Challenges in Managing Head and Neck Cancer During Pandemic: Experience of an Institution
DOI:
https://doi.org/10.31344/ijhhs.v6i0.414Keywords:
Head and neck cancer, chemoradiotherapy, pandemicAbstract
Objectives: Head and neck cancers are not uncommon, they represent approximately eight percent of all malignancies according to the site and specifically, nasopharyngeal carcinoma is the fourth most common malignancy in Malaysia. The challenges in managing these tumours are often reflected by multimodality treatment which requires a multidisciplinary team and multicentre involvement. Head and neck cancers often require postoperative chemoradiotherapy to achieve a complete response. Before the pandemic, patients were already at risk of delayed treatment due to multiple factors mentioned and the lack of radiotherapy centres in the country. The outbreak of COVID-19 added significant challenges and treatment dilemmas caused by quarantines, hospitalisation, screening protocols, illnesses and lockdowns interfering with patients' movement.
Method: Our centre received 144 newly diagnosed head and neck cancer patients during the period of March 2020 to August 2021. Standard treatment protocol for these patients includes uninterrupted chemoradiotherapy and multiple imaging scans and CT simulation.
Results: Three patients infected by COVID-19 during the treatment with additional 13 patients faced interruptions and delayed management due to the quarantine order as close contacts. An average delay of 10 days was observed during the period. All patients managed to complete treatment planned for them despite the challenges mentioned, made possible by vigorous team efforts, repeated RTK screenings whenever indicated, extra man-hours and multiple reminders and advice. Subsequent followups and clinical surveillance will determine whether the treatment response and survival rate are affected by disruption in the treatment process.
Conclusion: In conclusion, the COVID-19 pandemic has significantly caused difficulties in managing head and neck cancers in our centre. However, multiple solutions created managed to minimise the risk of incomplete treatment.
International Journal of Human and Health Sciences Supplementary Issue: 2022 Page: S24
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Copyright (c) 2022 Muhamad Yusri Musa, Jasmin Jalil, Siti Hajariah Kamarrudin, Gokula Kumar Appalanaido
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