When COVID-19 struck, the oncology community, along with health care systems across the globe, faced new challenges. Rutgers Cancer Institute of New Jersey in partnership with RWJBarnabas Health moved quickly to adapt to these new demands and made adjustments to operations in patient care to protect patients, their families and staff.
Andrew M. Evens, the associate director for clinical services and director of the lymphoma program at Rutgers Cancer Institute and the medical director of oncology services at RWJBarnabas Health, discusses the impact of the COVID-19 pandemic on cancer care.
What were the biggest adjustments that occurred to keep patients and staff safe?
As New Jersey’s only National Cancer Institute–designated Comprehensive Cancer Center and the state’s leading authority on cancer, experts at Rutgers Cancer Institute of New Jersey and RWJBarnabas Health know that cancer doesn’t stop, and cancer care simply can’t wait. Our primary concern is our patients, and even before COVID-19, we have been concerned about the risk of any patient with cancer contracting infection. We were tasked with meeting the ongoing needs of cancer patients and implementing safety guidelines so essential cancer treatments could continue.
Several processes and guidelines for reducing the spread of the virus have been implemented at our facilities across the state to ensure that patients can continue to receive their cancer care. These include screening for COVID-19 symptoms upon entry, following strict social distancing measures, prohibiting most visitors, enhancing already rigorous cleaning and disinfecting practices, and mandating a mask or face covering for all patients, visitors and staff. Through these heavy precautions and screening measures, we have maintained a stable environment to continue providing exceptional care to patients throughout the pandemic.
To further promote social distancing, we have leveraged the use of our telemedicine program that we had established last year pre-COVID as a way to better provide opinions from our oncology experts to patients who might be hours away. Some patients might still feel uncomfortable coming into our facilities, so telemedicine has been a highly useful option for managing care and giving patients the assurances that they need during the pandemic, including for new patient consultations.
How did COVID-19 impact treatment and surgery for cancer patients?
Rearranging or delaying cancer treatment because of the coronavirus has remained a highly individualized decision. Cancer experts have an understanding of which cancers need immediate treatment depending on a patient’s health, and have the knowledge to determine if treatment would outweigh the risk of the virus. In deciding whether to delay treatment, patients were encouraged to discuss a plan with their expert cancer care team. In New Jersey, surgical care for cancer patients continued during the pandemic. In adherence to all public health guidance and regulatory policies, we enhanced our safety measures to continue preforming essential cancer surgeries.
Currently, all patients are tested for coronavirus prior to undergoing any scheduled surgical procedures or prior to starting chemotherapy. Staff involved in surgical care are screened for exposure and tested for coronavirus as necessary prior to working in the operating room or being involved in a surgical procedure. Additionally, rigorous cleaning and disinfecting practices have been concentrated on surgical and recovery room spaces, frequently touched surfaces, exam rooms and computer terminals. Whatever we face in the coming months, our teams at Rutgers Cancer Institute and RWJBarnabas Health will continue to evaluate these safety practices in accordance with federal, state and local guidance.
How does COVID-19 impact access to cancer screening?
At the start of the pandemic, other aspects of cancer care including screenings were put on hold to slow the spread of COVID-19 in healthcare settings, especially in areas of high transmission. Research has shown that new cancer diagnoses have declined, possibly due to delayed cancer screenings or delayed routine appointments. This has led to some cancers being diagnosed at later stages, which can present treatment challenges.
Healthcare facilities continue to schedule routine screenings. Cancer screenings remain important as they help to detect cancer at its earliest stages. We are continuing to communicate with the community that rescheduling your routine screening is safe at this time, and it is imperative to focus on overall health and wellness while continuing to stay committed to preventing the spread of the virus.
Has COVID-19 impacted research or enrollment in clinical trials?
Cancer research globally has been impacted due to the pandemic. Across the world, research at cancer centers, academic institutions and within the industry was affected due to mandated procedural shifts, such as how many people were safely permitted inside a laboratory to conduct basic science research. In addition, restrictions also posed some limitations for clinical cancer research. However, Rutgers Cancer Institute did an outstanding job in maintaining enrollment on therapeutic clinical trials throughout the pandemic. Furthermore, Rutgers has designed and opened several clinical trials studying COVID-19, including in cancer patients.
