With COVID-19 limiting resources and presenting logistical challenges for elective treatments, Weill Cornell Medicine and NewYork-Presbyterian clinicians offer guidance on treating cancer in four recently published papers.
Framework Suggests How to Safely Provide Care to Patients with Cancer of the Nervous System
An article published April 9 in the Journal of Neuro-Oncology guides clinicians in neuro-oncology on how to prioritize treatment of patients with brain and spine tumors, as COVID-19 limits resources for elective medical care. Treatment options for central nervous system tumors include surgery, radiosurgery, chemotherapy and radiation therapy. The investigators discuss how to deploy these resources safely and systematically, even in patients with documented COVID-19 infections. These guidelines are also useful in any resource-constrained setting as they provide a framework to responsibly and fairly adjudicate hospital resources.
Corresponding author: Rohan Ramakrishna
Recommendations for Safe Delivery of Stereotactic Radiosurgery to Patients with Brain and Spine Tumors
Investigators offer guidance for medical centers on how to navigate the clinical and logistical challenges of delivering stereotactic radiosurgery, a noninvasive procedure that can be used to treat brain and spine disorders, such as benign and malignant tumors, during COVID-19 in a paper published on April 14 in Cureus. The guidance includes how to identify urgent vs. elective cases for radiosurgery. The authors also advise providers to minimize patients' potential exposure to COVID-19 by limiting their trips to the medical center, and to use telemedicine for patients visits, team case reviews and treatment-planning sessions. To refine treatment guidelines in the future, the authors suggest focusing on data from medical centers where infections have already hit a peak.
Corresponding author: Susan Pannullo
Guidelines Describe How to Adapt Hematology and Medical Oncology Care
A paper published June 4 in NEJM Catalyst describes the COVID-19 response of the Division of Hematology and Medical Oncology of Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center. The division consolidated practices, replaced in-person visits with telemedicine whenever possible, converted outpatient clinics to inpatient floors, supported the expansion of intensive care units, created new COVID-19 positive and Rule out-COVID-19 units, and reassigned healthcare workers to help meet the needs of the growing number of COVID-19 patients. Key leaders in hematology and medical oncology communicated regularly, in a daily call, as well as a weekly meeting, to troubleshoot and ensure cohesion as the situation rapidly evolved.
Corresponding author: Manuel Hidalgo