#WhatHCPsthink about COVID-19’s impact on cancer diagnosis and treatment

This article was first published on Pharmaphorum as part of our What HCPs Think series.

The COVID-19 pandemic has been mainstream headline news throughout 2020, as it continues to have a profound impact on all our lives. One of the areas of concern is the effect that COVID-19 is having on other areas of healthcare, particularly cancer diagnosis and treatment. CREATION.co were keen to understand what healthcare professionals (HCPs) felt about cancer diagnosis and treatment during the pandemic to bring to light the views of the HCPs for the development of solutions.

To answer this question, CREATION.co took a new approach to understanding the HCP conversation, and for the first time used public social media in collaboration with Sermo’s HCP survey platform, Sermo RealTime. This platform provides real time access to physician insights. When analysing the social media conversations within oncology and COVID-19 around cancer diagnosis, we saw that a small proportion of the conversation further described the causes for concern in diagnosis and treatment of cancer. Using Sermo RealTime we were able to look into those conversations that HCPs were already having online to provide a full picture of HCPs’ concerns and needs. By designing fast surveys based on insights from the online conversation empowered by our current observations of HCP perspectives, we get a powerful depth of insight. For the survey we recruited oncologists from the United States, United Kingdom and Spain.

HCPs shared concern for decreased cancer diagnosis

During the COVID-19 pandemic, delayed or decreased cancer diagnosis was highlighted by HCPs as a key concern. Many prominent figures, such as Oncologist and ex-director of the WHO Cancer Programme Professor Karol Sikora, shared news articles and utilised their networks to raise awareness of decreased cancer diagnosis.

In a usual April, we would normally see around 30,000 people diagnosed with cancer. I would be surprised if that number reaches 5,000 this month.

We are sleepwalking into a massive crisis and cancer patients will die unnecessarily if we don’t act now.https://t.co/mcy4Da1RrN

— Professor Karol Sikora (@ProfKarolSikora) April 22, 2020

However, only a fraction of HCPs explained why they experienced a decrease. Knowing the “why” can help to address the specific challenges that hospitals are facing to ensure patients are receiving the care they need.

Using Sermo RealTime to ask physicians to rank why they believe there has been a decrease in diagnosis at their hospital or practice, we discovered that cancelling of appointments by the hospitals was perceived to have caused the most impact. The reason that was ranked next as the most impactful was hospital staff being diverted to the COVID-19 effort. Knowing these reasons could help with resource allocation and impact assessments.

On social media, HCPs chose to encourage their peers to continue supporting their oncology patients during the COVID-19 pandemic. Again, key online influencers, such as Dr Tatiana Prowell – a well known medical oncologist specialising in breast cancer, were leading the call to continue to prioritise patients by raising awareness of the decreased diagnosis and the impact this will have long term. We have seen many HCPs supporting their peers online during the pandemic.

Great @Forbes piece on #COVID19nCancer by Dr. @MKnoll_MD

👉Personalize #cancer screening, esp in a #pandemic
👉Don’t confuse screening & diagnostic studies. Do not postpone the latter
👉Must ensure pts feel (& are!) safe w/ good #SARSCoV2 #infectioncontrol #advocacy #COVID19 https://t.co/sZalwwJwf0

— Tatiana Prowell, MD (@tmprowell) May 11, 2020

Uncertainty around cancer treatment shared by HCPs 

A significant part of the HCP conversation online discussed treatment of oncology patients during the COVID-19 pandemic. Physicians shared their concerns about delaying or changing treatment approaches and the impact this would have in the long term. When surveying physicians using Sermo RealTime, 79% of HCPs shared that they had delayed their patient’s treatment. While 52% of HCPs opted to change their patients’ treatment approach either by switching the drug their patient is on or changing the administration timing or dose. For the pharmaceutical industry this knowledge could help brand teams in their communication plans to best support HCPs during this time with their treatments and information or guidelines about treatment.

