Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
Sci Prog. 2021 Apr-Jun;104(2):368504211010626. doi: 10.1177/00368504211010626.
The Coronavirus (COVID-19) pandemic had a huge impact on all sectors around the world. In particular, the healthcare system has been subject to an enormous pressure that has surpassed its ability in many instances. Additionally, the pandemic has called for a review of our daily medical practices, including our approach to colorectal cancer management where treatment puts patients at high risk of virus exposure. Given their higher median age, patients are at an increased risk for severe symptoms and complications in cases of infection, especially in the setting of immunosuppression. Therefore, a review of the routine colorectal cancer practices is needed to minimize risk of exposure. Oncologists should weigh risk of exposure versus the patient's oncologic benefits when approaching management. In addition, treatment protocols should be modified to minimize hospital visits and admissions while maintaining the same treatment efficacy. In this review, we will focus on challenges that colorectal cancer patients face during the pandemic, while highlighting the priority in each case. We will also discuss the evidence for potential modifications to existing treatment plans that could reduce infectious exposure without compromising care. Finally, we will discuss the impact of the socio-economic difficulties faced by Lebanese patients due to a poor economy toppled by an unexpected pandemic.
冠状病毒（COVID-19）大流行对全球各地的所有行业都产生了巨大影响。特别是，医疗保健系统承受了巨大的压力，在许多情况下，其能力已超过极限。此外，大流行要求我们对日常医疗实践进行审查，包括我们对结直肠癌管理的方法，因为治疗会使患者面临很高的病毒暴露风险。鉴于他们的中位年龄较高，感染后患者的严重症状和并发症风险增加，尤其是在免疫抑制的情况下。因此，需要对常规结直肠癌实践进行审查，以最大程度地降低暴露风险。肿瘤学家在处理管理问题时，应权衡暴露风险与患者的肿瘤学益处。此外，应修改治疗方案，以减少医院就诊和住院次数，同时保持相同的治疗效果。在本次审查中，我们将重点讨论结直肠癌患者在大流行期间所面临的挑战，同时突出每个病例的重点。我们还将讨论对现有治疗计划进行潜在修改的证据，这些修改可以在不影响护理的情况下降低感染暴露的风险。最后，我们将讨论黎巴嫩患者因经济不佳和意外大流行而面临的社会经济困难的影响。
