[Outpatient care of oncological patients in palliative treatment situations and their relatives during the COVID-19 pandemic]
During the current pandemic situation, the public health care system must ensure the ongoing provision of regular medical care as well as the treatment of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infected patients. Resident oncologists and their practices are equally affected.
[Vaccination against SARS-CoV-2 in cancer patients]
Patients with cancer are at an increased risk to suffer severe coronavirus disease 2019 (COVID-19). Therefore, specific preventative measures including COVID-19 vaccines are especially important. Both anticancer therapies and the underlying malignancy itself can lead to significant immunosuppression posing a particular challenge for vaccination strategies in these patients. At the moment, four COVID-19 vaccines are European Medicines Agency (EMA) approved in Germany: two mRNA and two viral vector-based vaccines. All four vaccines show excellent protection against severe COVID-19. Their mechanism of action relies on the induction of the production of virus-specific proteins by human cells and the following activation of a specific adaptive immune response. Vaccination against COVID-19 has been prioritized for cancer patients and medical personnel in Germany. Regarding timing of vaccination, vaccination prior to initiation of anticancer therapy seems ideal in newly diagnosed disease. However, due to the significant risk of severe COVID-19 in cancer patients, vaccination is also strongly recommended for patients already undergoing anticancer therapy. In these patients, immune response might be reduced. In two particular patient cohorts, namely stem cell transplant recipients and patients treated with B‑cell depleting agents, an interval of several months following therapy is recommended because otherwise the response to vaccination will most likely be severely reduced. Preliminary data suggest only low rates of seroconversion following a single shot of vaccine in cancer patients. Therefore, on the long run, repeat vaccination regimens might be preferable in cancer patients.
[The problems of career (re)integration faced by cancer patients]
With the aim of better understanding the enabling and limiting factors regarding staying or returning to work for cancer patients and to test specific measures of support, advisory and survey projects took place at the Robert Bosch Hospital in Stuttgart (RBK), the National Centre for Tumor Diseases in Heidelberg (NCT) as well as partly on behalf of and in cooperation with the Working Group Social Work in Oncology (ASO) of the German Cancer Society e. V. All projects have shown that the problems of career (re)integration faced by cancer patients in treatment, therapy and aftercare need to be taken more into account, as they play an essential role in securing the livelihood of and managing the stress experienced by the patient. Experience with the implementation of specialised counselling (at the NCT) and low-threshold, relationship-oriented support (at the RBK) makes it clear in which direction psychosocial support services, in the context of the clinic, can be expanded to better support cancer patients in their efforts to "stay in life".
[Should children of cancer patients attend daycare centers or schools during the COVID-19 pandemic?]
[Nearly two years of the coronavirus pandemic from the perspective of people affected by cancer]
[Current clinical research landscape in Germany-an interdisciplinary position paper]
[Post-corona fatigue-a familiar picture in a new guise?]
Myalgic encephalitis or chronic fatigue syndrome (ME/CFS) has again come into focus as a result of coronavirus disease 2019 (COVID-19). Fundamentally problematic is the fact that ME/CFS is considered a separate entity; however, extreme fatigue is also a common symptom of an underlying disease. Our article aims to increase the acceptance of ME/CFS and extreme fatigue facing a symptomatology that is not fully understood, and to highlight the need for research, orientation for physicians, and counselling services for patients.
[Management of infections in patients with cancer]
Patients with cancer are at increased risk of infection due to disease-associated or therapy-induced immunosuppression. Taking into account globally increasing antimicrobial resistance rates and negative effects associated with antibiotic treatments, the effective, appropriate and guideline-conform use of anti-infectives must be promoted in this clinical setting. The application of antibacterial prophylaxis should be limited to high-risk patients. Infection diagnostics and therapeutic strategies differ depending on the extent of expected immunosuppression and the patient's individual risk factors.
[General palliative care during the pandemic]
The German healthcare system is facing unprecedented challenges due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. Palliative care for critically ill patients and their families was also severely compromised, especially during the first wave of the pandemic, in both inpatient and outpatient settings.
[Vaccination against hepatitis B as prevention for hepatocellular carcinoma]
Chronic infection with the hepatitis B virus (HBV) is an important risk factor for the development of hepatocellular carcinoma (HCC). Even though treatment options for HCC are constantly improving, preventive measures must not be neglected.
[Cancer survivorship care programs and self-management]
Survivorship care programs (SCP) are increasingly being implemented in order to ensure long-term and comprehensive care of physical and psychosocial cancer-related sequelae among survivors. In this article, we provide a short overview of SCP and the importance of health-related self-management.
[Cancer-related fatigue and immune checkpoint inhibitors]
Cancer-related fatigue (CRF) is a common, burdensome, debilitating subjective sense of tiredness or exhaustion in patients with cancer. The pathogenesis is assumed to be multifactorial with CRF being a final common pathway. Among other things, treatment with immune checkpoint inhibitors (ICI) is also associated with CRF. However, the toxic adverse events of ICI are not inevitably the only cause for CRF. Therefore, the diagnostic procedure should address other possible influencing factors, e.g., somatic, mental, cognitive, and psychosocial causes. To manage CRF evidence-based, causal, and symptomatic therapies are available. The key condition to manage CRF is active listening and shared decision making (SDM) with the goal to select those interventions from the broad spectrum of therapies that are best suited for the particular patient and their life circumstances. Providing information about ICI and CRF to reassure patients is already an effective intervention.
[Increasing combination possibilities for first-line treatment of metastatic clear cell renal cell carcinoma with nivolumab plus cabozantinib]
[Quality assurance in haemato-oncology specialist practices]
The regularly published quality reports of the haemato-oncology specialist practices primarily include billing data and results of patient and staff surveys as well as current project-related results. In order to obtain further information on structural quality, an additional survey was conducted among haemato-oncology practices.
[Pattern of opinions of young physicians in gynecology and obstetrics in northern Germany]
The new generation of physicians has disruptive effects and also does not stop at the discipline of obstetrics and gynecology. The discourse is still focused on Generation Y (1980-1994). In order to offer a constructive working environment to the new generation, time is pressing. It is important to be aware of their requirements for such an environment.