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Pediatric proton treatment in the age of COVID

por John R. Fischer, Senior Reporter | March 14, 2022
Rad Oncology Pediatrics Proton Therapy
From the March 2022 issue of HealthCare Business News magazine

On a weekend trip home to see her family, a 10-year-old cancer patient contracted COVID-19. The little girl was undergoing proton therapy at Mayo Clinic for a brain tumor, and while not terribly sick, her doctors made the decision to halt treatment temporarily until she tested negative.

“Our infectious disease team did not feel comfortable bringing her to the clinic area while she just had the new infection,” her radiation oncologist Dr. Anita Mahajan told HCB News. “After a few days, we had to bring her back and make sure she was negative. It did interrupt her treatment a bit, but fortunately did not affect her final outcome.”

As the pandemic continues, decisions like this have become a fact of life across patient populations. This can be tough for cancer patients, as some cancers may be too progressive to stop treatment. The situation is even more complex for child cancer patients who have additional needs that the pandemic has only exacerbated. In addition, the safety of other patients and staff must be considered.

Mahajan says her institution has a plan in place for when treatment cannot be put off. “For patients [to whom] we cannot introduce a break, we then use the appropriate PPE, make sure the treatment is safe for them and that the room is safe for patients afterward. Since it’s a shared service, we delay their treatment to the end of the day and make sure the room is ready and cleaned for the next day. It was initially very disruptive and created a lot of anxiety, but we manage and we have developed protocols to keep everyone safe.”

Balancing COVID and proton therapy
Like Mayo, all proton facilities have protocols to protect patients and staff during the pandemic. At Cincinnati Children’s Proton Therapy Center, pediatric patients that require sedation for proton therapy must take a COVID test every 96 hours throughout their course of treatment. Those who do not require anesthesia are tested every 28 days, and any who are symptomatic will be tested and placed in isolation until results are confirmed.

But even if a child tests positive for COVID, the institution will not turn them away, says Mary Beth Morgan, RN coordinator for the Cincinnati Children’s Proton Therapy Center. “Proton therapy is not considered an elective procedure. We work with anesthesia, medical and radiation Oncology teams to coordinate needed radiation treatment, as long as the patient is clinically stable. We also alert the infectious disease team, so charts can be flagged for COVID infection, and work with registration staff to ensure patients are taken back to a room, and not sitting in our lobby with other families, to decrease COVID exposure.”

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