Ovarian cancer is a serious gynecologic cancer and the fifth leading cause of cancer-related deaths among women in the United States.1 To minimize the risk of the coronavirus disease (COVID-19) transmission while still providing much-needed cancer care, oncology clinics and hospitals have increased access to telehealth services for their patients. This is especially important to people with cancer because they are at higher risk for COVID-19 as a result of immunosuppression caused by their treatment and the disease itself. While healthcare providers can address a number of health concerns that a person with ovarian cancer may have, such as mild side effects from cancer treatment, some aspects of their care like physical exams still need to be conducted in person.
When to Use Telehealth for Ovarian Cancer
While much of cancer treatment like chemotherapy and surgery needs to happen at the hospital, several appointment types and health needs can be addressed from home.
Before Your Next Appointment
Even if you’re scheduled for an in-person appointment with your doctor, you may still be asked to use telehealth services before your appointment. Your clinic may call you to screen you for COVID-19 symptoms. You may also have the chance to check in for your appointment and answer any insurance-related questions via a patient portal. This can help reduce wait times and potentially exposure to COVID-19 at the clinic.
After a Confirmed Diagnosis
Ovarian cancer is usually confirmed by a biopsy or surgery, which needs to be done at the hospital.1 Once a pathologist has examined your sample and determined the diagnosis, your doctor may be able to meet with you virtually to discuss next steps. They will discuss your results and recommend a comprehensive treatment plan.
Follow-up Appointments
Once you begin treatment for ovarian cancer, your oncology team will monitor your health through imaging studies, lab tests, and follow-up visits.1 Ask your oncologist if some of your follow-up visits could be conducted virtually. Your doctor may be able to speak with you on the phone or by video chat to update you on your latest lab test results and treatment plan, as well as answer any questions you may have.
New Symptoms or Side Effects
If you develop any new cancer symptoms or treatment side effects, don’t hesitate to reach out to your medical team. You may be able to send a message to your provider via the patient portal and set up a time to speak with them.
Any new symptoms or side effects severe enough to require emergency care always warrant an in-person visit, including uncontrolled vomiting or diarrhea, mental confusion, a high fever, or bleeding.
Post-surgical Follow-up Appointment
A common treatment modality for ovarian cancer is debulking surgery to remove as much of the tumor as possible. This surgery could affect your ovaries, uterus, cervix, fallopian tubes, lymph nodes, and even the small intestine.1 Depending on how involved your surgery is, your surgeon may be able to follow up with you after your procedure through a virtual visit. If your surgical incisions are red, painful, and oozing, you will need to see your doctor since these could be signs of an infection.
To Participate in Genetic Counseling
Doctors recommend that women who have been diagnosed with ovarian cancer undergo genetic counseling and discuss the results with their family members. Talk with your medical team about meeting with a genetic counselor virtually. There are also apps available to make the process more convenient.
To Enroll in a Clinical Trial
As part of your treatment, your oncologist may recommend joining a clinical trial to have access to a new medication or therapy that is not yet approved for cancer treatment. Due to the COVID-19 pandemic, many clinical trial research teams now work from home and are able to meet with study participants virtually. Also, medications used in these trials can now be mailed to your home, rather than having to be picked up in person.
Mental Health Help
Undergoing cancer treatment can be grueling, and it’s natural to feel down in the process. A recent study found that 89% of women undergoing treatment for ovarian cancer experienced high levels of worry about their health during the COVID-19 pandemic.1 If you have any concerns about your mental health, reach out to your medical team for support and resources. A therapist or psychologist can also meet with you virtually to discuss any problems you may be having with coping with your condition.
Some health concerns cannot be addressed through telehealth and require an in-person evaluation. You may need to visit your doctor’s office if:
- You have a high fever
- Your doctor recommends additional imaging studies
- You have a lab appointment to have blood drawn
- Your surgeon recommends a presurgical physical exam
- Your treatment plan include intravenous chemotherapy
Benefits and Challenges
There are several benefits to taking advantage of telehealth services for ovarian cancer, as well as a few challenges. Attending a virtual doctor’s appointment is usually more convenient than visiting the clinic in person. Research has shown that telehealth services save time and increase access to care. A 2020 study found that 82% of women with breast or gynecological cancer felt that using telehealth services like patient portals and virtual appointments improved their overall health.
