A Partnership Between Physicians and TheirCommunity
Maryland Oncology Hematology believes in providing patients with advanced, comprehensive cancer therapies in a community setting that allows patients to receive care near their support systems. Our highly trained and experienced physicians work closely with a talented clinical team that is sensitive to the needs of cancer patients and their caregivers. Choosing an independent practice offers patients the chance to receive compassionate, affordable cancer care that utilizes the latest technologies provided by top physicians who are experts in their field. The best of care, close to home.
Patients can be assured that as an independent practice, MOH physicians are able to send patients to the best specialists or make recommendations based on specific care needs. We are never beholden to a practice or network. Unlike some of the major hospitals, our doctors are focused solely on oncology, giving patients the expert care that they deserve. At Maryland Oncology Hematology, we believe that patients are more than a number. Each patient will have a dedicated care team by their side from diagnosis through treatment to recovery.
Maryland Oncology Hematology is a community-based practice, entirely owned and run by Maryland physicians. Our team is devoted to providing state-of-the-art patient care for hematology and oncology, working on behalf of our community for the benefit of patients.
“I’m excited to be part of this highly respected community-based private practice,” said Jason Taksey MD., medical oncologist and managing partner for new Annapolis location. “Maryland Oncology Hematology delivers state-of-the-art care and remarkable treatments in an outpatient center that is safe, modern, convenient, and responsive to patient feedback.”
Why Patients Trust MOH
Comprehensive care including new radiation oncology services offered at White Oak Cancer Center in Silver Spring
Top-Rated Breast and Colorectal Surgeons
Team of almost 50 physicians and more than 50 years of experience
Research and phase 1-3 drug trial participation
Convenient locations
Financial guidance
Support groups and education
Hospital affiliations
Choosing an Independent Cancer Provider
As an independent practice, Maryland Oncology Hematology is proud to offer patients increased access to integrated, evidence-based cancer care and clinical research throughout the communities of Maryland. When compared to oncology services at big hospitals, independent cancer centers are typically more conveniently located, more individualized, and more likely to offer all necessary services under one roof. Independent cancer centers are also more cost effective for patients.
At MOH, our state-of-the-art infusion centers offer a full range of chemotherapy services, laboratory testing, clinical trials, and support services, provided by people who have an unwavering commitment to achieving the best possible result.
Our providers also have the freedom to choose the best possible specialists and hospital services for our patients, as well as arranging referrals for additional consultation or specialty care when needed. We ensure that our patients receive the best care based on each person’s unique diagnosis and treatment needs.
Maryland Oncology Hematology is able to offer cutting edge and innovative clinical research trials without the delays that many hospitals face. In partnership with US Oncology Network, MOH is able to unite the practice with more than 1,380 independent physicians dedicated to delivering value-based, integrated care to patients. These independent doctors come together to form a community of shared expertise and resources dedicated to advancing local cancer care and to delivering better patient outcomes.
Benefits to Patients
At Maryland Oncology Hematology, we strive to help patients through positive patient-doctor relationships while utilizing the latest in advanced technology. Other benefits include:
Better Access and Convenience
Community facilities offer integrated care close to home meaning there is less travel for patients. This provides reduced ER visits, admissions, and overnight hospital stays because of the proximity to care. At community cancer care clinics, patients receive treatments from one care team. In the hospital setting, patients are likely to see a different doctor and nurse throughout treatment.
Personalized Medicine
Our team utilizes a multidisciplinary approach to cancer care, combined with the most advanced treatments, cutting-edge technologies, and clinical trials research program. This includes precision medicine based on the genetic profile of a patient or their specific diseases. Molecular testing can be used to help target cancer treatments, as well as improve accuracy of a diagnosis in complex cases or help patients learn if there is a risk of cancer that runs in their families.
Immediate Appointments
At Maryland Oncology Hematology, we offer immediate appointments to newly referred patients, ensuring they get the care they need without stressful and unnecessary delays they might otherwise experience in major hospital systems. Our team will schedule a consult with one of our experts who can provide guidance and treatment options, as well as address any patient and family member concerns.
