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Older Cancer Patients during the COVID-19 Epidemic: Practice Proposal of the International Geriatric Radiotherapy Group

Department of Radiation Oncology, Howard University, Washington, DC 20060, USA
Department of Radiation Oncology, University Hospital of Martinique, 97200 Fort-de-France, France
Institute of Radiation Oncology, Cantonal Hospital Graubuenden, 7000 Chur, Switzerland
Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Department of Radiation Oncology, Sant Joan de Reus University, University Rovira I Virgili, 43201 Tarragona, Spain
Department of Radiation Oncology, Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy
Department of Radiation Oncology, Fernando Pessoa Canarias Las Palmas University, 35001 Las Palmas, Spain
Department of Radiation Oncology, Clatterbridge Cancer Center, Liverpool CH63 4JY, UK
Department of Radiation Oncology, Arnau de Vilanova University Hospital, 25198 Lleida, Spain
Department of Radiation Oncology, Prof. Dr. Ion Chricuta Oncology Institute, 400015 Cluj-Napoca, Romania
Department of Radiation Oncology, McGill University, Jewish General Hospital, Montreal, QC H3T1E2, Canada
Department of Radiation Oncology, AMDI, Universiti Sains Malaysia, Penang 13200, Malaysia
Department of Radiation Oncology, Instituto Portugues de Oncologia do Porto Francisco Martins Porto E.P.E, 4200-072 Porto, Portugal
Department of Radiation Oncology, International Geriatric Group, Washington, DC 20001, USA
Department of Radiation Oncology, Baclesse Cancer Center, 14000 Caen, France
Author to whom correspondence should be addressed.
Cancers 2020, 12(5), 1287;
Received: 21 April 2020 / Revised: 12 May 2020 / Accepted: 15 May 2020 / Published: 19 May 2020
(This article belongs to the Special Issue The Impact of COVID-19 Infection in Cancer)
The coronavirus disease 19 (COVID-19) pandemic is unprecedented as it reached all countries in the world within a record short period of time. Even though COVID-19 infection may be just severe in any adults, older adults (65-year-old or older) may experience a higher mortality rate. Among those affected, cancer patients may have a worse outcome compared to the general population because of their depressed immune status. As the health resources of most countries are limited, clinicians may face painful decisions about which patients to save if they require artificial ventilation. Cancer patients, especially the older ones, may be denied supportive care because of their shorter life expectancy. Thus, special considerations should be taken to prevent infection of older cancer patients and to provide them with adequate social support during their cancer treatment. The following proposal was reached: (1) Education of health care providers about the special needs of older cancer patients and their risks of infection. (2) Special consideration such as surgical masks and separate scheduling should be made to protect them from being infected. (3) Social services such as patient navigators should be provided to ensure adequate medical supply, food, and daily transportation to cancer centers. (4) Close monitoring through phone calls, telecommunication to ensure social distancing and psychological support from patient family to prevent anxiety and depression. (5) Shorter course of radiotherapy by use of hypofractionation where possible to decrease the needs for daily transportation and exposure to infection. (6) Enrollment of older cancer patients in clinical trials for potential antiviral medications if infection does occur. (7) Home health care telemedicine may be an effective strategy for older cancer patients with COVID-19 infection to avoid hospital admission when health care resources become restricted. (8) For selected patients, immunotherapy and targeted therapy may become the systemic therapy of choice for older cancer patients and need to be tested in clinical trials. View Full-Text
Keywords: older; cancer patients; epidemic; corona virus 19; treatment older; cancer patients; epidemic; corona virus 19; treatment
MDPI and ACS Style

Nguyen, N.P.; Vinh-Hung, V.; Baumert, B.G.; Zamagni, A.; Arenas, M.; Motta, M.; Lara, P.C.; Myint, A.S.; Bonet, M.; Popescu, T.; Vuong, T.; Appalanaido, G.K.; Trigo, L.; Karlsson, U.; Thariat, J. Older Cancer Patients during the COVID-19 Epidemic: Practice Proposal of the International Geriatric Radiotherapy Group. Cancers 2020, 12, 1287.

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