . A 2020 survey found that people undergoing longer‐term follow‐up for NENs experienced greater anxiety and decreased psychosocial wellbeing during the pandemic, as well as a greater reluctance to seek out care 124 .…”

“…These challenges have been exacerbated by the COVID-19 pandemic, which had adverse effects on the mental health of people living with NENs. 55,[124][125][126][127][128] A 2020 survey found that people undergoing longer-term follow-up for NENs experienced greater anxiety and decreased psychosocial wellbeing during the pandemic, as well as a greater reluctance to seek out care. 124 Maggie's Centres and NCUK provide free counselling and psychotherapy services to help people with NENs talk through their concerns, including finances, treatments and MDT care.…”