The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts

Abstract

Coronavirus disease 2019 (COVID-19) has fundamentally disrupted the practice of oncology, shifting care onto virtual platforms, rearranging the logistics and economics of running a successful clinical practice and research, and in some contexts, redefining what treatments patients with cancer should and can receive. Since the start of the pandemic in early 2020, there has been considerable emphasis placed on the implications for patients with cancer in terms of their vulnerability to the virus and potential exposure in healthcare settings. But little emphasis has been placed on the significant, and potentially enduring, consequences of COVID-19 for how cancer care is delivered. In this article, we outline the importance of a focus on the effects of COVID-19 for oncology practice during and potentially after the pandemic, focusing on key shifts that are already evident, including: the pivot to online consultations, shifts in access to clinical trial and definitions of "essential care," the changing economics of practice, and the potential legacy effects of rapidly implemented changes in cancer care. COVID-19 is reshaping oncology practice, clinical trials, and delivery of cancer care broadly, and these changes might endure well beyond the short-to mid-term of the active pandemic. Therefore, shifts in practice brought about by the pandemic must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support if they are to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care.

Retrospective Analysis of Early Impact of COVID-19 on Systemic Cancer Treatment—A Pilot Study

“…The COVID-19 pandemic is slowly categorizing cancer care into "essential" and "nonessential" domains. 20 Our finding of a continued active systemic treatment and reduction in follow-up patients reflects an early deviation in our practice also in these lines.…”

“…Also, the long-term legacy that COVID-19 would leave on cancer is yet to be known, though experts predict that a new normal is going to come. 20,24 The limitation of our data are the short time period of the study and the small numbers of patients. Ideally the comparison should have happened between corresponding periods of 2 years but one of the units whose data has been taken for this study was not in established during the corresponding period of the previous year.…”

Modification in the Oncology Field during COVID-19 Pandemic

“…Cancer patients are highly at-risk of contracting Covid-19 in its severe form due to an impaired immune system and comorbidities [28]. Blood cancer patients could be at a greater risk of death and serious infection from Covid-19 compared to patients with tumors due to the fact that blood cancer patients have dwindling or deviant quantities of immune cells that generate antibodies against the virus [29]. Also, in cancer patients, the major risk factors for Covid-19 could comprise immunosuppressive treatments (e.g.…”

Impact of COVID-19 On Breast Cancer Management: A Radiological Prespective from A Tertiary Centre

“…Many studies have been carried out worldwide, such as those by Freer (2) and Broom et al (3), which state that the coronavirus pandemic has adversely affected the cancer management in general and breast cancer in particular. As a precautionary measure to reduce the infection, the level Impact of COVID-19 On Breast Cancer Management: A Radiological Prespective from A Tertiary Centre…”