Changes to Ovarian Cancer Treatment in the Age of COVID-19

“We’ve been primarily thinking about the risks to our patients with respects to their age,” Dr. Chapman says. “So, we know ovarian cancer disproportionately affects women over the age of 55 to 60, and we also know that the virus is more dangerous for people in older age groups. So, just by definition of having a cancer diagnosis associated with an older age group, that’s a particular risk. Then immunocompromised is a big risk factor for our ability to fight off infections of any kind — so patients that are on chemotherapy, they are also at risk.”

With those risks being considered, Dr. Chapman says she and her colleagues are still trying to not alter treatment plans for patients where it’s not absolutely necessary.

“The virus has a certain short span. We’re expecting that within a year or two, we’ll have more community immunity, we’ll have vaccines, the public health community will have gotten a better handle on these things,” Dr. Chapman says. “But our patients with ovarian cancer, many of them will go several years [in treatment], so we’d prefer not to compromise their oncology outcomes.”

Still, there are some things that have changed in recent months since the pandemic began spreading, Dr. Chapman says.

“There is a type of chemotherapy that we generally give in-patient … other institutions have published protocols on how to deliver that kind of chemotherapy as an outpatient [procedure] and so we’ve been changing our protocol to accommodate outpatient administration,” Dr. Chapman says.

She also pointed out that some chemotherapy regiments that were given on a more frequent basis can have the doses adjusted. That way treatment can be given every few weeks, patients are visiting hospitals less frequently and treatment outcomes still remain the same.

Dr. Chapman did point out that when you adjust the dosing so that patients can get chemo less often, the side effects may be different — and a little more difficult to manage, depending on the patient.

The typical chemotherapy combination given to women with ovarian cancer tends to have side effects like fatigue, hair loss, nausea, GI issues and neuropathy — tingling in the hands and feet. But side effects can vary greatly from patient to patient. For many of these side effects, doctors can give you medications or supplement/lifestyle recommendations to offset some of the pain or discomfort. For example, medications can be given to prevent nausea before chemotherapy to offset any discomfort later.

Changes to the dosage and frequency of chemo will likely lead to some changes in the “cycle” of side effects.

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