While the COVID-19 pandemic has caused concern and anxiety for all Canadians, cancer patients have been doubly impacted.
First, people with cancer can be at higher risk for more serious complications from the virus. Secondly, there’s the concern that surgeries, treatments and research might be delayed because of COVID-19-related restrictions in hospitals across the country.
When the country went into lockdown in mid-March, restrictions were placed on non-essential hospital services. With resources being reallocated to COVID-19, more than 600 cancer research trials were affected.
Dr. Aaron Schimmer, research director, senior scientist and staff physician at Princess Margaret Cancer Centre in Toronto, says that COVID-19 has had a “severe” impact on research in the blood cancer field. For example, the work of his own lab, which involves cutting-edge treatment strategies for acute leukemia using stem cells, had to be halted.
However, almost immediately after shutting down, Dr. Schimmer and his fellow researchers began developing a plan to restart research involving extensive safety precautions. He says that stopping research until COVID-19 is completely eradicated is simply not an option.
“We can’t stop now – not even for a pandemic. We are in a critical time where support for blood cancer research is more important than ever,” he says. “We have seen tremendous breakthroughs in cancer research that are now paying dividends in new treatments for our patients.”
Blood cancer research at Princess Margaret and across the country has now resumed, says Dr. Schimmer. “We aren’t yet back to full operations and the safety of our staff continues to be paramount, but we are now back to making those critical discoveries that will improve the lives of patients with blood cancer.”
Dr. Natasha Kekre, a hematologist in the Blood and Marrow Transplant Program at The Ottawa Hospital, says patients were nervous when the pandemic became an issue and hospitals had to change their protocols. Fortunately, individual health centres and Cancer Care Ontario, which oversees cancer programs in the province, had planned for contingencies such as outbreaks within hospitals that could have delayed or cancelled cancer patient treatments.
Dr. Aaron Schimmer,
research director, senior scientist and staff physician, Princess Margaret Cancer Centre
“We created our action plan in March and April at the same time as we were watching things unfold,” Dr. Kekre says. “We couldn’t predict the future, but at least we [would be] prepared. At The Ottawa Hospital and elsewhere in Ontario, we’ve never had to implement any of the most extensive scenarios.”
She adds, “We’re fortunate in Canada that [we] planned for the worst, [and] I have been pleasantly surprised.”
The Ottawa Hospital and other facilities took precautions that included pre-screening and testing patients who felt feverish, so that blood cancer patients and those undergoing chemotherapy would not be exposed to those testing positive. Dr. Kekre says they also switched to a lot of virtual appointments, so patients didn’t have to come in to the hospital.
“When patients realize that the accommodations being made because of COVID are being taken for their own safety, they are understanding,” she says.
Dr. Kekre is part of a team conducting the first clinical trial in Canada to manufacture immunotherapy for patients using genetically-modified T cells, important cells that fight off infection. Called CAR-T cell therapy, the trial involves taking T-cells from a patients' blood and re-engineering them in the lab to target their specific blood cancer.
Maintaining the CAR-T trial has been more challenging than simply rescheduling appointments, Dr. Kekre says, but after a short pause, the program is moving forward well. “This is a potentially life-saving type of treatment and everyone fought really hard to reopen our trials.”
Regardless of what happens in the future with the pandemic, Dr. Kekre says she and her colleagues are committed to continuing their work, while keeping the safety of patients a top priority.
Dr. Schimmer notes that while the negatives caused by COVID-19 are obvious, there have also been some bright moments. Scientists and clinicians across the world are collaborating more closely than ever before, barriers to sharing data are being torn down and approval processes have been streamlined without compromising safety, he says.
“I am hopeful that these measures put in place for COVID-19 will continue after the virus is eradicated and we will see even greater acceleration of science.”
The Leukemia & Lymphoma Society of Canada provides support and information for blood cancer patients with questions about COVID-19. For information about clinical trials, visit their clinical trials resource page
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