During the epidemic, the National Cancer Institute reminds patients that the connection with doctors should not be interrupted. In a press release, the institute indicates continuing its activity with the objective of guaranteeing continuous service to all of its audiences. In this sensitive context, they organized themselves to support cancer patients in order to better welcome them. Contact with his doctor, whether as part of treatment or for any other question relating to symptoms, remains essential. We publish the press release from the National Cancer Institute below.
A report from the joint World Health Organization and China mission published on February 28 said the death rate of cancer patients infected with the virus was 7.8%. This rate was 1.4% in the population without co-morbidity and 3.8% for all COVID-19 deaths. Also, precautions, in particular barring gestures for patients and their relatives as well as the instructions issued by medical teams, must be scrupulously observed to reduce the risk of contamination by the virus. However, this does not mean that patients should stop treatment without medical advice.
Cancer patients, care that should continue unless otherwise advised by their doctor
Cancer patients are 4 to 5 times more likely to develop a severe form of COVID-19 if infected with the virus. Their immune system weakened by certain treatments, including chemotherapy, makes them more fragile. The greatest precaution must be taken in particular with respect to barrier gestures and in contact with relatives. Continued treatment is the rule. However, and if the situation allows, the oncologist or hmatologist can adapt the monitoring of his patient. Its session may be rescheduled to guarantee the best possible safety conditions and to avoid, if treatment is provided in the hospital, any contact with people potentially carrying COVID-19. Many hospitals and cancer departments have adapted; specific circuits are set up in establishments. The mobilization of the entire medical community should enable everyone to benefit from the care they need during this troubled period.
“The announcement of cancer, the treatments, life after the disease are difficult proofs that patients should not cross alone. Medical teams are present throughout the course of care and the epidemic that we are currently experiencing In no case should they modify the bond that is established between the patient and the health professionals who accompany him. The legitimate fear that they may feel, in this period, should not prevent them from contacting the teams. It is therefore essential, and I insist, that each of them approach their oncologist or their treating doctor who will be able to explain to them and consider with them the adapted follow-up “. Professor Norbert Ifrah, President of the National Cancer Institute.
Adaptation of treatments to reduce the risk of contamination of cancer patients with COVID-19
Even if specific admission routes have been established, hospitals are places where there is a lot of human contact and may pose a risk of infection with the COVID-19 virus. Health authorities (notably the High Council for Public Health) recommend postponing trips to the hospital, when possible and without risk of loss of luck for the patient. In some cases, a consultation may be offered at the usual place of consultation. But this is not always possible.
A consequent work was carried out by the learned societies of health professionals. They identified, during this epidemic period, possible changes in rhythm, monitoring and treatment modalities for patients. In this context, the example of chemotherapy treatments given by the intravenous route, some of them can be replaced by drugs which are taken orally. Taken in a collegial manner, during a multidisciplinary concertation meeting, this decision on the evolution of treatment is recorded in the patient’s file.
However, each situation being so unique, patients should not hesitate to make contact by telephone, teleconsultation or email, with their care team or their treating physician, who alone are able to respond to them in a personalized manner.
Anticipate and organize recovery to guarantee the best quality of patient care
Providing patients with the best quality of care and preventing any loss of luck is a major objective for the Institute and the healthcare professionals who support people with cancer. To this end, and in order to envisage a return to normal as soon as the containment is gradually lifted, the Institute has undertaken national work to organize the recovery in its main principles. Locally, the care teams will contact each patient whose treatment, examinations or follow-up has been postponed in order to reprogram them.
Cancer screening: a postponement of devices for asymptomatic people
Under article 3 of the decree of 23 March 2020 prescribing the general measures necessary to deal with the COVID-19 epidemic in the context of the state of health emergency, it is specified that only “consultations and care cannot be postponed and consultations and care of patients suffering from a long-term condition “are authorized. In addition, and in view of the risk of exposure and dissemination of COVID-19, the screening procedures for cancer should be considered as less priority. Even if an interruption in screening risks losing chances[1], they cannot be valued for periods as short as those provided for this confinement period. Consideration has been given to the measures to be implemented for people whose confinement is expected to last beyond May 11.
Also, the 3 national organized screening programs (breast cancer screening, colorectal cancer screening and cervical cancer screening), which are aimed at asymptomatic people, are temporarily suspended. Analysis of exams as it continues. So, for example, if a colorectal cancer screening test is sent to the medical analysis laboratory, it will be analyzed and its result sent under the usual conditions. Only the invitations to participate in these screenings have been stopped and will resume, according to a scheme on which the Institute is currently working with public health actors, as soon as the situation allows. It will be a question of proposing a recovery strategy in order to prioritize and organize the national process of catching up with screenings while taking into account the capacities of health professionals. Work at local and national level is underway to address these issues of organizing the recovery; to avoid congestion, for example, priorities can be given. They remain to be defined.
Continuous monitoring in the event of an anomaly detected during a screening
The follow-up of people who have carried out a screening (screening for breast cancer, cervical cancer or even colorectal cancer) before the confinement period and whose result has revealed an anomaly, must continue the examinations supplements prescribed by their doctor. The National Cancer Institute specifies that the regional cancer screening coordination centers continue their missions in order to follow up on people for whom a screening test has proved positive. In fact, it is therefore necessary to guarantee them that the additional examinations useful for diagnosis but also the therapeutic support are carried out within the time required by their individual situation. The attending physician is of course the privileged contact of each patient; he can advise and guide him when necessary.
In case of symptoms, do not hesitate to consult your doctor
If the carrying out of examinations within the framework of organized screenings is currently suspended, the Institute recalls the need to consult its attending physician in the event of unusual, unexplained and persistent symptoms. Internet or telephone consultation systems have been authorized by the Minister of Solidarity and Health; they make it possible to ensure everyone’s safety in the face of the COVID-19 epidemic and to avoid situations of loss of chance in the diagnosis of possible cancers requiring treatment.
This indefinite period that we are currently going through with the COVID-19 epidemic must absolutely not put the brakes on the population when they need to consult their doctor. The medical offices and oncology services of the hospital centers have organized themselves to receive their patients under safe conditions and to avoid any contact with persons suspected of or affected by COVID-19.
Foster the continuity of work with researchers involved in the fight against cancer
The field of research is also largely impacted by the epidemic period of COVID-19. The academic research laboratories are called to mobilize on the research work related to COVID-19. Only researchers participating in projects in this field continue their activity in the laboratory. Those exploring other topics are working. Some of them are mobilized in hospitals, to support health professionals. Delay is inevitable for many research projects, particularly those using animal models, a frequent situation in the field of oncology.
To ensure continuity and support researchers during this difficult period, the Institute has taken several measures to continue the work and calls for tenders undertaken before the brutal halt related to confinement:
– working groups between the National Cancer Institute, researchers and external experts are organized in conference as soon as necessary;
– the grants awarded by the Institute are systematically extended. A waiver may usually be granted for an additional 12 months; as part of the epidemic, and in certain situations, it may last up to 60 months. It is a question of allowing the carriers of project, and their work, not to be penalized by this period of confinement;
– the deadlines for submission of files and their evaluation by the Expert Committees, for project calls already launched, are extended.
In addition, the Institute has to suspend and postpone the publication of new project calls and postpone the seminars organized during this period of confinement. It’s just a postponement. All of the measures taken are aimed at:
– promote the continuity of work with researchers;
– ensure a resumption of all research activity at the end of confinement in the best possible conditions.
The Institute will maintain its research effort in the service of patients.
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