COVID-19 Has Changed Surgery and Hospital Protocols for Ovarian Cancer Patients

For patients diagnosed with ovarian cancer, an initial surgery within a few weeks of diagnosisfor staging the cancer or what's called a debulking surgery, to remove all visible diseaseis usually recommended. However, the pandemic can make that decision less clear cut for several reasons: the increased risk of infection for patients, and also that in some communities hard hit by the virus, hospitals are restricting scheduled surgeries even if doctors feel they are necessary.

Despite the changes to cancer care necessitated by the pandemic, and the fact that many patients may have to check in with their doctors via tele-health visits at least temporarily, the oncologists SurvivorNet regularly consults assure us that cancer care isn't being compromised. In cities and hospitals that have been harder hit by the virus some doctors are delaying up-front surgery and giving patient a few more courses of chemotherapy until it's safer for them to undergo procedures. Though most cancer surgery would be considered at least semi-urgent, there may be situations where it can be safely delayed a little bit, one oncologist said.

Patients need to discuss their own situation with their doctor, taking into account conditions in the city where they live, to determine the wisest course of action for them.

If You Are Scheduled for Surgery…

If your doctor decides to proceed with surgery, and elective surgeries are being scheduled at your hospital, then it's super important to follow healthy lifestyle practices prior to surgery to support your immune system. Though these are important at any stage of the cancer journey, they're imperative during the pandemic, to maintainand maybe even boostimmune system strength.

Tips for keeping your immune system strong include:

• Getting enough healthy, restful sleep. Try for 7-8 hours of good quality sleep nightly
• Not smoking
• Avoiding foods that cause inflammation (simple sugars found in products such as cookies, cakes, candies, and soda)
• Eating a nutrient-rich diet of fruits, veggies, whole grains, and lean meats
• Striving for daily physical activity. During the pandemic choose exercises that can be done in and around the home such as push-ups and other calisthenics, short walks, indoor treadmills, and stationery bicycles

Expect Some Changes in the Hospital Setting

"I think the major [change] that patients may experience [having] surgery during COVID-19 is that there are limitations [on] hospital visitorswhich is a big deal in terms of having that support system," says Dr. Kimberly Levinson, Director of Johns Hopkins Gynecologic Oncology at Greater Baltimore Medical Center. "It's a different experience for patients being by themselves, then going into surgery and having people come in in masks, in shields, a lot of garb and gear. While [that part is] short because they're off to sleep pretty quick, it is different than our usual protocol.

“Also, we have completely different procedures in terms of getting patients to the OR, getting them asleep, and doing what we call intubation, or getting them on the ventilator for their surgery," Dr. Levinson adds. That’s to protect the healthcare teamthe nurses and doctors in the room, “because any procedures that require access to the airway system and to the lungs are higher risk if a patient were to be COVID positive.

“So [now] we have a specific team that does all of those procedures for the day in the hospital. And everybody exits the room when that is happening. Usually the patient is off to sleep and doesn’t realize a lot of that’s going on, but most of the time, outside of this time, I would be right by my patient’s side when they’re going off to sleep. And that’s something that right now I can’t do."

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