Seeking Treatment During the Pandemic
- The coronavirus pandemic has affected some treatments for ovarian cancer
- Oncologists are taking measures to minimize risks while continuing to maintain the level of care that is required of them
- This may mean surgery is delayed for some patients in favor of chemotherapy first (called neoadjuvant chemotherapy)
"I think everyone is concerned right now," says Dr. Renata Urban, a gynecologic oncologist with the University of Washington in Seattle. Dr. Urban says that she and her colleagues are addressing their patients' concerns by answering two questions. "For patients on treatment, what can be done to minimize their risk, and for patients who are not on treatment and may be undergoing follow-up care, what can we do to ensure that the care is being done safely, even if it’s temporarily interrupted?"
Read MoreUsually, treatment for ovarian cancer begins with primary debulking surgery, a preliminary operation to remove as much of a tumor's "bulk" as possible, ideally leaving no visible tumor behind. After debulking, patients are put on a regimen of chemotherapy–intravenous medications that further target the tumor. This two-step treatment has proved to be very effective for ovarian cancer, as the chemotherapy is better able to eradicate the cancerous tissue that remains after debulking has minimized it.
In some cases doctors recommend chemotherapy before surgery, called neoadjuvant chemotherapy. This may be preferred when when the disease is advanced and has spread in the abdomen or if the patient is deemed too frail. Reducing the tumors with chemotherapy first can make surgery afterwards more effective. Now, because of the pandemic, some doctors are recommending neoadjuvant chemotherapy to more patients.
"We may need to tailor that treatment, being cognizant of our current environment," says Dr. Urban. She explains that this is because primary debulking comes with more risks than chemotherapy, and may also mean a greater chance of exposure to the virus during a hospital stay. Dr. Urban says that patients don’t need to worry that starting their treatment with chemotherapy will compromise effectiveness. “We have numerous prospective studies showing that starting with chemotherapy and then having surgery lead to equal outcomes for patients, compared to primary debulking," she says.
Treatment for Patients Who’ve Completed Neoadjuvant Chemotherapy
Once patients have undergone neoadjuvant chemotherapy, specialists will then determine if it’s appropriate to proceed with debulking. "Those decisions need to be made on a case by case basis, depending on the patients as well as the incidence and prevalence of COVID-19 infections in their area," says Dr. Urban. For instance, doctors may opt to continue chemotherapy and further delay surgery until they think it will be safer. When the surgery is deemed medically necessary, though, it will almost always proceed as scheduled.
Additional Safety Steps
Besides possibly changing the order of treatment–chemotherapy before surgery–to protect vulnerable patients, most medical offices and hospitals are taking additional steps to protect their patients from COVID-19. Most now minimize the number of people in the waiting room, take patients’ temperatures before treatment, require masks, and ask about possible exposures. All of these steps help protect patients–and medical care providers–from the new coronavirus.
During the COVID-19 pandemic, it’s true that specialists have had to rethink some of the standards of care for ovarian cancer patients. But though this means that treatment may proceed slightly differently than before, all steps are being taken to minimize risk while patients continue to receive effective, ongoing care.
Learn more about SurvivorNet's rigorous medical review process.
