The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts

COVID-19 has fundamentally disrupted the practice of oncology, shifting care onto virtual platforms, rearranging the logistics and economics of running a successful clinical practice and research, and in some contexts, redefining what treatments cancer patients should and can receive. Since the start of the pandemic in early 2020, there has been the considerable emphasis placed on the implications for cancer patients in terms of their vulnerability to the virus and potential exposure in healthcare settings. But little emphasis has been placed on the significant and potentially enduring, consequences of COVID-19 for how cancer care is delivered. In this article we outline the importance of a focus on the effects of COVID-19 for oncology practice during and potentially after the pandemic, focusing on key shifts that are already evident, including the pivot to online consultations; shifts in access to clinical trials, and definitions of 'essential care'; the changing economics of practice; and, the potential legacy effects of rapidly implemented changes in cancer care. COVID-19 is re-shaping oncology practice, clinical trials, and delivery of cancer care broadly, and these changes might endure well beyond the short- to mid-term of the active pandemic. Therefore, shifts in practice brought about by the pandemic must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support if they are to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care