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Although the coronavirus epidemic has gained maximum prominence these weeks, life in hospitals continues. It seems that little by little normalcy is recovering to attend to the rest of diseases that had been relegated to the background. Between them, the Cancer, which is the second cause of death in Spain and a very frequent pathology among the population: this year there will be at least 277,000 new cases, as estimated by the Spanish Society of Medical Oncology (SEOM).
In the current context, where health care has been prioritized for coronavirus patients, both health centers and patients undergoing cancer treatment, and those pending diagnosis, have had to adapt to this new scenario to avoid any risk to your health.
Since the start of the alarm state, health centers have reduced the number of face-to-face visits and extreme hygiene measures in consultations to avoid infections among cancer patients, of particular risk due to immunosuppression. These, in addition, in the event of any symptoms or discomfort, should contact the oncology service of their center and “go to the emergency department in case of fever, independently of other symptoms, to adequately assess their situation, assess the need for tests, specific treatment or hospital admission ”, as established by the instructions of the Ministry of Health.
How are the treatments organized now?
Covid-19 patients have been given priority in practically all hospital centers, especially in the emergency and intensive care units, which has motivated delays in the diagnosis and treatment of many other pathologies, the experts point out, although “it is likely that over the next few weeks activity in hospitals will normalize for the diagnosis and treatment of our patients,” says Dr. Joan Carles Galcerán, specialist and coordinator of the Center’s Oncological Institute Teknon doctor from Barcelona.
It is because of that hospitals have had to reorganize to be able to continue caring for patients with other pathologies without putting their health at risk and continuing, as far as possible, with cancer treatments. In these cases, each oncologist, who “is a bit of a GP for cancer patients,” says Dr. Carles, has had to assess the risk-benefit of treatments. “It should be explained to them that in the current situation certain treatments can trigger risk situations, which are not determined by the treatment itself, but because of the health resources situation”And make a consensus decision with the patient.
Despite the difficulties, attempts have been made to not to delay too long the usual procedures in the diagnosis and treatment of cancer. Dr. Jesús García-Foncillas, director of the Oncohealth Institute of the Fundación Jiménez Díaz University Hospital, explains that “in his center they have kept“Parallel circuits for Covid positive patients and patients without viral infection who need tests and treatments that cannot be prolonged in time. “
Thus, in this center they have tried “reduce non-essential visits, we have modified some monitoring guidelines using computer platforms that allow us to carry out In-person consultations and symptom control through videoconference with the patient ”. For those who are in active treatment, a “continuous testing to identify possible asymptomatic carriers and avoid contagion within treatment units. ”
At the Teknon Medical Center in Barcelona they have followed a similar strategy, with the staff units doing weekly rotations, minimizing radiological tests and reducing face-to-face visits. “Only those treatments that have been considered essential for the good health of our patients have been administered”. Also, taking additional precautions, all the patients who came had their temperature taken when they arrived, they were offered a mask if they did not wear it and they proceeded to administer hydroalcoholic solution before entering consultations, “summarizes Carles.
Get back to normal
The specialists, in general, show optimism: “Most patients on radio or chemotherapy treatments have been able to complement their treatments without further ado, although many surgical interventions have had to be rescheduled, ”explains Dr. Raymond Miralbell Izard, medical director of the Quirónsalud Proton Therapy Center, the first of its kind in Spain, which began treating patients with this powerful technique at the end of last year. and it has continued with its healthcare activity “maintaining maximum security measures”. According to Carles, at the Teknon Medical Center, for example, in some cases where the surgery could not be carried out “we have been able to implement radiotherapy treatments that can offer similar results or start chemotherapy treatments to delay surgical treatment. “
Since surgery is the treatment of choice in more than half of cancer cases, these delays They will have an impact “at the start of the indicated complementary radio or chemotherapy treatments and the pressure will increase”, Miralbell assures, so you will have to be prepared for when this happens.
The restructuring of health centers during the epidemic has caused a huge effort “in the programming of oncological processes, meticulously weighing the risks of infection ”, concludes García-Foncillas. Above all, the goal has always been continue with the diagnostic and therapeutic processes without jeopardizing the prognosis of the disease and recover normality as soon as possible.
