Practical Strategies in the Management of Breast Cancer and Head and Neck Cancer in Indonesia during the COVID-19 Pandemic.docx

(Abstract)During this uncertain time, the COVID-19 pandemic has caused significant changes in the dynamics of the health delivery system. Cancer care is one of the impacted parts in this situation as patients with cancer require elaborate attention to their treatment regimen. Breast cancer is the most prevalent cancer found in Indonesia, and most often patients came in with a locally advanced stage. Similarly, patients with head and neck cancer also present with a locally advanced stage. The consequence of this fact is that disease progressivity must be taken into consideration as it may worsen the cancer burden. However, affected by this unprecedented pandemic, patient visits, surgeries, and other aspects of cancer care are heavily regulated as an effort to reduce risk and potential harm for COVID-19 transmission for both patient and healthcare workers. A surgical oncologist, despite acting as a front-liner in health care delivery, is exposed to a high risk of COVID-19 transmission as they are interacting with possible aerosol-generating procedures, especially in treating cases of head and neck cancer. With ongoing issues and challenges in this rapidly changing era, strategic approaches must be applied to deliver optimal care for the patients without increasing the potential risk for each patient and the medical personnel involved.