THREAD: I’ve been a consultant cancer specialist for 15yrs. Seasonal flu has NEVER seriously impacted my clinical practice.
On the contrary #COVID19 has had a dramatic impact, so all those on social media calling to end lockdown need to understand the seriousness of this pandemic
On the contrary #COVID19 has had a dramatic impact, so all those on social media calling to end lockdown need to understand the seriousness of this pandemic
For starters, I’ve been assigned to the #COVID19 wards rota. Somewhat scary for a non-acute physician, but actually a privilege to be able to help the dedicated teams on the frontline.
Meanwhile, the cancer service must continue.....
Meanwhile, the cancer service must continue.....
I am now doing mainly teleconsultations for routine follow up and treatment follow ups. Still bringing most new patients, and patients I’m worried about, to my clinics for full assessment. To be fair, this could be a good new way to do a lot of my work in future.
In terms of treatment decisions, this has been a tough new world for oncologists. We lack the data to accurately guide us and we are taking a pragmatic approach based on national and international expert consensus opinion. Practice has definitely changed and continues to change.
I manage lung cancer and prostate cancer and am now giving less chemotherapy. Eg We have stopped giving adjuvant chemotherapy to lung cancer patients after lung surgery. This will reduce cure rate by at least 5% in these patients. Same is true for breast cancer
We have also deferred all curative prostate radiotherapy. I am less concerned about this because it won’t effect mortality because we can cover the higher risk patients with hormone treatment. However, there’s going to be a huge backlog to address when we lift restrictions
Interestingly, I’m actuality giving more lung cancer radiotherapy than ever before, because the surgeons are operating much less due to #COVID19 risks, and we can use stereotactic radiotherapy to treat early stage lung cancer as a very good alternative to surgery.
So whilst the amazing thoracic surgeon, @joeldunning in Middlesbrough, has retrained in ITU nursing to help with the #COVID19 pandemic, I can do his operations without a knife, using stereotactic radiotherapy!
In summary, social commentators who want to reopen the country on the basis that they think the #COVID19 pandemic is no worse seasonal flu, are dangerously wrong. Stay at home as per advice. It’s tough, but we need to hang in there. The public have been amazing so far. Keep it up
