Treatment of cancer patients during the COVID-19 pandemic in the Philippines

Abstract

The COVID-19 pandemic has caused disruptions in cancer care around the world due to logistical and psychosocial reasons. This paper was written with the primary objective of providing a guide for medical oncologists in addressing concerns in the management of adult patients with solid tumours in the Philippines and for those working under similar circumstances. These recommendations are divided into prioritisation of cancer care, ensuring a safe work environment, organising the transition of cancer care, and maintaining cohesion in a time of isolation.

Challenge of treating cancer amid the COVID-19 pandemic: case of skeletal muscle metastasis from primary carcinoma of the lung mistaken as sarcoma

“…A painful, palpable soft tissue lump in the posterolateral aspect of the patient's left arm prompted consult at the emergency department, despite an ECQ that required crossing multiple border controls from 134 km south of the hospital, and period when clinic visits were suspended to help prevent nosocomial spread of the SARS-CoV-2. A key challenge to cancer care during the pandemic is uncertainty, and the anxiety that arises from it [34]. Upon request by the patient to have shorter hospital stay and recognition of his fear of getting nosocomial COVID-19, the need to expedite hospital care without the advantage of a biopsy-proven diagnosis became a crucial dilemma in our case.…”

“…Cities were forced to close their borders in an attempt to contain the local transmission, and the ECQ was further expanded nationwide. In a country where cancer treatment centers are concentrated in highlyurbanized areas, the ECQ undeniably made access to cancer care more di cult for patients living in faroff provinces due to the unavailability of public transportation and limitation of drug availability [34].…”

Updated general recommendations in cancer management during the COVID-19 pandemic in the Philippines

“…Consistent with our previous recommendations, a triage/screening area manned by personnel with appropriate personal protective equipment (PPE) should be in place in all cancer institutions to ensure the safety of both patients and healthcare workers [ 12 , 23 ].…”

“…In May 2020, the Philippine Society of Medical Oncology (PSMO) published its initial article on the treatment of cancer patients during the SARS-Cov-2 pandemic, dwelling on the prioritisation of cancer care, ensuring a safe work environment, organising transition of cancer care and maintaining cohesion in a time of isolation [ 12 ]. However, the application of these guiding principles in a real-world setting has remained unclear for medical oncologists who are faced with dilemmas on testing for COVID-19 among patients and healthcare workers.…”

Medical oncology care amidst the COVID-19 pandemic at the National University Hospital in the Philippines

“…To reduce the number of clinic visits and the possibility of exposure of patients and staff to COVID-19 cases, a hotline for medical oncology patients was created to triage concerns and to determine if a face-to-face consultation was necessary. Prioritisation for delivery of systemic cancer treatment was based on the potential treatment benefit and therapeutic intent [ 3 , 6 ]. Treatment schedules were revised to minimise the possibility of patient exposure to COVID-19.…”