Lessons from the COVID-19 Pandemic: A New Paradigm in Treating Patients with Colorectal Cancer

Main Article Content

Budhi Ida Bagus http://orcid.org/0000-0002-0310-7415

Abstract

Starting in 2020 and continuing for 2 years thereafter, the COVID-19 pandemic has greatly affected routine clinical practice, particularly in treating patients with gastrointestinal cancer. Delay, postponement or refusal to continue multimodal treatment have increased the number of emergency cases, and consequently patient morbidity and mortality.


Many recommendations have been announced to guide the adaptation of clinical practice during and after the COVID-19 pandemic. Although early diagnosis and screening should proceed as usual before the pandemic, adjuvant treatment for patients with gastrointestinal cancer should be evaluated in the future. For example, during the pandemic, most recommendations state that adjuvant treatment for patients with colorectal cancer is still required, and many adaptations have been suggested according to local conditions.


In some instances, 6 months of adjuvant chemotherapy has been modified to an optional 3 month duration. A common challenge is that most patients remain unsure about the decreased chemotherapy duration, although many guidelines recommend this modified treatment strategy. Short term follow up has already indicated promising clinical outcomes of this modified adjuvant duration, but the long-term outcomes remain to be evaluated.

Keywords: colorectal cancer, COVID-19 pandemic, adjuvant treatment

Article Details

How to Cite
BAGUS, Budhi Ida. Lessons from the COVID-19 Pandemic: A New Paradigm in Treating Patients with Colorectal Cancer. Medical Research Archives, [S.l.], v. 11, n. 4, apr. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3700>. Date accessed: 28 mar. 2024. doi: https://doi.org/10.18103/mra.v11i4.3700.
Section
Case Reports

References

1. Madan A, Siglin J, Khan A. Comprehensive review of implications of COVID-19 on clinical outcomes of cancer patients and management of solid tumors during the pandemic. Cancer Med. 2020 Dec; 9(24):9205-9218. doi: 10.1002/cam4.3534. Epub 2020 Oct 20. PMID: 33078903; PMCID: PMC7774721.

2. Kopel J, Ristic B, Brower GL, Goyal H. Global Impact of COVID-19 on Colorectal Cancer Screening: Current Insights and Future Directions. Medicina (Kaunas). 2022 Jan 10; 58(1):100. doi: 10.3390/medicina58010100. PMID: 35056408; PMCID: PMC8778776.

3. Patel VR, Gereta S, Blanton CJ, Chu AL, Reddy NK, Mackert M, Nortjé N, Pignone MP. #ColonCancer: Social Media Discussions About Colorectal Cancer During the COVID-19 Pandemic. JCO Clin Cancer Inform. 2022 Jan;6:e2100180. doi: 10.1200/CCI.21.00180. PMID: 35025670.

4. Shah SK, McElfish PA. Cancer Screening Recommendations During the COVID-19 Pandemic: Scoping Review. JMIR Cancer. 2022 Feb 24;8(1):e34392. doi: 10.2196/34392. PMID: 35142621; PMCID: PMC8914792.

5. Barsouk A, Saginala K, Aluru JS, Rawla P, Barsouk A. US Cancer Screening Recommendations: Developments and the Impact of COVID-19. Med Sci (Basel). 2022 Mar 1;10(1):16. doi: 10.3390/medsci10010016. PMID: 35323215; PMCID: PMC8949858.

6. Gupta R, Gupta J, Ammar H. Impact of COVID-19 on the outcomes of gastrointestinal surgery. Clin J Gastroenterol. 2021 Aug;14(4):932-946. doi: 10.1007/s12328-021-01424-4. Epub 2021 Apr 29. PMID: 33928515; PMCID: PMC8083095.

7. Lesi OK, Igho-Osagie E, Walton SJ. The impact of COVID-19 pandemic on colorectal cancer patients at an NHS Foundation Trust hospital-A retrospective cohort study. Ann Med Surg (Lond). 2022 Jan;73:103182. doi: 10.1016/j.amsu.2021.103182. Epub 2021 Dec 15. PMID: 34931144; PMCID: PMC8673748.

8. Skowron KB, Hurst RD, Umanskiy K, Hyman NH, Shogan BD. Caring for Patients with Rectal Cancer During the COVID-19 Pandemic. J Gastrointest Surg. 2020 Jul;24(7):1698-1703. doi: 10.1007/s11605-020-04645-z. Epub 2020 May 15. PMID: 32415658; PMCID: PMC7228429.

9. Allaix ME, Lo Secco G, Velluti F, De Paolis P, Arolfo S, Morino M. Colorectal surgery during the COVID-19 outbreak: do we need to change? Updates Surg. 2021 Feb;73(1):173-177. doi: 10.1007/s13304-020-00947-8. Epub 2021 Jan 2. PMID: 33387170; PMCID: PMC7778389.

10. Balzora S, Issaka RB, Anyane-Yeboa A, Gray DM 2nd, May FP. Impact of COVID-19 on colorectal cancer disparities and the way forward. Gastrointest Endosc. 2020 Oct;92(4): 946-950. doi: 10.1016/j.gie.2020.06.042. Epub 2020 Jun 20. PMID: 32574570; PMCID: PMC7529970.

11. Wexner SD, Cortés-Guiral D, Gilshtein H, Kent I, Reymond MA. COVID-19: impact on colorectal surgery. Colorectal Dis. 2020 Jun;22(6):635-640. doi: 10.1111/codi.15112. Epub 2020 May 22. PMID: 32359223; PMCID: PMC7267609.

12. Tang G, Pi F, Tao J, Wei Z. Impact of the COVID-19 pandemic on surgical outcomes in patients undergoing colorectal cancer surgery: A retrospective study and meta-analysis of data from 11,082 participants. Front Public Health. 2022 Sep 29;10:907571. doi: 10.3389/fpubh.2022.907571. PMID: 36249184; PMCID: PMC9556652.

13. Patel S, Issaka RB, Chen E, Somsouk M. Colorectal Cancer Screening and COVID-19. Am J Gastroenterol. 2021 Feb 1;116(2):433-434. doi: 10.14309/ajg.0000000000000970. PMID: 33038127; PMCID: PMC7553028.

14. Kadakuntla A, Wang T, Medgyesy K, Rrapi E, Litynski J, Adynski G, Tadros M. Colorectal cancer screening in the COVID-19 era. World J Gastrointest Oncol. 2021 Apr 15;13(4):238-251. doi: 10.4251/wjgo.v13.i4.238. PMID: 33889276; PMCID: PMC8040064.

15. Mazidimoradi A, Tiznobaik A, Salehiniya H. Impact of the COVID-19 Pandemic on Colorectal Cancer Screening: a Systematic Review. J Gastrointest Cancer. 2022 Sep; 53(3):730-744. doi: 10.1007/s12029-021-00679-x. Epub 2021 Aug 18. PMID: 34406626; PMCID: PMC8371036.

16. Rottoli M, Gori A, Pellino G, Flacco ME, Martellucci C, Spinelli A, Poggioli G; COVID–Colorectal Cancer (CRC) Study Group. Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy. JAMA Netw Open. 2022 Nov 1;5(11):e2243119. doi: 10.1001/jamanetworkopen.2022.43119. PMID: 36409496; PMCID: PMC9679872.