Delayed Urological Cancer Care during the COVID-19 Pandemic: Urologists' Experience. Issue 3 (30th May 2021)

• Record Type: Journal Article
• Authors: Wittmann, Daniela; Faris, Anna; Montie, James E.; Chisholm, Stephanie; Duby, Ashley; O'Dell, Diana; Sarle, Richard; Johnston, William K.; Morgan, Todd M.; Hawley, Sarah T.; An, Lawrence C.; Herrel, Lindsey A.
• Is Part Of: Urology practice. Volume 8:Issue 3(2021)
• Page Start: 367
• Page End: 373
• Publication Date: 2021-05-30
• Subjects: COVID-19 -- urologic neoplasms -- time-to-treatment -- physician distress -- emotional distress
• DOI: 10.1097/UPJ.0000000000000210
• Languages: English
• ISSNs: 2352-0779

Abstract

Abstract: Introduction: The arrival of coronavirus disrupted health care systems and forced delays in cancer treatment. We explored the experience of urologists who had to delay their patients' cancer care. Methods: Urologists who treat prostate, bladder, and renal cancers, selected through purposive sampling, responded to a survey about cancer treatment delay. They were asked about their practice setting, decision making and interactions with patients, and they were asked to reflect on their personal experience. A 0 to 10 point scale, modeled on the National Comprehensive Cancer Network' Distress Thermometer (NCCN-DT), validated for cancer patients with cancer, was used to estimate physician distress. We used descriptive statistics to analyze survey results. Results: Of the 64 participating urologists, 98% delayed surgical treatment; fewer delayed cases of advanced cancers (42% for ≥T3/T4 or Gleason ≥8 prostate cancers, 58% for muscle invasive bladder cancer, 61% for ≥T2 renal cancers). They reported feeling anxious (44%) and helpless (29%), and their median distress score was 5 (range 0–10). They relied on their own risk assessments (67%) and consulted colleagues (56%) and national guidelines (53%) when making treatment deferral decisions. They identified a number of concerns as they resumed surgeries. Conclusions: Based on a comparison to the NCCN-DT clinical cutoff distress level of 4, urologists experienced moderately high levels of distress as they delayed cancer care during the COVID-19 pandemic and expressed concerns going forward. While the focus on patient care is paramount in a pandemic, it is important to recognize physician distress and develop practical and psychological strategies for distress mitigation.