The 3 Bs of cancer care amid the COVID-19 pandemic crisis: "Be safe, be smart, be kind"-A multidisciplinary approach increasing the use of radiation and embracing telemedicine for head and neck cancer - PubMed (original) (raw)

. 2020 Sep 15;126(18):4092-4104.

doi: 10.1002/cncr.33031. Epub 2020 Jul 8.

Richard J Wong 2, Eric J Sherman 3, Alisa Rybkin 1, Sean M McBride 1, Nadeem Riaz 1, C Jillian Tsai 1, Yao Yu 1, Linda Chen 1, Kaveh Zakeri 1, Daphna Y Gelblum 1, Erin F Gillespie 1, Marc A Cohen 2, Jennifer R Cracchiolo 2, Ian Ganly 2, Snehal Patel 2, Bhuvanesh Singh 2, Jay O Boyle 2, Benjamin R Roman 2, Luc G Morris 2, Ashok R Shaha 2, Lara A Dunn 3, Alan L Ho 3, James V Fetten 3, Jatin P Shah 2, David G Pfister 3, Nancy Y Lee 1

Affiliations

The 3 Bs of cancer care amid the COVID-19 pandemic crisis: "Be safe, be smart, be kind"-A multidisciplinary approach increasing the use of radiation and embracing telemedicine for head and neck cancer

Jung Julie Kang et al. Cancer. 2020.

Abstract

Because of the national emergency triggered by the coronavirus disease 2019 (COVID-19) pandemic, government-mandated public health directives have drastically changed not only social norms but also the practice of oncologic medicine. Timely head and neck cancer (HNC) treatment must be prioritized, even during emergencies. Because severe acute respiratory syndrome coronavirus 2 predominantly resides in the sinonasal/oral/oropharyngeal tracts, nonessential mucosal procedures are restricted, and HNCs are being triaged toward nonsurgical treatments when cures are comparable. Consequently, radiation utilization will likely increase during this pandemic. Even in radiation oncology, standard in-person and endoscopic evaluations are being restrained to limit exposure risks and preserve personal protective equipment for other frontline workers. The authors have implemented telemedicine and multidisciplinary conferences to continue to offer standard-of-care HNC treatments during this uniquely challenging time. Because of the lack of feasibility data on telemedicine for HNC, they report their early experience at a high-volume cancer center at the domestic epicenter of the COVID-19 crisis.

Keywords: coronavirus disease 2019 (COVID-19); head and neck cancer; radiation oncology; telehealth; telemedicine.

© 2020 American Cancer Society.

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Conflict of interest statement

Nadeem Riaz reports grants from Pfizer, Bristol‐Myers Squibb, AstraZeneca, and REPARE and consulting fees from REPARE, Illumina, and Mirati Therapeutics outside the submitted work. C. Jillian Tsai reports consulting for Varian outside the submitted work. Yao Yu reports travel funds from Elekta outside the submitted work. Nancy Y. Lee reports grants from Pfizer, Merck, Merck Serono, and AstraZeneca and consulting for Pfizer, Merck, Merck Serono, and Lilly outside the submitted work. The other authors made no disclosures.

Figures

Figure 1

Figure 1

Incorporating telehealth and COVID‐19 precautions into cancer care during the pandemic: preflight checklist. COVID‐19 indicates coronavirus disease 2019; CT, computed tomography; EUA, examination under anesthesia; LN, lymph node; MRI, magnetic resonance imaging; PET, positron emission tomography; PPE, personal protective equipment.

Figure 2

Figure 2

Panels comparing endoscopic examinations with cross‐sectional imaging in (Left) base of tongue and (Right) tonsil patients. The combination of magnetic resonance imaging (lower left images) and positron emission tomography/computed tomography (lower right images) provides valuable tumor localization and staging information that can be overlooked by conventional computed tomography (upper right images) and endoscopic examination alone (upper left images). When endoscopy is not possible, multiple forms of dedicated cross‐sectional imaging can be used for treatment planning.

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