Making — and explaining — cancer care choices during a pandemic

Cancer care, like so much of medicine during the coronavirus pandemic, is facing new challenges. Three new papers offer prioritization strategies, how to discuss them with patients, and what happened before the pandemic when some treatment was put on hold.

• Lessons learned in Rwanda and Tanzania could guide priority setting in the U.S. “For many, it is the first time that external circumstances demand that they ask, 'Is this [visit, procedure, intravenous drug administration, scan, laboratory test] truly essential? If so, can it wait, and for how long? How is essential defined in this new reality?'” the authors write.
• How should a doctor answer a patient who asks, “Is it not important to treat cancer as soon as it is discovered?” This perspective calls for recognizing fear and showing context, consideration, caring, and commitment. Translation: “Cancer is scary and it is natural to feel like you need to do something right away. For some cancers, it can be OK to wait a little while to start treatment.”
• When hospitals are overwhelmed with Covid-19 patients, surgical delays become common. A study analyzing pre-pandemic delays in treatment found that for patients diagnosed with the early-stage breast cancer known as ductal carcinoma in situ (they waited) or early-stage estrogen receptor-positive breast cancer (they took a hormone therapy), there was no impact on overall survival.