Opinion: Safe care for cancer patients in the COVID-19 era

The COVID-19 pandemic has affected nearly every aspect of health care, and cancer services is certainly not immune to this new coronavirus. Despite this challenging and worrisome time, many positive developments have emerged that we can be grateful for, including how cancer patients continue to get the care they need at Nuvance Health.

Cancer patients are among the most vulnerable to COVID-19. We’ve taken every precaution to protect them, including stringent Centers for Disease Control and Prevention criteria for weighing the benefits and risks of continuing to treat patients. Every decision we make includes the patient’s wishes and has their best interest at the forefront of their treatment plan.

The cancer centers at Nuvance Health have continued to provide high quality care for our patients during this crisis because of the following safeguards we have in place.

To reduce the number of people interacting with each other, staff who can effectively do their job remotely are working from home. We divided our clinical staff into teams who work only with each other. All patients and staff are screened for COVID-19 risk factors, and anyone suspected or confirmed COVID-19 is not allowed in our cancer centers.

To prepare for the inevitable outbreaks of COVID-19 in our communities, we implemented a “no visitor” policy early on, which was a decision we did not take lightly. We know it’s very difficult to have cancer and go through a new diagnosis or treatment without family present. But it’s just not worth the risk to let visitors into the cancer centers. We connect patients with loved ones virtually. Many of our patients and their families are relieved to know we don’t allow visitors.

Infection prevention protocols are more critical now than ever before. We’re using barriers at check-in stations, markings on the floor for where to stand, and assigned seating in waiting areas to help guide appropriate social distancing. Check-in stations, chairs, and exam rooms are sanitized between each patient. We follow cleaning protocols at least hourly throughout the day, with a deep clean daily. All patients and staff are required to wear a mask, and hand hygiene stations are throughout the cancer centers.

Telemedicine has been a real game-changer for our patients, the majority of whom are coming in for three-, six- and 12-month follow-ups. Most patients showing no progression of disease can be seen via telemedicine, while those needing a physical exam or CT scan are of course accommodated.

We’re working together to reduce the number of in-person visits required for patients who need a physical exam. For example, our breast care team has done an excellent job of outlining who needs to see patients in person: The breast surgeon does the physical exam, and anyone else conducts telemedicine sessions based on that exam.

Many of our patients continue to receive infusion chemotherapy and radiation oncology. Surgery was the only cancer treatment that was generally on hold, although we still operated on patients whose best treatment option was immediate surgery. Now, as our communities observe a decrease in the rate of new COVID-19 infections, we may be able to resume more procedures and operations following the guidance of the state and federal government.

We follow national guidelines, such as from the American College of Surgeons and Society of Surgical Oncology, to determine if a patient should have surgery or if it’s safe to delay surgery and explore other treatment options. During a twice-weekly, system-wide surgical oncology case review, over 25 cancer surgeons across Nuvance Health discuss each individual patient and determine the benefits or risks of surgery. Some patients who will ultimately need surgery can have chemotherapy, endocrine therapy, or radiation therapy before surgery to shrink cancerous tumors, which is a standard treatment that we’ve provided for our patients well before COVID-19.

We’re testing patients for COVID-19 before surgery, and taking extra precautions if they test positive. For all surgical patients, we’re limiting the number of people in the operating room to those actively participating in the operation, and we get our patients out of the hospital as soon as possible after surgery, within safety guidelines.

I’m so incredibly proud of Nuvance Health cancer leaders, physicians, and our entire care teams. We’ve been working around the clock, implementing these new processes and protocols to ensure safety measures are taken to protect our cancer patients and staff at all of our hospitals and care centers. I firmly believe that’s why our patients have been doing so well.

We’ll emerge from this situation stronger, and with more options for care as many new developments will carry forward long after we overcome this pandemic. And that’s something for which our incredible patients — present and future — can all be grateful.

Dr. Margo Shoup is the Network Chair of Cancer Services for Nuvance Health which encompasses Danbury Hospital, New Milford Hospital, Norwalk Hospital, Sharon Hospital in Connecticut; Northern Dutchess Hospital, Putnam Hospital, and Vassar Brothers Medical Center in New York.