Using telehealth options may be safer as well. It’s estimated that patients with cancer are about twice as likely to contract COVID-19 than the general public.5 Attending an in-person appointment raises the chance of being exposed to the virus both at the hospital and during the commute to the care location.
Because doctors offices now need to be more reliant on telehealth visits in response to the COVID-19 pandemic, care may be delayed. One survey found that 33% of American women with ovarian cancer reported delays in their care related to the pandemic, usually related to postponing surgeries.
The use of telehealth in ovarian cancer care has also been associated with heightened concern about their conditions among cancer patients.6 This may be due to the fact that meeting virtually does not always feel the same as seeing your doctor face-to-face. If your hospital’s patient portal is complicated or confusing, the process itself may even bring on anxiety.
How to Prepare for a Telehealth Visit for Ovarian Cancer
When preparing for your telehealth visit, think through any questions you may have for your provider. When making the appointment, ask the clinic representative how long the appointment will last and if you will be on the phone or video chat. Find out who will be attending your appointment and if you can include friends or family on the call.
Ensure that you have a reliable device with access to the internet or plan to borrow one from a friend. Also, call your hospital’s or doctor’s office billing department to find out if telehealth visits are covered by your insurance plan.
On the day of your appointment:
- Find a quiet place in your home where you’ll be able to talk with your provider without interruptions. If you are using a public computer, bring headphones.
- Install any needed software and test out the camera and microphone on your device. Ask a relative or friend for help if you’re having trouble getting it set up.
- Make sure your device is charged and that you have the phone number for the clinic in case you are disconnected.
- Think through the questions you’d like to ask and any updates for your team. Keeping written notes with you may help.
- Write notes about any changes to your treatment plan, including medications, chemotherapy schedule, or radiation therapy.
In 2020, the United States Congress passed three federal stimulus packages, which included guidelines for telehealth coverage. If you have Medicare, your virtual appointments should be billed the same as in-person visits, and there should not be any geographic or eligibility restrictions.7 If you have Medicaid, call your local Medicaid office to find out what is covered. If you have private insurance, call your insurance company directly to determine what services are considered telehealth. When researching telehealth coverage, a good starting place is the National Consortium of Telehealth Resource Center, which offers a database of telehealth billing policies by state.
What Happens During the Visit
The length and style of your telehealth visit will vary by the reason of your visit and will feel similar to an in-person appointment for the same purpose. Once both you and your provider have logged on to the call, you will discuss your treatment and any new problems. You will then work together to make a plan going forward.
Before starting the visit, you may be asked to acknowledge the fact that you understand the limitations of a telemedicine visit, including the inability to do a full medical exam, possibly missing subtle findings that might have been obvious on a face-to-face visit.
You have the right to refuse to participate in services delivered via telemedicine and ask for an in-person visit.
Visit with a New Provider
For initial consultations, your oncologist will review the results of your biopsy with you and explain your cancer stage and grade. Your doctor may recommend further testing to determine if cancer has spread.1 It’s common for your doctor to share their screen with you to show you lab results or pictures. Your doctor will also take time to review your entire health history and any family history that involves cancer or gynecological conditions. From there, your doctor will recommend a treatment plan and explain each type of therapy. Be sure to take notes during the appointment.
Follow-up Visits
For follow-up visits, your oncologist or another provider will ask for an update about how you’ve been feeling. They may share results from recent lab tests or imaging studies, as well as any alterations that need to be made to your treatment plan. These appointments are a good opportunity to discuss new symptoms or side effects, as well as any questions you may have. Ask your provider if future appointments will be conducted virtually or in person.
During telehealth visits, you are entitled to privacy just as you are during in-person appointments. Providers offering telehealth visits must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and protect your health information during and after the appointment. Protected health information includes any data that could identify you such as your name, date of birth, social security number, diagnosis, and more. Health providers must use “non-public facing remote communication product that is available to communicate with patients.”
A Word From Verywell
Undergoing treatment for ovarian cancer is an overwhelming experience, and hopefully, telehealth services can make the process just a bit easier. To get started, ask your oncology team about what telehealth services they offer and how to access them. Talk with your insurance company or hospital billing department about which types of calls and appointments are covered. If you feel intimidated by the patient portal or telehealth software, ask for help from a provider or friend. Virtual visits cannot replace in-person exams but they can certainly help you receive more of your care from the safety and convenience of your home.
This article was published by Verywell Health.