Abstract
COVID-19 pandemic has had a catastrophic impact on the society, economy and heath-care system all over the globe with virus showing no signs of losing potency. As the situation appears to worsen, extra burden on other specialities like oncology seems to increase. Specific recommendations are necessary for management of cervical cancer in the current context. All concerned specialities must work together in the best interest of the patient. Attempts should be made at managing cervical cancer while limiting the viral spread among the patients and health-care workers without the loss of opportunity. Surgical intervention for early cervical cancer should be postponed or alternative modalities be considered. In a locally advanced disease, concurrent chemoradiation is the treatment of choice. In addition, the following under mentioned suggestions aim to discuss ways of minimizing infection spread, workload rationalization and providing guidance for management of cervical cancer in the presence of COVID-19 infection.
Highlights
Corona Virus Disease-19 (COVID-19) was declared a worldwide pandemic by World health organization (WHO) on March 11, 2020
In the face of challenges posed by the COVID-19 pandemic, we have attempted to review the literature for providing the strategies to optimize clinical practice for cervical cancer patients with maximal safety and efficacy, while alleviating the extra burden on health-care system especially in a developing country like ours
Extended field radiotherapy is recommended for gross paraaortic disease or electively in case of a) Positive Common Iliac Node and/or b)>3 pelvic nodes.[14]
Summary
Corona Virus Disease-19 (COVID-19) was declared a worldwide pandemic by World health organization (WHO) on March 11, 2020. In the face of challenges posed by the COVID-19 pandemic, we have attempted to review the literature for providing the strategies to optimize clinical practice for cervical cancer patients with maximal safety and efficacy, while alleviating the extra burden on health-care system especially in a developing country like ours. Cervical cancer is considered a ‘Category 1’ disease, i.e. rapidly growing tumors with a short volume doubling time in whom prolongation of treatment beyond 2 days should be avoided for 95% of the patients.[5] Shen et al noted a significant decrease in 1 year and 5 year survival, if cervical cancer treatment was delayed and delivered >4 months after the initial diagnosis.[6] Aim should be to provide best possible care for cancer patients keeping in mind the safety of the patients, their families and the health-care workers. The following considerations have been briefly summarized for management of cervical cancer patients in the present COVID-19 scenario. (d) Medium or low priority is assigned to patients with suspicion of tumor recurrence and for follow-up patients
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