Experts Discuss How COVID-19 Has Impacted Gynecologic Oncology Practices

A group of gynecologic oncologists spoke to the challenges they have seen in their clinics in the face of the coronavirus disease 2019 (COVID-19) pandemic.

Chad A. Hamilton, MD, of the Inova Health System, says that almost every facet of business has been impacted by COVID-19, although it depends a lot on the prevalence of COVID-19 in different areas of the country. At his center in Virginia, there are many changes the patient will see within their first 15 minutes of walking into the clinic, which includes the removal of chairs in the waiting room; limited number of companions they can bring, although most times these family members and caregivers are asked to wait in the car; and everyone is masked.

Thomas C. Krivak, MD, of the Allegheny Health Network in Pennsylvania, notes that his area, Pittsburgh, is a lower impact area than others, and his institution was ahead of the game as they had converted to telemedicine fairly early on during the pandemic. However, patients with gynecologic cancers have limitations in regard to what visits can be done virtually. An important part of their visits is the pelvic exam, which telemedicine can not accommodate.

There is a lot of fear in patients, but Krivak says he is more comfortable coming into work than going somewhere like the grocery store because of all the screening questions at the door and extra precautions being taken in the hospital setting. However, the clinic is seeing about 40% fewer patients than they used to, and he expects there will be a delay in diagnosis over the next few months for patients with gynecologic cancers.

Shannon N. Westin, MD, of The University of Texas MD Anderson Cancer Center, agrees that patients aren’t necessarily seeing their physicians or are possibly deferring visits for evaluation of symptoms of concern. At her center in Texas, they are beginning to see patients again with the normal precautions Hamilton mentioned, but the majority of visits are still telemedicine-based. However, she is beginning to see new patients and new consults in person when it’s possible or necessary.

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