The National Comprehensive Cancer Network® (NCCN®)–an alliance of leading cancer centers–is continuing to share new resources for optimal cancer management amid new and changing challenges related to the Coronavirus Disease 2019 (COVID-19). The nonprofit organization’s Best Practices Committee has published a new article online-ahead-of-print in JNCCN–Journal of the National Comprehensive Cancer Network detailing their recommendations for keeping cancer patients, caregivers and staff as safe as possible.
“The unprecedented challenges we are all facing from the COVID-19 pandemic heighten NCCN’s commitment to sharing evidence-based consensus from leading medical experts as rapidly as possible, free-of-charge, to everyone around the world,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “We are doing everything we can to review and share reliable information that will help keep oncology patients, providers, and staff safe under the new reality of increased risk.”
“We can continue to provide our patients with effective and compassionate care, without sacrificing the health and safety of our teams, colleagues, and families, by carefully evaluating any emerging research and modifying our treatment approaches accordingly,” said lead author Pelin Cinar, MD, MS, UCSF Helen Diller Family Comprehensive Cancer Center. “People with cancer and their loved ones already go through so much, and now they face new fears around catching COVID-19 or delaying necessary treatment. By sharing these recommendations, we want to reassure the oncology community that there are some aspects of care that we can and will control in order to improve outcomes for people with cancer.”
The JNCCN article contains the most current information at the time of publication, but notes that recommendations regarding public safety and practice may change rapidly; individuals can also keep up with the most up-to-date information via the CDC website.
The NCCN Best Practices Committee recommendations can be summarized as follows:
Patient Safety
- Prescreen and screen for COVID-19 symptoms and exposure history via telephone calls or digital platforms
- Develop screening clinics to allow for patients with symptoms to be evaluated and tested in a dedicated unit with dedicated staff
- Convert in-person visits to telemedicine visits when possible
- Limited or no visitor policy
- Limit surgeries and procedures to only essential, urgent, or emergent cases
- Consideration of alternative dosing schedule to allow for fewer in-person visits to the cancer center and/or the infusion center
- Switch from infusional therapy to oral oncolytics if equivalent formulation is available
- Transition outpatient care to care-at-home whenever possible (e.g. pump disconnection, administration of growth factors, hormone therapy)
- Increase interval between scans or use biochemical markers in lieu of scans
- Provide resources for wellness and stress management for patients
Healthcare Worker Safety
- Assure availability and use of appropriate personal protective equipment (PPE) per guidelines
- Create a centralized resource or website to communicate recommendations to the healthcare workers around PPE and workflows
- Implement daily screening tools and/or temperature checks
- Telecommute when possible, with limited onsite staff participating in rotations on a daily basis
- Establish clear stay-at-home and return-to-work guidelines
- Provide resources for wellness and stress management for healthcare workers
