BEFORE & AFTER: THE EVALUATION OF THE EFFECT OF THE COVID-19 PANDEMIC ON CANCER PATIENTS IN PALLIATIVE CARE CENTER

Year 2024, Volume: 25 Issue: 3, 384 - 389, 18.07.2024

Zeynep Irmak Kaya , İsmail Beypınar , Muslih Ürün

https://doi.org/10.18229/kocatepetip.1386018

Abstract

OBJECTIVE: In addition to the high risk of death from COVID-19 infection in cancer patients, delays in cancer diagnosis may result in delayed treatment of cancer patients. The study aimed to evaluate the changes in the characteristics of cancer patients, such as diagnosis, stage and prognosis, between the pre-pandemic and post-pandemic one-year periods in Turkey.
MATERIAL AND METHODS: The records of patients who received palliative treatment in the palliative service between March 11, 2019 and March 11, 2021 were reviewed retrospectively. Age, gender, diagnosis, type of diagnosis, type of treatment, place of arrival to the palliative service, and way of discharge were retrospectively scanned from patient files. The first hospitalizations were evaluated in patients with recurrent hospitalizations. Patients with inadequate patient records were excluded from the study.
RESULTS: The proportion of patients diagnosed with cancer radiologically has increased. While radiological findings of cancer were detected in 9.1 percent of patients in the pre-pandemic period, this rate was 16.2 percent in the post-pandemic period. When the patients were evaluated in terms of the oncological treatment they received before inpatient palliative care, a significant difference was found (p=0.002). This difference was due to the increase in the proportion of patients who were not suitable for oncological treatment after the pandemic.
CONCLUSIONS: We believe that the pandemic had great effects on newly diagnosed patients and patients in need of palliative care services. In the present study, we observed an increase in cancer patients who were radiologically diagnosed with cancer and treated in palliative care services in the post-pandemic period.

Keywords

Cancer, Cancer Patients, Colleteral Damage, Covid-19, Palliative Care, Pandemic

COVID-19 PANDEMİSİNİN PALYATİF BAKIM MERKEZİNDEKİ KANSER HASTALARI ÜZERİNDEKİ ETKİSİNİN DEĞERLENDİRİLMESİ; ÖNCESİ & SONRASI

Abstract

AMAÇ: Kanser hastalarında COVID-19 enfeksiyonundan kaynaklanan yüksek ölüm riskine ek olarak, kanser tanısındaki gecikmeler kanser hastalarının tedavisinin gecikmesine neden olabilir. Bu çalışmada, Türkiye'de pandemi öncesi ve sonrası bir yıllık dönemler arasında kanser hastalarının tanı, evre ve prognoz gibi özelliklerindeki değişikliklerin değerlendirilmesi amaçlanmıştır.
GEREÇ VE YÖNTEM: Palyatif serviste 11 Mart 2019 ile 11 Mart 2021 tarihleri arasında palyatif tedavi alan hastaların kayıtları retrospektif olarak incelendi. Hasta dosyalarından yaş, cinsiyet, tanı, tanı tipi, tedavi tipi, palyatif servise geliş yeri ve taburculuk şekli retrospektif olarak tarandı. Tekrarlayan yatışları olan hastaların ilk yatışları değerlendirildi. Hasta kayıtları yetersiz olan hastalar çalışma dışı bırakıldı.
BULGULAR: Radyolojik olarak kanser tanısı konulan hastaların oranı artmıştır. Pandemi öncesi dönemde hastaların %9,1'inde radyolojik olarak kanser bulgusu saptanırken, pandemi sonrası dönemde bu oran %16,2 idi. Hastalar yatarak palyatif bakım öncesi aldıkları onkolojik tedavi açısından değerlendirildiğinde anlamlı fark saptandı (p=0,002). Bu fark pandemi sonrası onkolojik tedaviye uygun olmayan hastaların oranındaki artıştan kaynaklanmaktaydı.
SONUÇ: Pandeminin yeni tanı alan ve palyatif bakım hizmetlerine ihtiyaç duyan hastalar üzerinde büyük etkileri olduğunu düşünüyoruz. Bu çalışmada, pandemi sonrası dönemde radyolojik olarak kanser tanısı alan ve palyatif bakım servislerinde tedavi gören kanser hastalarında artış gözlemlendi.

