As the COVID-19 pandemic continues to develop, the situation for patients with haematological malignancies is also evolving. With the effects on health-care systems still being felt, and the enormous global research effort to uncover the biological mechanisms of COVID-19, an expert consensus for how to treat patients with cancer during the pandemic was published last month by the European Society of Medical Oncology. Key recommendations include the need to test patients regularly for the virus, and to proceed with treatments as much as possible, taking the local infection rate into consideration. The recommendations also note that face-to-face consultations should be used for key appointments, such as during diagnosis.
The recommendation for face-to-face consultations for the delivery of key information contrasts with the rapid move towards the use of telemedicine, which is the safest option for patients and health-care workers to prevent the spread of the virus. Many aspects of health care can be delivered with telemedicine, such as prescribing oral medication already part of a treatment plan; however, the value of face-to-face consultations should not be underestimated, especially for initial diagnoses and for the management of complex treatments, such as haematopoietic stem-cell transplantations.
Delays in diagnoses are a concern; two modelling studies published in The Lancet Oncology provide predictions for the UK, with over 3000 additional deaths estimated within 5 years because of diagnostic delays. The situation could be further complicated by the possibility of some symptoms of haematological malignancies being mistaken for those of COVID-19. Ensuring that risks and benefits for patients with haematological malignancies are balanced in terms of protection from the virus and providing timely diagnosis and treatment will be essential as the pandemic continues to develop.
© 2020 Dr P Marazzi/Science Photo Library