Status: 12.02.2021

Good news for cancer patients in the Hannover Region: care for cancer patients in the Hannover area has been maintained at a high level during the first wave of the pandemic. This is shown by the first interim results of the OnCoVID joint project funded by the Federal Ministry of Education and Research (BMBF), which is investigating the effects of the corona pandemic on oncological care. "Extensive preparations and successful dynamic adjustments to care processes appear to have been significant here," says project leader Prof. Dr. Jörg Haier, Managing Director of the Comprehensive Cancer Center Hannover at Hannover Medical School (MHH).

For almost a year now, the coronavirus has demanded a lot from medical care: right at the beginning of the pandemic, planned medical treatments had to be postponed and existing treatment regimens had to be adapted to the care situation in a pandemic. This poses particular challenges for patients and treatment teams in cancer medicine. The situation requires intensive consideration of additional, pandemic-related risks and the effects of treatment changes. This was expected to cause additional stress and uncertainty for everyone involved, especially in the initial phase of the pandemic.

Since July 2020, an interdisciplinary team of MHH scientists from the Comprehensive Cancer Center Hannover, together with colleagues from Leibniz Universität Hannover, has been investigating the effects of the pandemic on oncological care during the first wave in spring 2020. The investigation focuses on the following questions: To what extent were medical treatments not carried out or delayed? To what extent were existing treatment patterns adapted to the pandemic conditions? How did the treatment teams deal with such decision-making conflicts?

The study analyzed routine data on oncological treatment at the MHH, conducted written surveys of nurses and physicians working in the Hannover region and supplemented these with in-depth interviews with oncology specialists and patients.

Hardly any deviations in admission figures and length of stay

Initial results indicate that the COVID-19 pandemic has only had a limited impact on oncological treatment in the Hannover region and at the MHH. An analysis of the admission figures for oncology patients in the first half of 2020 showed that the inpatient admission figures for most of the groups of people and oncological clinical pictures examined were within the usual fluctuation range of the past four years. Only non-melanotic neoplasms of the skin and, in the case of women, oral neoplasms and benign neoplasms showed a reduction in admissions in the range of 13 to 17 percent compared to previous years (2017 to 2019). The length of stay of MHH patients undergoing oncological treatment and the presentation rates in tumor conferences also did not deviate significantly from the fluctuations of previous years.

200 oncology nurses and physicians surveyed

Further evidence of constant oncological treatment during the first wave can be seen in the surveys of over 200 oncology nurses and physicians from various inpatient and outpatient Facilities or Institutions in the Hannover Region. For most areas of oncological treatment - in particular curative therapy, therapy for advanced cancers and palliative care - only minor changes were perceived during the first wave of the pandemic. More than three-quarters of respondents said that the pandemic had little or no impact on these aspects of treatment in spring 2020.

There was a comparably greater impact in the areas of prevention and early detection, as well as psychosocial care. Although the majority of respondents (just over 50 percent) stated that the pandemic had little or no impact on treatment decisions and diagnostics, these areas of preventive and follow-up care appear to have been more significantly affected by the pandemic than direct oncological treatment.

Comparatively low pandemic-related psychological stress for caregivers

Oncology nurses and physicians seemed to be able to cope well with the stress caused by the pandemic, as the evaluation shows. Very few of those surveyed stated that they felt stressed (8 percent), anxious (1 percent), lonely (2 percent) or depressed (3 percent) more often or most of the time during the pandemic. In contrast, pandemic-related decision-making problems in connection with oncological treatment were reported by 33% of the professionals surveyed and were associated with significantly higher emotional stress.

"Overall, the results so far indicate that oncological treatment in the Hannover region and specifically at the MHH was maintained at a high level during the first wave of the pandemic, which may be due to the extensive preparations and successful dynamic adjustments to care processes during the coronavirus pandemic," emphasizes Professor Haier. "For the most part, the treatment teams were able to sufficiently compensate for any decision-making conflicts that arose, but particularly affected subgroups still need to be analyzed further."

In the coming weeks, the previous analyses will be further expanded and supplemented using health insurance data on the treatment of oncological diseases from across Lower Saxony. Further interviews will follow. Based on this broad knowledge base, the next steps will involve working with medical ethicists and lawyers from the Centre for Ethics and Law in the Life Sciences (CELLS, Leibniz University, Prof. Dr. Nils Hoppe) to evaluate ethical and legal issues relating to oncological care in the coronavirus pandemic. "In particular, a pandemic guideline to be developed should make it possible to ensure the ethically and legally sound care of oncology patients in future pandemics," explains Prof. Dr. Nils Hoppe, who is in charge of the OnCoVID sub-project with an ethical and legal focus.

The research project "OnCoVID - Management in oncology during the COVID-19 pandemic - ethical, legal and health economic implications" is a collaboration between the MHH and Leibniz Universität Hannover. The BMBF is supporting the research with 492,280 euros from June 2020 to November 2021.

Forfurther information, please contact project leader Prof. Dr. Jörg Haier, ccc@mh-hannover.de, telephone (0511) 532-19343.