The coronavirus pandemic has led many hospitals to triage cancer patients, requiring the delay of some individuals’ surgeries, according to an opinion essay published in The New York Times by thoracic surgeon Daniel Boffa, MD, of the Yale School of Medicine.

“These postponements,” Boffa writes, “can be wrenching and frustrating for doctors and have forced patients into a battle on two fronts, against their disease and against the coronavirus."

 

Changes in how people receive cancer care are being enacted due to research suggesting that going to health care settings for tests, procedures and treatments may increase the risk of coronavirus infection. Additionally, chemotherapy, radiation and surgery for cancer may suppress the immune system, exacerbating the risk of infection. Furthermore, hospitals need to free up beds and other resources for people with COVID-19, the disease caused by the coronavirus.

The American College of Surgeons, the Commission on Cancer and other organizations have established triage guidelinesto help health care providers determine who most urgently needs to stay the course with their cancer treatment and who can have their treatment plan altered.

Health care providers may suggest delaying cancer surgery by providing chemotherapy before the operation instead of afterward—a shift that might not change the outcome of treatment.

Unfortunately, so many of the details that clinicians require to make the most informed decisions about how to handle cancer treatment at this difficult time remain unknown, given how new COVID-19 is. But clinicians around the world are conducting and publishing research about the coronavirus at a furious pace, so the picture is poised to grow steadily clearer.

Furthermore, most of the guidelines that suggest delaying cancer surgery assume the pandemic will subside within three to four months. If it doesn’t, triaging decisions will become even more difficult and ethically fraught.

 

“It’s unlikely that many cancer patients will see that as a bright spot right now when the normal anxieties surrounding cancer are intensified by the threat of coronavirus infection,” Boffa writes. “It may be hard for patients to have faith in anyone in such disquieting times, but navigating uncertainty is a cornerstone of medicine, and doctors have never been more committed to do what’s right for their patients.”

Check out the Cancer Health article “What People With Cancer Need to Know About the New Coronavirus.”

To read the New York Times article, click here.