Due to COVID-19, Many Ovarian Cancer Patients Remain In Limbo

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OVID-19 is presenting challenges for doctors treating ovarian cancer patients. And the ways in which they are adapting is changing in real time as the pandemic unfolds. First and foremost, a lot of patients with symptoms are staying at home, as they are being instructed to by the shelter-in-place directives. "But that means a lot people are at home with symptoms that aren't being addressed," says Dr. Lori Weinberg, gynecologic oncologist with Minnesota Oncology in the Minneapolis area

Covid-19 continues to pose challenges for doctors caring for ovarian cancer patients.
Due to shelter in place directives, women experiencing symptoms at home may not be getting lab work, or visiting with their doctor.
Surgery is being delayed as a result of the pandemic.
Starting treatment with chemotherapy rather than surgery is often the best option.

COVID-19 is presenting challenges for doctors treating ovarian cancer patients. And the ways in which they are adapting is changing in real time as the pandemic unfolds.

First and foremost, a lot of patients with symptoms are staying at home, as they are being instructed to by the shelter in place directives. "But that means a lot people are at home with symptoms that aren't being addressed," says Dr. Lori Weinberg, gynecologic oncologist with Minnesota Oncology in the Minneapolis area. "I think there are many scenarios where women with symptoms are not getting the ideal workupmeaning CAT scans, biopsies, even a visit with their doctor to help manage their symptoms. In addition, we’re also struggling with the surgical side of things."

At start of the pandemic, the American College of Surgeons called on physicians to halt nonessential procedures. Most people assume that means facelifts or perhaps knee replacements that could be temporarily delayed without too much harm to the patient. But elective surgery is, by definition, any surgery that is scheduled. That includes cancer surgery, organ transplants, and other lifesaving procedures, many of which are now on hold. Though the guidelines specify that treatment shouldn't be delayed if it would harm a patient, many surgeries remain in limbo.

"We are not able to take patients to the operating room right away, even when we feel like it’s necessary, because of hospital restrictions that are based on the number of COVID cases in our communities," Weinberg says. Those restrictions aren't always due to a lack of capacity to treat patients but more about trying to preserve ventilators, PPEthe protective equipment like masks and gowns that are in short supplyand ICU beds for patients with the virus.

Of course doctors are also concerned about bringing patients who may already be immunocompromised into hospitals where they may be exposed to the virus, Weinberg says.

"For ovarian cancer we do have the benefit of the fact that we can treat our patients with upfront chemotherapy" rather than doing the surgery first. "We know from several studies that the outcomes are just as good if we consider doing neoadjuvant chemotherapy" where doctors start with chemotherapy and then follow that up with surgery after about three or four cycles of treatment”in certain scenarios. This gives us the opportunity to wait out these surges in COVID patients and still care for our patients the best way we can."

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Dr. Lori Weinberg is a gynecologic oncologist with Minnesota Oncology. Read More

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