What measures should we take regarding routine follow-up visits for well patients in surveillance during the coronavirus pandemic?

Topics: Breast Cancer • Radiation Oncology • Gynecologic Cancers • Medical Oncology • COVID-19

When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as scheduled?

Wagih Shehata, Meadowview Regional Medical Center

Added March 14, 2020

1 person agreed with this answer

3-6 months.

Thomas Eichler, Sarah Cannon Cancer Institute

Added March 19, 2020

2 people found this helpful

As per FAQ’s posted by ASTRO:

From currently available data, all cancer patients are at higher risk of COVID-19 related mortality, and older people (men more than women) appear to be at higher risk of COVID-19 related mortality than younger people. Thus, efforts to reduce the risk of exposure of COVID-19 to all patients are needed, for example with reduction in the frequency of follow-up visits and replacing in-person visits with telephone or remote telemedicine follow-up.

All asymptomatic routine follow-up patients may be rescheduled for three months or longer. The majority of patients who have recently completed radiotherapy can safely have their follow-up extended by two to three months or more, with telemedicine as needed.

There are published data on nurse-led telephone follow-up and virtual PSA monitoring suggesting that prostate cancer patients can be monitored remotely unless symptomatic or with concerns for clinical progression.

A small study randomizing lung cancer patients to symptom-based follow-up versus routine imaging found a survival benefit favoring symptom-based strategy. Whether telephone follow-ups can substitute in the short term for in-person visits is unknown.

EVIDENCE: Casey et al. (2017), Boyajian et al (abstract ASTRO 2018), Denis et al (2019)

SOURCE: Institutional experience

For the full ASTRO guidelines see: https://www.astro.org/Daily-Practice/COVID-19-Recommendations-and-Information/COVID-19-FAQs

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