Dr. Vikram Gorantla

Dr. Vikram Gorantla from the UPMC Hillman Cancer Center discusses why it’s important to talk with your doctor and resume care if you’ve delayed appointments due to COVID-19.

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Read The Full Podcast Transcript

– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider. What you need to know about getting your health care back on track, especially when it comes to cancer care. Hi, I’m Tonia Caruso. Welcome to the UPMC HealthBeat Podcast, and joining us right now is Dr Vik Gorantla, from the UPMC Hillman Cancer Center. Doctor, thanks so much for joining us.

– Thank you for including me, Ms. Caruso, in getting this very important message out.

– Doctor, you have so many different areas of expertise and specialties when it comes to cancer, and let’s just tell folks a little bit about them.

– Well, I’m a cancer care expert. I work at Hillman Cancer Center. I’ve been here since 2011. My areas of expertise and focus are breast and GI malignancies.

– And so when COVID first came to the area, lots of preparations were made, lots of changes were made. Talk about what care looked liked inside the hospital. Were there patients that you were telling to stay away? What was sort of the plan of action?

– It went case by case, really. In terms of what happened in March and April, we were also in a time of uncertainty. We didn’t know how this was going to play out. So in terms of our patients, we were risk stratifying our patients, patients who we thought could be, whose visits, whose appointments could be deferred, who could be managed with a simple phone call, we were asking to stay away till we figured out what the situation would be like on the ground. Certain patients who were already on active treatment, who were actively already getting their surgeries or getting their chemotherapies, we recommended they still continue to follow up with us, with very, very close monitoring, surveillance for any signs and symptoms of the COVID-19 virus.

– And so now that things are moving forward, talk about the plan now and why everyone feels it’s important now that people come back in for health care.

– In western Pennsylvania, we understand where we stand in terms of the COVID-19 virus. As you can see, the Allegheny County Health Department has shared the statistics, and also what we have seen here in our experience is that we have not been affected as much as our unfortunate friends and colleagues over in eastern Pennsylvania or in New York City. So it’s important that we focus back on the active illness that our patients are dealing with. Cancer is not stopping, and neither should we, so it’s important that we get back to treating the active illness that we have, in some ways, a little bit deferred

or delayed, to prevent any further complications from their underlying cancer, which again has not stopped. Each patient is unique, each patient is special. They all have their own unique needs, which need to be addressed as soon as possible. It is important that we do not neglect our unique needs without involving a physician. If you are concerned, if you are worried about the impact of COVID-19 on your health, please reach out to your physician. Please talk to them. A simple visit, or a simple telephone call, or a video visit, could help address those concerns and prevent further complications.

– Right. So you’re saying, throughout this, some patients were coming in for their treatments. Were you doing surgeries on other patients? Talk about what that looked like.

– So in terms of patients who had emergencies from their cancer, absolutely, they were getting their surgeries. At the end of the day, the cancer issue, complication is an emergency, it is life-threatening, so those operations were happening. Only the cancers that were deemed to be slow-growing without any major complications, those cancer surgeries were delayed.

– And, doctor, why should we be doing routine screenings? Why are they just as important?

– I think routine screenings help catch cancers at an early stage. A mammogram saves lives. A mammogram catching a cancer early could potentially not only save a patient’s life, but also reduce the intervention that they would require, including chemotherapies later down in their care. Colonoscopy, catching a colon cancer in earlier stage, could potentially reduce or eliminate the need for chemotherapy. This is why these are important. And of course, remember, the earlier we catch the cancer, the less likelihood of having an emergency or a complication.

– Doctor, can you touch upon the safety precautions that the Hillman Cancer Center, that Magee, that all of the UPMC locations are taking for patients when they come in? What can a patient expect?

