HJAR May/Jun 2021

MEDICAL ONCOLOGY RHONDA GENTRY, MD, MEDICAL DIRECTOR OF MEDICAL ONCOLOGY The impact of the coronavirus on medi- cal oncology volume has interestingly been minimal, and our volumes have continued to increase overall. Like many other specialties, we have, unfortunately, seen that some pa- tients presented later than they would have outside of a pandemic, and thus we have seen more advanced cancers as a result. The vaccine has profoundly positively impacted our patients. Aside from the ob- vious physical protection that is conferred, they psychologically and emotionally are freer to live life to the fullest again, despite difficult medical journeys. This can go a long way in a patient’s approach to and ability to navigate a cancer diagnosis. While we should be encouraging most of our patients to receive the vaccine whenever they are eligible, occasionally, we have pur- posefully postponed the timing of it for some patients currently undergoing chemothera- py. We do this to minimize the side effects from chemotherapy in hopes that tolerability of the vaccine would be better. Rhonda Gentry, MD Gentrycompleteda fellowship inhematology/oncologyand residency in internal medicine at the University of Medical Sciences in Little Rock,Arkansas,where she also received her medical degree. Radiation plays a vital role in fighting many different types of cancer and often requires patients to come into the clinic for daily treatments over multiple weeks. This presented many challenges early in the pandemic and resulted in diagnostic delays due to operating room shutdowns. Our normal practice has been to implement shorter course treatments (hypofraction- ation, SBRT) when applicable and safe, so our recommended treatment courses for patients were not all that different. Similar to our experience with enlarged lymph nodes during mammograms, we have experienced patients who have gotten the vaccine having enlarged lymph nodes on imaging. In collaboration with radiology, we have been able to tease out whether these findings are truly related to their cancer. That said, the most important change since the rollout of the vaccines is that we are see- ing less patients having to quarantine due to a COVID exposure, which allows them to be able to continue with their life-saving treatments. It is important to note that, with rare exceptions, the COVID vaccine is safe to receive during the course of radiation treatment. Thankfully, there is no need to alter, delay or stop radiation treatments for patients who are considering receiving the COVID vaccine. In fact, we highly encourage people to get their vaccine and are able to work our treatment schedule around their vaccine appointments to make it as easy as possible for them to get vaccinated. Obviously, there could be an impact on outcomes due to diagnostic delays during the pandemic. We have seen numerous pa- tients that knew something was going on, but who chose not to seek care because of fears of the virus. That led to delays of up to six months or more in getting their cancer diagnosed and treated. Radiation oncology as a practice has been moving toward shorter, more efficient treat- ment schedules, and the pandemic helped nudge some practices further that way if they were reluctant to do so before that pandemic. RADIATION ONCOLOGY MATTHEW HARDEE, MD, PHD, MEDICAL DIRECTOR OF RADIATION ONCOLOGY, AND JONATHAN PAGAN, MD, MS, RADIATION ONCOLOGIST Matthew Hardee, MD, PhD Hardeecompletedaresidency inradiationoncologyatNew York University School of Medicine in NewYork, NewYork. He earned a medical degree from Duke University School of Medicine in Durham,North Carolina. Jonathan Pagan, MD, MS Pagan completed a residency in radiation oncology at Vanderbilt University in Nashville,Tennessee. He earned a medical degree from the University of Medical Sciences in Little Rock,Arkansas. HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2021 19