The 2019 Coronavirus Panademic challenges the delivery of care for patients with head and neck cancer.  An important aspect of this care has been the evolution of enhanced survivorship services which include surveillance for recurring cancer and prevention of second primaries.  The application of evidence based approaches to identification and management of treatment and tumor related toxicities has embraced the use of validated patient reported outcomes instruments (PROs), health promotion, and care coordination.  In this manuscript we describe how our multidisciplinary team of survivorship providers have accommodated to the need to provide patients with social distancing while acknowledging the importance of continued care during treatment and through the spectrum of survivorship.

With the arrival of the coronavirus disease (SARS-CoV-2) in the U.S., care practice paradigms have drastically changed. Data from China suggests the new virus poses additional risks as case fatality of patients with cancer was higher at 5.6% compared to 2.3% of the general population. There are three proposed major strategies to address care for patients with cancer in this SARS-CoV-2 pandemic with postponing treatment for those with stable cancer, increasing personal protection provisions for cancer patients, and increasing monitoring if a patient becomes infected with SARS-CoV-2.  In this present commentary, we discuss the unique mental health challenges and burdens of head and neck cancer (HNC) patients in the times of the SARS-CoV-2 pandemic and approaches to mitigate these stressors through telemedicine to reduce future burdens to the patient and the health care system.

Background: In the context of COVID-19, cancer survivors represent a particularly vulnerable population that may be “doubly hit” both by costs of cancer treatment and financial strain imposed by the pandemic. Methods: We performed a review of the literature pertaining to cancer, financial toxicity, and economic challenges.Results: Multiple societies have put forth recommendations to modify delivery of cancer care in order to minimize patient exposure to the virus. Cancer survivors, especially patients with head and neck cancer, have been disproportionately affected by rising unemployment levels and economic recessions in the past, both of which are linked to higher cancer mortality. Patients who rely on employer-provided insurance and do not qualify for Medicaid may lose access to life-saving treatments. Conclusions: It is essential to implement interventions and policy changes in order to mitigate the effects of this pandemic but also to ensure this becomes a non-issue during the next one.

Full author listEric Adjei Boakye, PhD, MA1,2, Wiley Jenkins, PhD, MPH1,2, Arun Sharma, MD, MS2,31Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois2Simmons Cancer Institute at SIU, Southern Illinois University School of Medicine, Springfield, Illinois3Department of Otolaryngology – Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois