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At VCU Massey Cancer Center we have implemented changes in our clinics to mitigate the coronavirus (COVID-19) situation and keep our patients and medical teams safe.

Our providers are highly trained at screening for and managing highly infectious diseases, and we are regularly updating our care practices.

To maximize safety, Massey’s clinical oncology operations are focused on depopulating and reducing density in our clinics and infusion areas, and all providers and patients are wearing masks in clinic.

“Massey leaders are working in a coordinated effort to ensure the safety of our patients and providers as we march through the COVID-19 crisis,” said Douglas Arthur, M.D., chair and professor in the Department of Radiation Oncology at Massey and VCU School of Medicine and Florence and Hyman Meyers Endowed Chair in Radiation Oncology. “Together, we have changed valet parking to guided parking, expanded waiting areas, provided masks for all patients and providers, initiated patient COVID-19 screening and testing, restricted visitors, increased communication with our patients regarding treatment times and implemented the use of telemedicine where possible. These measures allow our patients to continue through their treatment and remain safe.”

Scheduling appointments

Massey is committed to treating every person who needs our services. All incoming patient referrals and requests will be scheduled an appointment by a patient coordinator on the first phone call. A nurse navigator will then review the referral and discuss with an oncologist what type of appointment the patient needs: telehealth, over the phone or in-person. Staff members are doing everything they can to maintain the original date and time for patient appointments, but it is possible that appointments may need to be changed based on unforeseen circumstances.

If you or your child do/does not have fever or respiratory symptoms, we recommend that you keep your scheduled cancer treatment appointments. If you or your child are/is having mild symptoms, we recommend rescheduling an appointment if it is not urgent. If you or your child have/has symptoms and your appointment is urgent, you must contact your Massey medical team prior to coming to see us so we can take appropriate precautions and avoid the spread of illness.

COVID-19 tests

Massey is implementing COVID-19 testing for patients on active cancer treatment, especially those receiving chemotherapy, selected patients receiving radiation therapy and before surgery. The testing, which involves a nasal swab, is performed 48 hours prior to their treatment and is available at multiple VCU Health locations throughout the region. Testing can be paired with lab draw or provider visits, and results post as soon as they are available, usually within 48 hours. Drive-thru sites are available for convenience. For more information on COVID-19 testing and locations, click here.

Infusion and radiation treatments

Massey enacted several procedures to spread out infusion appointments to decrease patient density in the clinics. As a result, blood draws now begin at 7 a.m. for any patients who require same-day labs. Care teams will determine a patient’s need for a same-day blood draw compared to an off-site draw prior to infusion on an individual basis for each patient. Same day face-to-face infusion visits are being minimized and providers will conduct virtual visits prior to infusion appointments where possible. Massey’s gynecologic oncology team is consolidating the days in which outpatient chemotherapy will be administered.

Radiation therapy treatments at Massey will continue without interruption, although several changes have been made to reduce the risk of viral spread including the opportunity for onsite COVID-19 testing prior to treatment start beginning May 11.

“Our dedicated team is working harder than before to make sure cancer patients receive their treatments in a timely manner and safe environment,” said Khalid Matin, M.D., vice-chair of clinical affairs in the Division of Hematology, Oncology and Palliative Care and medical director of community oncology and clinical research affiliations at Massey. “Treatments remain on schedule, and we are still screening patients for clinical trials, as we believe in giving our patients the best available treatment options.”

Surgical procedures

All surgical oncology and other surgical procedures at Massey are being scheduled again after statewide restrictions on non-emergency surgeries were lifted on May 1. As surgical services are increased over the next few weeks, it is expected that Massey's surgical oncology facilities will return to full capacity in a safe environment.

Following Governor Ralph Northam's statewide restrictions on non-emergency surgeries and other procedures, we limited all elective procedures that were non-urgent and offered alternative solutions for routine care to increase our ability at Massey to care for those with urgent and emergency medical needs in times of COVID-19. Elective surgeries are procedures that are not required to support the health and wellness of a patient, including preventive mastectomies, cosmetic surgeries and orthopedic surgeries for issues that do not limit a patient’s ability to maintain a normal, healthy life.

“With the influx of COVID-positive patients and the need for the preservation of personal protective equipment during the pandemic, we were previously limited in our ability to bring patients into the operating room,” said Kandace McGuire, M.D., chief of breast surgery and surgical leader of the Breast Health Program at Massey. “Because of that limitation, we looked at innovative ways to keep our patients safe while treating their cancers. Many patients were being placed on the systemic therapy they would have completed after their surgery in a pre-surgical fashion. That allowed us an opportunity to potentially shrink their tumor while they awaited surgery at a safer time.”

Urgent surgeries include procedures that, if delayed, pose a threat to the patient’s life or well-being and other surgeries that have no reasonable method of delay. Massey patients who have completed a regimen of preoperative chemotherapy are being classified as ‘urgent’ and should undergo surgery within 3-6 weeks of completing their final treatment.

“Massey is committed to treating every patient who needs our services, and our patients can be reassured that should they need surgery, they will get surgery,” McGuire said. “If we can safely delay surgery and reduce the risk of infection, then we will safely delay surgery. We have our patients’ well-being and safety at the forefront of every decision we make.”

Telehealth

Measures are being taken to replace face-to-face consultations and follow-up appointments with virtual visits as much as possible. Health care providers at Massey’s Dalton Oncology and Stony Point Clinics are performing virtual phone visits. Oncologists can use the Zoom video conferencing platform in place of phone visits to communicate with patients. Plans are in place to implement a new telemedicine platform for use by all Massey clinical staff and patients in the future.

Parking, arrival and visitors

Patients coming for outpatient appointments, radiation treatments or infusion treatments at Massey’s downtown location should come to the North Hospital entrance at 1300 E. Marshall Street. Patients have the option to valet park or self-park. Valet parking is provided at no charge for outpatient cancer visits. For self-parking, patients are directed to park in the nearby Goodwin Research Laboratory parking garage. Valet representatives are available onsite to assist with wayfinding, wheelchairs and parking needs. For more information on valet and parking, please refer to this article.

All patients who come to Massey for an ambulatory visit will be provided a surgical mask as a protective measure for their compromised immune systems. Screening for COVID-19 occurs at all Massey entrances, and patients who screen positive will receive formal testing.  

To further reduce population density in the Dalton Clinic waiting room, an additional waiting area is provided in the Goodwin Research Laboratory adjacent to North Hospital.

We are instituting the following temporary outpatient appointment and visitor policies:

• Only patients with verified appointments may enter our hospitals and clinics. Appointments will be verified at entry screening stations.
• For adult patients with verified appointments: One support person, 16 years or older, will be permitted to accompany them to their appointment and in the treatment area.
• For pediatric patients with verified appointments: Two accompanying adults, 18 years or older, permitted per patient.
• Both the patient and support person will be required to wear a wristband after the appointment is verified. They must have wristbands visible at all times while onsite.
• Patients and accompanying individuals must wear a face mask at all times. Face masks must cover both nose and mouth.

For more information about the visitor policy, please refer to this article.

For more information about COVID-19, visit https://combatcovid.hhs.gov/

Editor's Note: This article was edited on June 30, 2020 to reflect ongoing updates to Massey's outpatient clinical care.

Written by: Blake Belden