Komen to patients: Doctors using treatment sequences to minimize the exposure to COVID-19
With hospitals straining against shortages in beds and protective equipment, many governments are calling on doctors to delay elective surgeries to free up capacity and to reduce the risk of unnecessary exposure for patients and staff. Yet according to Susan G. Komen®, the world’s leading breast cancer organization, news of delays to needed procedures has led to increased anxiety among many breast cancer patients who worry about what impact it will have on their treatment and chances for long-term survival. Komen urges patients to discuss their treatment options with their health care team.
The term “elective” surgery does not always mean optional, rather that the surgery can be scheduled in advance. This doesn’t mean your surgery isn’t important. It just means it’s not urgent or life-threatening. Surgery (in the form of lumpectomy or mastectomy, and often with lymph node surgery as well) remains an important component of breast cancer treatment. However, it can often be postponed without compromising the patient’s outcome. One strategy to safely postpone surgery involves treatment with chemotherapy and/or special breast cancer-fighting pills, which can be delivered for several months prior to the surgical management.
“The silver lining in this crisis is that health care teams are using new technologies such as telemedicine to provide care that doesn’t require an in-person visit,” said Victoria Wolodzko, Komen’s senior vice president of Mission. “Rest assured that operations that are urgent and a critical part of a breast cancer patient’s care are unlikely to be delayed.”
“The concept of elective breast cancer surgery is definitely evolving,” says Dr. Lisa Newman, a member of Komen’s Scientific Advisory Board and a surgical oncologist at the Weill Cornell Medicine New York Presbyterian Hospital Network. “We are taking advantage of treatment sequences where we deliver medical therapies before surgery, and we have abundant clinical research demonstrating that this sequence of care is not only perfectly safe, but it has several advantages, such as the prospect of decreasing the breast tumor size and improving lumpectomy options.”
The American College of Surgeons recently issued guidelines (https://www.facs.org/covid-19/clinical-guidance/elective-case/breast-cancer) on the triage of patients undergoing elective cancer surgery during the COVID-19 pandemic.