F
rom currently available data, almost all cancer patients are at higher risk of COVID-19
related
mortality, and older people (men more than women) appear to be at higher risk of
COVID-19
related
mortality than younger people. Thus, efforts to reduce the risk of exposure of COVID-19
to all
patients are needed, for example with reduction in the frequency of follow-up visits and
replacing
in-person visits with telephone or remote telemedicine (Skype, Zoom,
Liyfe are some free ones) follow-up.
All asymptomatic routine follow-up patients may be rescheduled for three months or
longer. The
majority of patients who have recently completed chemo therapy or radiotherapy can
safely have
their
follow-up extended by two to three months or more, with telemedicine as needed.
There are published data on nurse-led telephone follow-up and virtual PSA monitoring
suggesting
that
prostate cancer patients can be monitored remotely unless symptomatic or with concerns
for
clinical
progression.
A small study randomizing lung cancer patients to symptom-based follow-up versus routine
imaging
found a survival benefit favoring symptom-based strategy. Whether telephone follow-ups
can
substitute in the short term for in-person visits is unknown.