Elective Surgeries For Cancer Are Coming Back — Louisiana Is The Latest State To Relax Regulations

“We know that cancer patients are immunocompromised, whether they are new or previous cancer patients, so they can have worse outcomes with Covid-19 infections so we are very careful with our cancer patients,” Dr. Kelly Finan, a colon and rectal surgeon at Mary Bird Perkins Our Lady of the Lake Cancer Center in Baton Rouge, Louisiana, tells SurvivorNet.

Dr. Finan says that surgeries at Lady of Lake have been shut down for five weeks as opposed to other hospitals who have had a lengthier shut down. Now that surgeries have been given a green light, Dr. Finan says she and her team are determining which delayed surgeries will be rescheduled immediately through a case-by-case basis.

“For us, we are looking for patients who have been waiting with cancer, so colon cancer. People who have completed their neoadjuvant therapy for rectal cancer or if someone had a poor response to therapy we really want to get them to the operating room. And I think with people who don’t have other treatments possible, like early stage cancers, we don’t want them to progress so those are the patients we’re really looking at who don’t have other means of offering chemotherapy or radiation to them to slow their progression so we also want to get them to the operating room.”

Additionally, Dr. Finan says patients with biopsy positive cancer or high grade dysplasia where surgeries can possibly cure them will also be prioritized. However, Dr. Finan is vehement about having open and transparent conversations with patients to determine whether they’re comfortable going forward with surgery during this uncertain time.

“It’s a different health care setting it was six months ago,” Dr. Finan says.

Surgeries Going Forward During Covid-19

Similar to Louisiana, some Texas hospitals have also started rescheduling delayed elective surgeries for cancer patients under revised regulations. Hospitals may sign up to dedicate 25% of their capacity to Covid-19 patients, and restrictions on surgeries will be lifted.

"The goal is to get the patient taken care of as quickly as possible," Dr. Allison DiPasquale of Texas Oncology tells SurvivorNet in a separate interview. "They're very excited about this as their next step, and the good news is that we're going to get to these patients very quickly and we're going to give them the exacting care that we would have even if Covid-19 hadn't happened. That's the good news for these patients."

While some hospitals are starting to lift surgery restrictions, that doesn’t mean cancer patients haven’t been receiving care during Covid-19. Dr. Heather McArthur, the Medical Director of Breast Oncology at Cedars-Sinai Medical Center in Los Angeles, told SurvivorNet that she is still enrolling patients in clinical trials and treatment options are still available despite disruptions caused by the virus.

"I don't want my patients to lose hope or think that their future is compromised because of this pandemic,” Dr. McArthur says.

Determining whether a surgery must be done immediately or can be postponed is a case-by-case basis, according to Dr. Stephen Freedland, Director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai.

"I think it really is a discussion with the patient," Dr. Freedland says. "Can this safely be delayed for a period of time? I think the challenge is if we knew this would be two or three months it would be one discussion, but we don't know how long this will be delayed."

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