ABSTRACT

Cancer Core Europe (CCE) have been forced by COVID-19 to adapt their approach to the treatment of patients with cancer. While still providing the same quality of care, of course. The specialist centres not only want to prevent the spread of the virus in general, but also to protect patients with cancer whose disease and treatment make them especially vulnerable to complications if infected. They describe the measures taken in an article in the authoritative journal Nature Medicine

In the space of just a few weeks, the European cancer centres have had to drastically revise and reorganise their patient care and scientific research due to the coronavirus crisis. For example, treatments have been postponed or adjusted to protect the immune systems of patients with cancer. Contact moments have been limited or converted to remote interactions, complete with as many guarantees as possible that this will not affect patient care. Clinical studies have been reassessed to see if they should continue. CCE’s seven cancer centres have taken steps to maintain high standards of care despite facing shortages of personal protective equipment, beds, staff and other resources.

‘In this situation the centres have not, as they’re used to, been able to rely upon the knowledge they’ve built up over years of thorough research,’ says Emile Voest, Medical Director of the Netherlands Cancer Institute. ‘Our medical staff suddenly find themselves in a parallel universe, where they have to use all their know-how, experience and wisdom to make critical clinical decisions in line with new medical and ethical considerations. That’s a drastic change. And why it’s essential that other medical institutions can draw upon our experiences and choices so that we all become ‘pandemic-proof’ in a responsible manner. Not least with an eye to the future.’

In Nature Medicine the seven European cancer centres share the choices they have made to adapt to the new COVID-19 world, as well as the considerations and uncertainties they face. Together with other such centres around the world, from now on they will continue to generate and disclose new data in order to make well-founded choices and judgements in the future. ‘This will probably be a dynamic and rapidly evolving process,’ says Voest. ‘We hope that our collective experiences will help guide others.’

There are several aspects that medical institutions need to take into account to ensure continuity in cancer care:

• Clinical activities (adapting tasks to keep cancer centres free of COVID-19; adjusting standard treatment regimens and deviating from established treatment protocols for safety reasons).

• Communication with and psychosocial care for patients.

• Qualified personnel (speed and sufficient capacity to test the centre’s own staff for COVID-19 is essential to ensure continuity of care).

• Capacity of care institutions (discussing alternative treatments such as radiotherapy and/or systemic therapies, discussing the postponement of certain elective operations and accelerating treatments as long as sufficient capacity is still available).

• Regional and national collaborations (sharing the burden of care for cancer patients).

‘This crisis is also opening up new learning opportunities,’ Voest declares. ‘Especially with regard to the trend towards using less invasive treatments where possible, which has been picking up gradually in recent years. But also how we can use technological aids to make healthcare faster and more accessible.’

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