So many things in the professional world have changed because of COVID-19 pandemic. Since early 2020, the medical and oncology communities have been very resilient and are adapting to the ever-changing situation. Scientific meetings have gone virtual. ASCO, ESMO, and other oncology organizations elected not to postpone the presentation of new research results that would advance oncologic research, improve patient care, and change practice. They held their annual meetings online. Although we all missed in-person meetings and networking, and experienced some inevitable technical difficulties, we were happy with the end results and relayed advances and new knowledge to our patients. The extraordinary and innovative efforts by ASCO in May 2020, ESMO in September 2020, and other oncology meeting leaderships were highly appreciated and recognized. Meeting after meeting, we are learning how to take advantage of digital information technology with our computer science engineers and professional conference organizers. On local and regional levels, the Lebanese Society of Medical Oncology held its Annual Meeting and its Best of ASCO Lebanon meeting virtually in a very successful manner that included pre-recorded and live streaming presentations.

We have learned and adapted our clinical practice to cope with COVID-19 pandemic as it persists among us, as well as at its high peaks. We produced guidelines to protect our most vulnerable patients as well as our relatively stable ones. We demanded that health authorities and hospital administrations ensure and apply measures to protect both patients and health care workers as much as possible. We prioritized in-person care procedures and moved to more and more telemedicine. We hold our multidisciplinary tumor boards on schedule, business as usual, but in virtual or hybrid formats according to the number of participants and size of conference rooms.

Clinical trials were severely affected at the time of high COVID-19 peaks, but we managed to make sure our patients could get their medications on time, even when periodic tests and evaluations had to be postponed because of lockdowns.

Then came the month of October, and the world is facing another wave of COVID-19, as the number of infected people has exceeded 40 million, with over 1 million deaths worldwide. We in Lebanon, like all oncologists worldwide, are concerned that as many patients are avoiding clinic and hospital visits for fear of catching coronavirus, we will start seeing more patients presenting with cancer at advanced stages. Therefore, in Lebanon, we decided not to cancel nor postpone our annual Pink October Awareness and Action campaigns, but rather proceed and focus on breast self-examination (BSE). We have made lots of progress with screening and early detection campaigns which resulted in a significant decrease of cases of advanced breast cancer, increase of diagnosis at early stages or DCIS, rise in partial mastectomy rates and decrease of total mastectomies, and improved survival up to 80% to 90% for early-stage breast cancer.

The Lebanese Breast Cancer Foundation, in collaboration with the American University of Beirut Medical Center (@AUB_Lebanon) produced a short video (#khabazte) showing women how to do breast exams, once a month, 5 to 7 days after the beginning of menstruation, or at beginning of each month after menopause. Monthly BSE, yearly clinical breast exam by a physician, and screening mammography are the three essential tools for early detection of breast cancer. During COVID-19, as women decrease nonessential visits to doctors’ offices and radiology units, BSE is safest because it can be done at home.

With the help of volunteers, breast cancer survivors, and social media influencers, we took our message to social media platforms, TV stations, and online and print press. The short video campaign and interviews have been very well received, have a very large audience, and met great successes!  

October 2020 breast cancer awareness campaign volunteers and survivors with Dr. El Saghir (center) in downtown Beirut, Lebanon. They are pictured at Beirut Souks, a popular outdoor venue/market where part of the breast cancer awareness video campaign was filmed during the COVID-19 pandemic.

Ms. Mirna Sabbah Hoballah, vice president of LBCF, with EM Ali in an interview on France24 satellite TV about the breast cancer awareness campaign.