Allocating Scarce Health Care Resources During Pandemics: Making the Case for Patients with Advanced and Metastatic Cancer. (27th August 2020)

• Record Type: Journal Article
• Authors: Langston, Amelia A.; Quest, Tammie E.; Abernethy, Eli Rowe; Campbell, Gavin Paul; Owonikoko, Taofeek K.; Pentz, Rebecca D.
• Is Part Of: Oncologist. Volume 25:Number 10(2020)
• Page Start: e1586
• Page End: e1588
• Publication Date: 2020-08-27
• Subjects: Oncology -- Periodicals; Tumors -- Periodicals; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Oncology; Tumors; Neoplasms; Electronic journals; Periodicals; Periodicals; 616.994
• DOI: 10.1634/theoncologist.2020-0442
• Languages: English
• ISSNs: 1083-7159

Abstract

Abstract: The oncology community is concerned that patients with cancer will be unfairly classified in pandemic allocation guidance. Past guidance either excluded patients with metastatic cancer from consideration or categorized them as having a survival of less than 1 year. Given recent improvements in treatments, we recommend that the prognosis of an individual patient with cancer be determined with input from a cancer specialist or, if this is impractical, that the presence of active metastatic solid cancer or relapsed hematologic malignancy is graded as a major comorbidity, with a likelihood that survival will be less than 5 years; severe limitation in physical functioning (3 or 4 on the Eastern Cooperative Oncology Group performance status) would define a patient with advanced cancer as having a severe comorbidity, with a likelihood of less than 1 year of survival. Cancer may be the "Emperor of all Maladies, " but it is no longer a certain death sentence. Abstract : The COVID‐19 pandemic has stressed the health care system, prompting the need for guidance on the most equitable steps to follow for the emergency allocation of critical care resources. It is important that such guidelines treat all patients fairly during the pandemic, including patients with cancer, whose diagnosis need not be considered terminal.