Keywords

Kanser, Kanser Hastaları, Kolleteral Hasar, Covid-19, Palyatif Bakım, Pandemi

Ethical Statement

The study was approved by both the Turkish Ministry of Health and the Ethics Committee of Eskişehir Osmangazi University Faculty of Medicine (26.10.2021 dated and 9 numbered) and carried out following the principles of the Declaration of Helsinki and all applicable regulations.

Supporting Institution

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References

• 1. Wassenaar TM, Zou Y. 2019_nCoV/SARS-CoV-2: rapid classification of betacoronaviruses and identification of Traditional Chinese Medicine as potential origin of zoonotic coronaviruses. Lett Appl Microbiol. 2020;70:342–8.
• 2. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. Severe acute respiratory syndrome-related coronavirus: The species and its viruses–a statement of the Coronavirus Study Group. BioRxiv. 2020.
• 3. Benvenuto D, Giovanetti M, Ciccozzi A, et al. The 2019-new coronavirus epidemic: Evidence for virus evolution. J Med Virol. 2020;92:455–9.
• 4. Lu R, Zhao X, Li J, Niu P, Yang B, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet.2020;395:565–74.
• 5. Jiang F, Deng L, Zhang L, et al. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID- 19). J. Gen. Intern. Med. 2020;35:1545–9.
• 6. Organization WH. Coronavirus Disease 2019 Situation Update. World Heal Organ. 2020;14:1–16.
• 7. Thomson DJ, Palma D, Guckenberger M, et al Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiation Therapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement. Int J Radiat Oncol Biol Phys. 2020;107:618–27.
• 8. Mohile NA, Blakeley JO, Gatson NTN, et al Urgent considerations for the neuro-oncologic treatment of patients with gliomas during the COVID-19 pandemic. Neuro Oncol. 2020;22:912–7.
• 9. 30 Buyuksehir ve Zonguldak ilinde 23-24-25-26 Nisan tarihlerinde uygulanacak sokaga cikma kisitlamasi. https://www.icisleri.gov.tr/30-buyuksehir-ve-zonguldak-ilinde-23-24-25-26-nisan-tarihlerinde- uygulanacak-sokaga-cikma-kisitlamasi. Erişim tarihi: 20.11.2023.
• 10. Beypinar I, Urun M. Intravenous chemotherapy adherence of cancer patients in time of covid-19 crisis. International Journal of Hematology and Oncology. 2020;30:133–8.
• 11. Karacin C, Bilgetekin IB Basal F, Oksuzoglu OB. How does COVID-19 fear and anxiety affect chemotherapy adherence in patients with cancer. Futur Oncol. 2020;16:2283–93.
• 12. Guven DC, Aktas BY, Aksun MS, Ucgul E, Sahin TK, et al. COVID-19 pandemic: Changes in cancer admissions. BMJ Support Palliat Care. 2024;e376-9.
• 13. Desideri I, Pilleron S, Battisti NML, et al . Caring for older patients with cancer during the COVID-19 pandemic: A Young International Society of Geriatric Oncology (SIOG) global perspective. J. Geriatr. Oncol. 2020;11:1175–81.
• 14. Mehta AK, Smith TJ. Palliative Care for Patients with Cancer in the COVID-19 Era. JAMA Oncol. 2020;6:1527– 8.
• 15. Dinmohamed AG, Visser O, Verhoeven RHA, Louwman MWJ, van Nederveen FH, et al Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. Lancet Oncol. 2020;21:750–1.
• 16. Kutikov A, Weinberg DS, Edelman MJ, Horwitz EM, Uzzo RG, et al. A War on Two Fronts: Cancer Care in the Time of COVID-19. Ann. Intern. Med. 2020;172:756–8.
• 17. Editorial. "COVID-19: global consequences for oncology." Lancet. 21. 2020;467.
• 18. Burki TK. Cancer guidelines during the COVID-19 pandemic. The Lancet Oncology. 2020;21(5):629-30.
• 19. Masroor S. Collateral damage of COVID‐19 pandemic: delayed medical care. Journal of cardiac surgery. 2020;35(6):1345-7.
• 20. Schrag D, Hershman DL, Basch E. Oncology practice during the COVID-19 pandemic. Jama. 2020;323(20):2005-6.
• 21. Pal SK, Miller MJ, Agarwal N, et al. Clinical cancer advances 2019: annual report on progress against cancer from the American society of clinical oncology. Journal of Clinical Oncology. 2019;37(10): 834-49.
• 22. Guven DC, Sahin TK, Aktepe OH, et al. Perspectives, knowledge, and fears of cancer patients about COVID- 19. Frontiers in Oncology. 2020;10:1553.