Management of Cancer Patients during Coronavirus Disease 2019 Pandemic: A Literature Review

Abstract
Introduction: The number of confirmed cases of Coronavirus Disease 2019 (COVID-19) in the world has been increasing significantly since December 2019. Cancer patients are one of the vulnerable populations to become severe cases of COVID-19 or death when they are contacted with COVID-19. A treatment delay is associated with higher breast cancer-specific mortality and all-cause mortality. However, there is still limited data about how to manage cancer patients in this pandemic of COVID-19. This study aims to appraise the current evidence about the management of cancer patients during the COVID-19 pandemic.Method: We searched and found 16 articles evaluating the management of cancer patients during the COVID-19 pandemic by searching in PubMed and EMBASE databases. We only included articles discussing COVID-19 and cancer in adults. There were three observational trials, four review articles, two case reports, six letters to the editor, and one guideline.Results: There were several recommendations regarding patient care in the COVID-19 era. Firstly, outpatient visits, such as follow-up and surveillance of cancer patients, should be postponed. Alternatively, they can do teleconsultation, and their drugs will be delivered to their homes. Stratification and screening for the risk of COVID-19 infection should be done to those who needed urgent or emergency surgery. Otherwise, elective surgery should be postponed. However, several cases can be proceeded after discussion in the Multidisciplinary Team (MDT). Adjuvant and palliative chemotherapy should also be done as scheduled after discussing in MDT. Patients with ongoing radiation treatment should be continued as daily scheduled. Meanwhile, new patients should be carefully evaluated, and those with stable cancer can be postponed for treatment Conclusions: There is still scarce evidence related to the management of cancer patients during the COVID-19 pandemic. Further studies, in terms of stratification, risk, and management of cancer patients during the pandemic, need to be done to get better evidence on it.