Community care offers patients:
Shorter wait times
Easily accessible surface parking and patient drop-offs
Less likelihood of catching infection associated with hospital visits
Access to support services, including social workers, financial assistance, and reimbursement specialists
Access to groundbreaking clinical trials
Lower cost of care across all cancer types when compared to hospital settings[1]
“We’re grateful to have the privilege to bring remarkable cancer care advances to our patients, as well as offer therapies that can improve their quality of life,” said Dr. Jason Taksey. “At MOH Annapolis, we are excited to offer superior care options for our patients and our surrounding community.”
About Maryland Oncology Hematology
Maryland Oncology Hematology (MOH) is the largest independent oncology practice in the state of Maryland with locations in Annapolis, Bethesda, Brandywine, Clinton, Columbia, Frederick, Germantown, Lanham, Laurel, Mt. Airy, Rockville and the White Oak Cancer Center in Silver Spring. Our more than 40 physicians are devoted exclusively to providing comprehensive, compassionate, and high-quality cancer care. For more information, visit MarylandOncology.com.
Every aspect of the Coronavirus disease 19 (COVID-19) pandemic has occurred at record speeds, from disease transmission to vaccine development. COVID-19, caused by a novel coronavirus known as SARS-CoV-2, targets the respiratory system. Most people experience flu-like symptoms; however, in the elderly and those with comorbidities, mild respiratory issues can quickly progress to Acute Respiratory Distress Syndrome, resulting in multiple organ failure and death.
The highly contagious nature of this virus, which is spread through droplets and aerosols released when an infected person sneezes or coughs, is evident by the fact that over 106 million COVID-19 cases have been reported worldwide. Over 2.35 million people have already succumb to the virus1–3.
The limitations of hospital capacity, ventilators, and healthcare personnel have been constant concerns throughout this pandemic. Worldwide regulations promoting social distancing and hygiene have prevented transmission, but they have also crippled the economy and stifled social freedoms1,2.
The overwhelming nature of this pandemic has led to the development of COVID-19 vaccines within an unprecedented timeframe. Despite the relief that this brings to some, many are concerned about the effects of the vaccine. A poll conducted by The Associated Press-NORC Center for Public Affairs research reported that of the 20% of Americans that did not want the COVID-19 vaccine, 70% were concerned about side effects4. Furthermore, the speed with which the COVID-19 vaccines were developed have left many questioning whether proper precautions and protocols are still being implemented. The Food and Drug Association (FDA) has stated that vaccine production will be in accordance with legal and regulatory guidelines5.
A cancer patient, who’s immune system is likely compromised by the effects of chemotherapy, would be understandably concerned about the virus and possible risks associated with the vaccine. This article aims to provide insight into the COVID-19 vaccine, concerns for cancer patients, and recommendations of healthcare professionals.
The COVID-19 vaccine: development, efficacy, and side effects
A vaccine is considered effective when it reduces the infection rate, disease severity, or disease transmission. One of the main goals of a vaccination strategy is to create herd immunity, which is a large population of people that are immune to a specific disease6. With the aid of new vaccine development technologies, human clinical trials for the first potential COVID-19 vaccine began on March 16th 2020, just 4 months following the outbreak7. On February 10th 2021, the New York Times Coronavirus Vaccine Tracker reported that 69 COVID-19 vaccines were in the human clinical trial phase8.
Vaccine development was previously a 10-15 year process, and had the COVID-19 vaccines been made in this manner, scientists would still be the exploratory phase of the development process9. Soon after the COVID-19 outbreak in China, scientists unraveled the genetic code for SARS-CoV-2, which serves as the blueprint for the virus’s structure10.Then, by studying the virus’s structure, a protein called the spike protein was found on the outer surface of SARS-CoV-2. Researchers found that SARS-CoV-2 uses the spike protein to bind to and enter human cells, where it can replicate and cause sickness11. The spike protein is now the main target for COVID-19 vaccines12.