– So first of all, we are following all the CDC-mandated rules on COVID-19 protection, period. In term of steps that we have taken, it starts at the door, literally at the door. Patients are screened for any symptoms of viral illness: cough, shortness of breath, exposure to somebody with the COVID-19 virus. Their temperature is taken, and then they are provided with a facemask, and they are again counseled about maintaining social distance. Now, we even go a step further. For patients who are coming in for a visit, they are actually screened on the phone itself. We’re calling them, asking them, “Hey, any symptoms or signs of COVID-19, that you are worried about?” to prevent even that patient from potentially coming in through the door and risking not only their own health, but also the health of our workers and other patients.

– And when it comes to a mammogram, it’s equipment that is used, that’s used all day long. Talk about the steps that folks are taking there to make sure that patients are safe while getting a mammogram.

– Now again, with every mammogram, like you said, that surface is cleaned between every test. We take more than just the usual measures to clean this. We go beyond that, extraordinary measures, making sure not only the equipment is cleaned, but also the room is also sanitized.

– Are you finding when patients do come back in, they tell you that they’re relieved to getting back to their health care?

– Absolutely. I think something has to be said about the physical contact, the physical exam. I think patients are worried about their health, worried about their cancers. They are savvy, they do realize what is going on, and they do realize that this is just a temporary measure and that we need to move forward with their cancer treatments or their cancer surveillance.

– So if a patient does have cancer and they’re undergoing treatment, are they more susceptible to COVID-19, and if so, what sort of precautions are being taken to protect them?

– I think that’s a great question. It depends upon the treatment that the patient is undergoing. Now, remember, different cancers have different prognoses, different treatments. Some cancer treatments’ chemotherapy regimens are very, very immunosuppressive. An example would be someone undergoing treatment for lymphomas or leukemias. For those patients, we should take utmost precautions to reduce their risk of exposure to COVID-19. For those patients, we are aggressively counseling them to avoid sick contacts, practice social distancing, self-quarantining.

– Right, so screening patients, but talk about the safety steps for the staff as well and the preparation that goes into keeping the staff safe.

– Absolutely. Great question. So now, again like what I talked about before, these safety measures start at the door, where, not only patients are being screened, but so are staff members. Any exposure, any cough, any fever, shortness of breath, patient providers are asked to self-quarantine, period. Now if I can just give you an example, we did have an exposure at work. They made the affected worker go back home, and then they self-quarantined anybody and everybody who came in contact with her.

– And do you feel there are enough tests available for your staff?

– Absolutely.

– And so, I guess, at the end of the day, what do you want to say to people about the importance of getting their health care back on track?

– I think it’s important that we take charge of our own health, we talk to our physicians about what’s going on, and make informed decisions. For my cancer patients, like I said before, cancer does not stop. Neither should we. It’s important if you’re concerned, that you talk to your physician, raise your concerns. If you can’t see them in person, then there’s always an option of maybe doing a tele-visit, a video visit or even a telephone call. It is important that you reach out and talk to your physician. Each case is unique, and your situation should be addressed by your medical oncologist or your surgical oncologist.

– And my last question, if you would, take a minute to talk about the staff and how the staff has worked together so hard during this time.

– I think our staff, our management, has done a commendable job of putting their patients ahead of themselves. I think it’s been an incredible experience watching all these, all the entire team, starting from our people at the front door, all the way up to our management, to our physicians, to our nurses, to our staff who’s cleaning the rooms, come together, again, to put patients ahead of them. It’s been an incredible experience. It’s been a very rewarding experience. This is why we do what we do.

– Doctor, thank you so much for spending time with us today. We certainly do appreciate it.

– Oh please, thank you very much. I think it’s very important we get this message out to our community. It’s safe, it’s important that we restart where we left off.

– Thank you for your time. And thank you for joining us. I’m Tonia Caruso. This is UPMC HealthBeat.

About UPMC

Based in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and more than 700 doctor’s offices and outpatient centers. Our expert physicians are among the leaders in their fields, and we are leaders in groundbreaking research and treatment breakthroughs. UPMC Presbyterian Shadyside ranks as “One of America’s Best Hospitals” and No. 1 in Pennsylvania in U.S. News & World Report’s listings.