In the wake of Hurricane Maria, a devastating storm that produced the longest blackout in U.S. history, radiation oncologists from the mainland United States and Puerto Rico prepared a set of crisis-planning tips for radiation therapy clinics to minimize gaps in cancer treatment after a catastrophic event. Their emergency preparedness suggestions were published online April 15 in Practical Radiation Oncology, the clinical practice journal of the American Society for Radiation Oncology (ASTRO).
“Worst-case scenarios do occur, and if you wait for something to happen and then start preparing, it’s too late,” said Hiram A. Gay, MD, an associate professor of radiation oncology at the Washington University School of Medicine in St. Louis and lead author of the article. “You need to have systems in place so that patients are better taken care of when disaster hits.”
The paper — a compilation of guidance from experts including radiation oncologists who were in Puerto Rico during the disaster — provides “a list of what we wish we had done beforehand and what we needed most afterwards,” the authors wrote.
On September 20, 2017, Hurricane Maria struck Puerto Rico with sustained wind gusts of 155 mph., a category 4 storm that caused widespread devastation, wreaked havoc on the island’s infrastructure and left the entire island without power and safe drinking water for months. Radiation oncology patients — many who needed treatments on a daily basis — were often unable to get to cancer treatment clinics, and clinics struggled to remain open due to power outages, a lack of safe, running water, insufficient diesel fuel to run generators and technology challenges such as radiation treatment machines that were no longer able to communicate with servers. With cell phone service disrupted, communication between clinics and patients also suffered, making it difficult to reach patients in need of treatment or let them know where they could find it.
Under the leadership of then ASTRO Chair Brian Kavanagh, MD, FASTRO, radiation oncologists with expertise in the most commonly treated cancers collaborated with Dr. Gay to provide suggestions for Puerto Rican clinics to mitigate the potential adverse impact on patient outcomes following Hurricane Maria. While they are not official guidelines, these physicians’ recommendations can offer guidance to radiation therapy clinics should a natural disaster or other crisis cause an extended interruption in treatment.
