The National Comprehensive Cancer Network’s® (NCCN®) Best Practices Committee has published a preprint article in JNCCN—Journal of the National Comprehensive Cancer Network detailing their recommendations for keeping patients with cancer, as well as their caregivers and health-care staff, as safe as possible during the pandemic.
Robert W. Carlson, MD
“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 of 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 of the article Pelin Cinar, MD, MS, of the University of California, San Francsico Helen Diller Family Comprehensive Cancer Center, in an NCCN press release.
“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,” she added.
Recommendations
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-visitor 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 at-home care whenever possible (eg, 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.
Health-Care Provider Safety
- Assure availability and use of appropriate personal protective equipment (PPE) per guidelines
- Create a centralized resource or website to communicate recommendations to health-care workers about 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 health-care workers.
The JNCCN article contains the most current information at the time of publication, but the authors noted that recommendations regarding public safety and practice may change rapidly.
Disclosure: For full disclosures of the study authors, visit jnccn.org.
