Alternative Cancer Treatment in the Era of New Normal Aimed at minimizing patients’ concerns during COVID-19

“The COVID-19 outbreak have a direct and profound impact on healthcare professionals (HCPs) who are called to the frontline of the pandemic to deal with the overwhelming demands of this pandemic. In order to tackle this burden, we should implement 3 medical guidelines that will align with the New Normal way of healthcare. These guidelines include 1. The prioritization of patients’ cases based on emergency to reduce the frequency of hospital visits, 2. The adjustments of treatment methods that will help reduce treatment time in the hospital and relieve burden for healthcare professionals and 3. The adjustment of treatment for outpatients through the utilization of technology to help in consultation and treatment such as telemedicine,” Dr. Aumkhae Sookprasert, Medical Oncologist, Srinagarind Hospital, Khon-Khaen University stated

“In the circumstance that hospitals have limited resources of medical professionals, subcutaneous treatment methods will not only reduce the risk and potential exposure to the virus for patients but it will help lighten the overwhelming workload for healthcare professionals so they can free up more time to take care of other patients as well as reduce occupancy of medical beds and the crowd density within the hospital”.

The European Society for Medical Oncology (ESMO) recommends that oncologists worldwide prepare for the New Normal method of treatment as well as implementing telemedicine in order to monitor and consult with patients via online platforms to reduce the frequency of hospital visits. Moreover, doctors are urged to change treatment methods to subcutaneous or oral therapies as oppose to its intravenous alternative whenever possible.1

Subcutaneous (SC) injection is administered into the fat layer between the skin and muscle and can reduce considerable treatment time of each cycle when compared to the traditional IV method. As far as the efficiency of both treatment methods, it is clinically proven that the SC treatment is comparable to its IV alternative and switching administration method will not compromise the efficacy or safety.2Additionally, the administration of some SC therapy for breast cancer requires only 3.3 minutes per session compared to 40-90 minutes required by the IV method.3

“Some patients are required to receive continuous treatments throughout the course of a year. In this case, SC therapy can help reduce significant time at the hospital when compared to the IV therapy by over 50 per cent or 13 hours per patient.3 Based on the study on lymphoma patients, SC therapy can also help reduce treatment time by up to 74%,”[1] Dr. Chawalit La-Kamme, Hematologist, Yanhee International Hospital revealed “This treatment method utilizes a smaller needle than regular chemotherapy, which is helpful in increasing the flow of treatment, reducing pain and discomfort for patients as well as minimizing risks of infection and side effects that may occur during IV therapy. [2]This alternative will offer an efficient solution for cancer patients in Thailand while complying with the health and safety measures, which signals a promising future for cancer care during the COVID-19 era”.

Today, cancer patients in Singapore can receive treatment at medical centres near their homes through the NCIS-on-the-Go program, established by the National University Cancer Institute, Singapore (NCIS). Lead by a trained team of oncology nurses from the NCIS Community Care team, the program offers simple nursing procedures and treatment services such as blood tests and treatments including SC therapy at predetermined locations according to Singapore's Ministry of health guidelines. This program is aimed at reducing travel time to the hospital for patients while retaining same efficiency and safety as hospital treatments and services. In addition to increasing patient’s convenience and satisfaction and enhancing their quality of lives, offering mobile medical services near patients can also help relieve the strains of medical professionals at the hospital. In this case, low risk patients can access treatment at NCIS-on-the-Go service centres near their homes in order to increase the flexibility and accessibility of comprehensive cancer care and treatments.

“The cancer burden in Singapore is continuing on an upward trajectory due to an aging population and rising incidence for some cancers. However, the development of modern technology and innovative treatment are helping to prolong patients’ life expectancy. This leads to a rising demand for comprehensive cancer care and treatment that is more flexible, convenient and accessible,” Professor Lee Soo Chin, Head and Senior Consultant, Department of Haematology-Oncology, National University Cancer Institute, Singapore (NCIS) stated

“The NCIS-on-the-Go program has been established to align with the Singapore Ministry of Health’s ‘Beyond Hospital to Community’ strategy, which is an initiative to improve the sustainability of the public health system in Singapore while catering to the demands of the patients in the country. To further enhance the efficiency and maximize patients’ satisfaction, our future directions are to increase our locations and widen the range of treatments”. 

The recent development of medications for breast cancer and lymphoma that can be administered subcutaneously is considered a medical advancement that complies with the New Normal way of life for people in Thailand and worldwide. Patients can gain access to more information of these treatments by acquiring more information at the hospital.

Reference 

1. Burki, T. K. (2020). Cancer guidelines during the COVID-19 pandemic. The Lancet Oncology, 21(5), 629-630. doi:10.1016/s1470-2045(20)30217-5

2. Hanah: Ismael G, et al. Lancet Oncol 2012 and SafeHer: Jung KH, et al. Abstract 1956, Mon 28 Sep, 9:15–11:15

3. Pivot X, et al. ESMO 2012 (Abstract 272P)

4. PLOS ONE 2016; 11(6): e0157957

5. PrefHer: Pivot X, et al. SABCS 2013 (Abstract P4-12-11)