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Hello. It's Mark Kris, from Memorial Sloan Kettering in New York City, which is, sadly, the new epicenter for the COVID-19 pandemic worldwide. I'd like to focus on some practical ideas that have been helpful to me, and I hope will be helpful to you, in managing cancer patients during this time.
The first thing is to speak to the patient and go over their personal situation. When it comes time for a treatment, make sure that the treatment is the right one at the right time. Make sure that the patient is comfortable coming in.
In general, try not to have any blanket rules on postponing treatments. However, I think we can have more flexibility in testing and we should look very closely to be sure a test is absolutely needed, particularly a scan.
When we decide with our patient that it is necessary to go ahead with an in-person visit for cancer treatment, it's absolutely critical to make sure that the treatment is in a single place, that a patient is not going to multiple places within an institution and exposing many floors and many people, that the treatment is given over the shortest amount of time, and that the person has the smallest number of contacts as possible during that time.
Patients are very happy to have that personal contact and they fully understand that it's not business as usual. They appreciate limiting the contact with the staff, yet not limiting the discussion and the mutual agreement on how to proceed with their healthcare team.
There are a couple other things about how to accomplish this on a practical level. One thing that has been very useful is not to let your normal clinic schedule disappear. It's very important not to let the visits that are scheduled become haphazard.
Number one, it gives you a fixed time to connect with the patient, which is very important. It keeps you from losing track of somebody and it lets the patient know that they're going to have time with you and the other members of the healthcare team to address their concerns. This also reassures patients that things won't fall between the cracks because, let's face it—we're about as distracted as we've ever been in our medical careers.
Second, we usually have other support in place during these clinic visits. There's usually administrative support as well as support to help schedule the next visit or next test.
Last, it gives a chance for all members of the healthcare team to be present. If the doctor says, "Oh, I'll call this patient when I have a chance," that takes away the opportunity for the nurse—who may have an absolutely critical role in that patient's care and emotional well-being—to be present whenever the doctor squeezes in the call. Everybody can be available when it's done at a set time.
Also, if you keep your clinic on schedule, you keep patients' treatments on schedule. Where treatment decisions have to be made, they can be made as best you can in this new world, and they'll be done on time.
Even though you're less available on a face-to-face basis, you can be as available or even more available by electronic means. It is very easy to use FaceTime for anybody with an iPhone. There are many other ways to communicate; our institution uses Cisco Jabber. I'm sure everybody by now has had many wonderful Zoom video conferences with their friends and family.
In general, it's important to be more connected with patients now. There are more concerns, patients don't want to be left alone, and they don't want to be set aside while doctors are focused on other things.
We owe it to our patients. They have literally put their lives and futures in our hands. We have to deliver what we've promised to them, despite all the issues that COVID-19 has brought on.
Mark G. Kris, MD, is chief of the thoracic oncology service and the William and Joy Ruane Chair in Thoracic Oncology at Memorial Sloan Kettering Cancer Center in New York City. His research interests include targeted therapies for lung cancer, multimodality therapy, the development of new anticancer drugs, and symptom management with a focus on preventing emesis.
Medscape Oncology © 2020 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Mark G. Kris. Practical Tips on Cancer Care During the COVID-19 Pandemic - Medscape - Apr 24, 2020.