Gastrointestinal oncology in the midst of the COVID-19 pandemic

The COVID-19 pandemic which we are currently witnessing, and will hopefully live through, will undoubtedly impact how we practice medicine and provide oncologic care. It remains to be seen how the pandemic will impact the global cancer burden and more specifically gastrointestinal cancers, in particular, the worldwide common gastric, liver hepatocellular carcinoma (HCC), and colon cancers.

Liver function test abnormalities have been attributed to COVID-19 although clinically significant liver injury appears to be uncommon (1) and maybe inconsequential (2).

Within the gastrointestinal oncology world the potential side effects of chemotherapeutic, targeted therapy, and immunotherapy agents remain to be seen in the setting of COVID-19. To date, there is limited published data to rely upon, although there is one report of a patient with HCC and liver transplantation who recovered (3).

Nonetheless data is sparse and we need to remember that we are at the beginning of understanding how to treat COVID 19 and understanding the impacts on the gastrointestinal tract and related cancers (4).

As the medical community works toward understanding COVID-19 and its impact on human health the opportunities for learning are substantial, and will be tackled over generations to come. The social distancing has enhanced our virtual connectivity with patients and embrace new practices for delivery of medical care. We acknowledge the gains but also the limitations of virtual medical care. Does every symptom need to be assessed in clinic? Can we introduce virtual care as standard practice? Can we provide the most prescribed treatment of reassurance virtually? These virtual practices transcend many physical boundaries and we are witnessing a very rapid period of change in the delivery of medical care. More to come in the “AC” (After-COVID-19) era!

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the Guest Editor (Ghassan Abou-Alfa) for the series “Global perspectives on digestive diseases” published in Digestive Medicine Research. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/dmr-2020-10). This series “Global perspectives on digestive diseases” was commissioned by the editorial office without any funding or sponsorship. GKAA reports grants from Genoscience, Polaris, personal fees from Genoscience, Gilead, Polaris, during the conduct of the study; grants from ActaBiologica, Agios, Array, Astra Zeneca, Bayer, Beigene, BMS, Casi, Celgene, Exelixis, Genentech, Halozyme, Incyte, Mabvax, Polaris Puma, QED, Roche, personal fees from Agios, Astra Zeneca, Autem, Bayer, Beigene, Berry Genomics, Bioline, Celgene, CytomX, Debio, Eisai, Eli Lilly, Flatiron, Genentech, Genoscience, Incyte, Ipsen, LAM, Loxo, Merck, MINA, QED, Redhill, Roche, Silenseed, Sillajen, Sobi, Targovax, Therabionics, Twoxar, Yiviva, outside the submitted work; In addition, GAA has a patent ARTICLES AND METHODS FOR PREVENTING AND TREATING DERMATOLOGIC ADVERSE EVENTS, identified by International Patent Application No. PCT/US2014/031545 filed on March 24, 2014, and priority application Serial No.: 61/804,907; Filed: March 25, 2013 licensed. GKAA serves as the unpaid guest editor of this series and serves as an unpaid editorial board member of Digestive Medicine Research from Dec. 2019 to Nov. 2021.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

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