We regularly see HCPs share treatment guidelines on social media to provide support when there is confusion around new or existing treatment approaches, often creating their own guidelines when none exist.

ASCO Coronavirus Resources – FAQs ⁦@ASCO⁩ ‘Patients with diagnosed COVID-19 on active anti-cancer treatment, follow standard clinical management plans for delay or modification of cancer treatment in a patient with active infection’ https://t.co/AQUzNqJ1Be

— Aditya Bardia, MD (@dradityabardia) March 14, 2020

And in our survey of physicians using Sermo RealTime, 58% of respondents shared that regulatory guidelines have been their go-to source for information and advice for treatment during the COVID-19 pandemic, alongside consulting their peers. However, even HCPs’ go-to source did not always provide as much support as they would have liked, with some HCPs sharing that they are still unsure of the correct treatment for patients during the COVID-19 pandemic or for cancer patients that have COVID-19.

I know these guidelines are reasonable, but I am having a hard time deciding which of my cancer patients should continue treatment during #COVID19 outbreak and which can delay treatment for 3 mos.#noeasychoices #inthetimesofcoronavirus #lcsm @HemOncWomenDocs pic.twitter.com/kVTle1JWtI

— Dr. Estela Rodriguez (@Latinamd) March 28, 2020

When further surveying HCPs about how confident they were about the information and advice they have received about continuing treatment for their COVID-19 positive or negative cancer patients, 70% of physicians shared that they were “somewhat confident but consulted with their peers”, showing how important peers support is during this time.

Despite focusing on the here and now HCPs also look to the future

As COVID-19 continues to affect countries around the world, HCPs are concerned about the short term and long term implications this pandemic will have on patient diagnosis and care. Despite having to respond reactively day-to-day, and the focus on the here and now, the future is still on HCPs’ minds. Dr Stephanie Graff, a breast cancer oncologist, shared her concerns about “what this might mean long term—stage at diagnosis for example”, and how to bring patients safely back to care.

I am worried about what this might mean long term—stage at diagnosis for example. I also worry about the way forward to bring everyone safely back to care. #COVID19 #bcsm https://t.co/vJiQAOKD0n

— Stephanie Graff, MD, FACP, FASCO (@DrSGraff) May 7, 2020

When physicians in our survey were asked what some of the key concerns are for them going forward, they shared the backlog of patient cases that will need manual review and further investigations, switching to less effective or immunosuppressive treatments, and patients hesitancy or distress preventing them getting treatment. Others also shared the same concern as Dr Graff, that cancer patients present at a later stage because of backlogs and hesitancy to come to hospitals having a much larger impact on the treatment approach for these patients.

Across both open and closed online networks HCPs are concerned about the future of patient care.

This paper clearly shows a danger even worse than COVID-19 which is the lack of cancer diagnosis and a future excess of more advanced cancer diagnosis #OncoAlert #lancet https://t.co/TZGOeH1nx5

— Marina Garassino (@marinagarassino) May 1, 2020

The online HCP conversation continues at a steady rate each day with oncologists, nurses and specialists continuing to share their concerns and needs online among their peers. Throughout the year, HCPs still continue to seek the answers they are looking for and share resources to help online.

https://twitter.com/Jessica_Bate/status/1323915624259735553

These concerns all present opportunities for pharmaceutical companies, hospitals, advocacy groups and medical organisations to support HCPs in very specific areas. Listening to the voices of HCPs online, especially as they are more active during this time, can help you discover key areas for engagement and support, and identify potential remedies.

Using Sermo RealTime alongside public social media is a new more comprehensive approach to understanding HCPs’ perspectives. This project has revealed much to the CREATION.co team and we are excited to continue to use this method of investigation to continue to deepen and enrich the world’s only source of verified HCP insights.

To stay up to date on all the latest HCP insights, sign up to the monthly CREATION Knowledge eJournal or get in touch, we’d love to help.