How to provide cancer care in a natural disaster scenario

A new paper focuses on how to prepare for natural disasters so that physicians who provide radiation therapy to patients with cancer have guidelines for what to do in advance, and how to recover afterward.

When Hurricane Maria churned across Puerto Rico on September 20, 2017, it was the island’s second hurricane in less than two weeks.

More than 1 million residents were already without power because of a glancing blow from Hurricane Irma, which had ravaged nearby islands before going on to wreak havoc in Florida. Maria’s direct hit to the already fragile island was catastrophic. Extreme winds, torrential rains, flooding, and landslides destroyed most of the power and telecommunications infrastructure in the storm’s path.

In the days following Maria, Puerto Rico native Hiram A. Gay, an assistant professor of radiation oncology at Washington University School of Medicine in St. Louis, worked to contact family members, friends, and radiation oncology colleagues across the island. Despite the distance and erratic telecommunications, he was hoping to find some way to help.

Lessons that Gay and his colleagues learned appear in the new paper in Practical Radiation Oncology.

The guidelines aim to give physicians who provide radiation therapy to patients with cancer ideas on what to do in advance, and how to recover after a natural disaster. Recommendations include:

• Having a clear method of communication with staff and patients laid out in advance.
• Providing portable data to individual patients about their own treatment plans in case they need to receive care at a different clinic.
• Following appropriate guidelines for how to compensate for missed radiotherapy sessions.

While the paper is specific to radiation oncology, some of the lessons may broadly apply, the researcher say. For example, all sorts of health-care providers had to contend with loss of clean water, fuel, power, and communication.

Here, first author Gay, who is also a radiation oncologist at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University, discusses disaster preparedness in the wake of Maria and what he learned from the hurricane.

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