Italy and the rest of the world are experiencing an outbreak of a novel beta-coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this context, in Italy, we reorganized the National Health System and prioritized the clinical cancer care scenario, balancing risk of SARS-CoV-2 transmission versus the magnitude of clinical benefit deriving from a specific therapeutic approach. As initial actions, we recommended that routine screening be suspended and that patients with early and advanced cancer be treated as outpatients as much as possible and at the nearest medical center. Patients who need to be hospitalized for cancer treatment were protected from potential SARS-CoV-2 infection by creating a dedicated diagnostic and therapeutic internal pathway for cancer treatment. We implemented reorganization of the hospital networks, based on a hub-and-spoke design. Stronger personal protection was made available for patients with cancer. Because of the extreme burden created by COVID-19, antitumor treatment was initiated only after considering patient performance status, comorbidities, biology of disease, and the likely impact of treatment on outcome. Treatment strategies were discussed in the context of a multidisciplinary tumor board. Treatment decision making balanced risk and benefits of treatment in the context of the specific pandemic level, on a case-by-case basis.

How to Guarantee the Best of Care to Patients with Cancer During the COVID-19 Epidemic : The Italian Experience / G. Curigliano. - In: THE ONCOLOGIST. - ISSN 1083-7159. - 25:6(2020), pp. 463-467. [10.1634/theoncologist.2020-0267]

How to Guarantee the Best of Care to Patients with Cancer During the COVID-19 Epidemic : The Italian Experience

G. Curigliano
Conceptualization
2020

Abstract

Italy and the rest of the world are experiencing an outbreak of a novel beta-coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this context, in Italy, we reorganized the National Health System and prioritized the clinical cancer care scenario, balancing risk of SARS-CoV-2 transmission versus the magnitude of clinical benefit deriving from a specific therapeutic approach. As initial actions, we recommended that routine screening be suspended and that patients with early and advanced cancer be treated as outpatients as much as possible and at the nearest medical center. Patients who need to be hospitalized for cancer treatment were protected from potential SARS-CoV-2 infection by creating a dedicated diagnostic and therapeutic internal pathway for cancer treatment. We implemented reorganization of the hospital networks, based on a hub-and-spoke design. Stronger personal protection was made available for patients with cancer. Because of the extreme burden created by COVID-19, antitumor treatment was initiated only after considering patient performance status, comorbidities, biology of disease, and the likely impact of treatment on outcome. Treatment strategies were discussed in the context of a multidisciplinary tumor board. Treatment decision making balanced risk and benefits of treatment in the context of the specific pandemic level, on a case-by-case basis.
Betacoronavirus; COVID-19; Clinical Decision-Making; Coronavirus Infections; Hospitalization; Humans; Infection Control; Italy; Mass Screening; Medical Oncology; Neoplasms; Pandemics; Patient Care Team; Patient Selection; Pneumonia, Viral; SARS-CoV-2; Patient Care
Settore MED/06 - Oncologia Medica
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/824672
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