The Cancer Research UK Cambridge Centre and six other leading European cancer centres share knowledge and experiences to define new guidelines for treating cancer patients during the COVID-19 pandemic.
The current crisis presents healthcare professionals with the challenge of managing the rapidly increasing numbers of COVID-19 patients while continuing to provide the best possible care for cancer patients.
Seven leading European cancer centres, forming an alliance known as Cancer Core Europe (CCE), have been forced by COVID-19 to adapt their approach to the treatment of patients with cancer, while maintaining the same high quality of care.
The Cancer Research UK Cambridge Centre clinical cancer services are provided by Cambridge University Hospitals (CUH) and Royal Papworth Hospital.
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 they have taken in an article published today in the journal Nature Medicine.
In the space of just a few weeks, the seven 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 has been limited or converted to remote interactions, complete with as many guarantees as possible that this will not affect patient care; and clinical studies have been reassessed to see if they should continue.
All of the cancer centres have taken steps to maintain high standards of care despite facing shortages of personal protective equipment, beds, staff and other resources.
“COVID-19 has created a unique challenge: how to adjust cancer management to minimize the disruption caused to oncology care by the COVID-19 pandemic.” said Prof Carlos Caldas, co-lead author of the article, member of the senior management team of the Cancer Research UK Cambridge Centre, and Group Leader at the Cancer Research UK Cambridge Institute.
“Our medical staff across disciplines (surgery, radiology, pathology, radiation oncology and medical oncology) have been truly amazing at very quickly producing COVID-19-adjusted treatment guidelines."
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 cancer centres around the world, they will continue to generate and disclose new data in order to make well-founded choices and judgements in the future.
Prof Caldas added: “We hope that our collective experiences will help guide others and will also reassure cancer patients that we are doing everything we can to avoid compromising their oncological care.”
There are several factors that medical institutions need to consider 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 COVID-19 crisis is making us rethink care, and some of the changes might in the long run have positive effects, for example minimising hospital visits and face-to-face consultations or delivering care using telemedicine.” Prof Caldas reflected.
The Cancer Core Europe (CCE) alliance of seven leading European cancer centres was founded in 2014 to accelerate the development of innovative cancer therapies through close collaboration in translational and clinical research. Its seven member centres collectively treat approximately 350,000 patients annually.
Joris van de Haar ... Carlos Caldas and Emile E Voest Caring for patients with cancer in the COVID-19 era Nature Medicine 16 April 2020
We would like to acknowledge and thank the many clinical staff at Addenbrooke’s who have contributed their expertise across multiple disciplines (surgery, radiology, pathology, radiation oncology and medical oncology), including: Jean Abraham, Thankamma Ajithkumar, Richard Baird, Gill Barnett, Emma Beddowes, Richard Benson, Charlotte Coles, Pippa Corrie, Gary Doherty, Hugo Ford, David Gilligan, Luke Hughes-Davies, Ekpemi Irune, Rashmi Jadon, Sarah Jefferies, Siong-Seng Liau, Karen McAdam, Paul Pharoah, Elizabeth Smyth, Elizabeth Tweedie and Charles Wilson.
The Cancer Research UK Cambridge Centre acknowledges funding from Cancer Research UK (Major Centre Award A25117), the National Institute for Health Research Cambridge Biomedical Research Centre, and The Mark Foundation for Cancer Research.