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Should we be stopping new starts of patients who can be triaged for 2-3 months like prostate cancers on ADT when significant community spread of COVID-19 is detectable in our area?

Mitigating the spread of COVID-19 is of utmost priority now that containment measures have failed. Social distancing will help "flatten the curve" of new cases so as to prevent catastrophic failure of health care delivery systems that are overwhelmed by new serious cases of pneumonia. Radiation oncology services should do their part to triage patients where timely care is not absolutely necessary so as to prevent further transmission to a very vulnerable population.
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Radiation Oncology · Washington University School of Medicine
Answered on · Updated on

I would for those patients requiring ADT, which is the way I interpreted the question. I want to elaborate more because @Dr. First Last brought up other scenarios we should consider and he brings some more good points:

Many patients could get active surveillance for a period of time before ADT is co...

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Radiation Oncology · Case Western Reserve University/ University Hospitals Seidman Cancer Center
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Lets break it down by risk group:

Very low/low risk: Should be put on active surveillance and return in 6 months for a PSA.

Favorable intermediate risk: Should be put on active surveillance for the current time and return in 3-6 months for a repeat PSA. Very good data that early on active surveillan...

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Radiation Oncology · Washington University School of Medicine
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I agree with my colleague, @Dr. First Last. I would add that many patients for whom ADT is not necessary can be convinced to a more appropriate Active Surveillance strategy and avoid or delay ADT and XRT altogether. High risk patients can safely be treated with a longer interval of 'neoadjuvant' ADT...

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Radiation Oncology · Fox Chase Cancer Center
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I agree with my colleagues above. Our hypofractionation regimen is 7020 cGy/26 fractions to the prostate and prox SVs and 5200 cGy/26 fractions to the distal SVs and lymph nodes. As @Dr. First Last referenced above, the 10 year results from our phase III clinical trial were just published in the JCO...

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Radiation Oncology · Karmanos Cancer Institute - McLaren Proton Therapy Center
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Don't forget prostate SBRT in 5 fractions, every other day.

A commonly employed regimen is 8 Gy to prostate and 5 Gy to SV. Some series have even given 5 Gy to nodes for high risk patients. There have been thousands of patients treated with prostate SBRT now with excellent PSA control and low single...

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Radiation Oncology · Lynn Cancer Institute at Boca Raton Regional Hospital
Answered on

Yes, at the Lynn Cancer Institute we have delayed all non-essential starts and follow ups, including prostate and breast patients that are on hormonal therapy.

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Radiation Oncology · Sarah Cannon Cancer Institute
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As per FAQ’s posted by ASTRO:

New patient consults and new patient starts may be triaged on a case-by-case basis according to the urgency of the situation following discussion with the multidisciplinary care team. Examples of non-urgent cases that may be delayed for up to two months include prostate...

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Radiation Oncology · University of Florida
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Yes.

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Radiation Oncology · West Virginia University School of Medicine
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This is all very important what has been discussed so far about prostate cancer, but how about addressing the original question of this post "stopping new starts of patients who can be triaged for 2-3 months LIKE prostate cancers on ADT" (=but NOT prostate cancers, but other cancers)? I need your in...

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