Traditionally, vaccines contained a weak or inactivated form of a virus that would allow the body to trainagainst a weakened opponent so it would be better prepared to fight the same virus during an actual infection13. The COVID-19 vaccine was developed using RNA technology, an idea that was introduced in the 90’s by French researchers14. An RNA vaccine contains an mRNA sequence, which is simply a refined version of the blueprint used to build a particular protein. Once in the body, cells can process this code to produce the protein. If this is a viral protein, the body recognizes it as foreign, and the immune system is trained to eliminate it. Some COVID-19 vaccines introduce the code for the spike protein so that the body will be trained to fight it when presented with the actual virus13. Two of the leading COVID-19 vaccines, BNT162b2 Pfizer-BioNTech and mRNA-1273 Moderna, which have been approved for emergency use in the U.S. and E.U., are mRNA vaccines that target this spike protein8,15. COVID-19 vaccines may require periodic updates, similar to the Influenza vaccine, in order to accommodate mutations16.
The Centers for disease control and prevention (CDC) reports a 94.1% efficacy with the Moderna vaccine based on 1 large Phase III clinical trial with 30,000 participants aged 18-95 that had not previously tested positive for COVID-19. Systemic adverse effects, described as mild to moderate, were more common after the 2nd dose. These effects were more severe in patients under 6517. Pain, swelling, and redness were reported as localized reactogenicity symptoms, while chills, fatigue, and headaches were listed as systemic adverse effects18. The World Health Organization (WHO) reported that the Moderna vaccine is safe in patients with comorbidities, such as hypertension or diabetes, and chronic infections, provided that their condition is stable and controlled. Due to the possibility of severe allergic reactions, vaccinees must be monitored for 15 minutes after administration. They also report that the effect on immunocompromised people has not been properly investigated. Persons who have previously tested positive for COVID-19 are not deterred from getting vaccinated, but are advised to wait 6 months19.
Both the Moderna and Pfizer vaccine require 2 doses for maximal efficacy. The New England Journal of Medicine reported 95% efficacy in persons that received both doses of the Pfizer vaccine and 52% efficacy is expected after the 1st dose20. A recent report from Israel described a 33% reduction in COVID-19 cases after the first dose. It is important to consider that the Israeli report is based on persons over 60 years, whereas the original Pfizer study included young people as well21. The Pfizer Emmergency Use Authorization Fact Sheet reports similar side effects to that of Moderna, and immunocompromised patients are asked to report their conditions beforehand22.
Female doctor showing two coronavirus vaccine options
The COVID-19 vaccine: considerations for cancer patients
Due to the heterogeneity in cancer patients, there has been some debate as to whether they should be considered a high-risk group. Morbidity and mortality rates between 5 and 61% have been reported in cancer patients that contract COVID-1923. The immunosuppressive effect of many cancer treatments make cancer patients more susceptible to infection. One literature review reported that 10/11 studies in COVID-19 patients reported higher fatalities in patients that also had cancer, especially hematological cancers. Such data argues that cancer patients should be also receive priority vaccination23,24.
Data concerning the effect of the COVID-19 vaccine in cancer patients is very scarce. Of the nearly 44,000 participants in the Pfizer clinical trial only 3.7% were cancer patients23. The immunosuppression in cancer patients caused by chemotherapy, radiation, and/or targeted therapy is also expected to reduce the efficacy of the vaccine. The goal of a vaccination is to elicit an immune response that will train the immune system to fight against a particular disease. A weakened immune system is less likely to respond to this challenge and may therefore be incapable of being trained25. Some have tried to compare the COVID-19 vaccine to the Influenza vaccine; however, studies reporting the vaccine efficacy in cancer patients who received the flu vaccine show that the outcome depends on the cancer type and treatment26–28.
Dr. Nora Disis, a medical oncologist and the director of the Institute of Translational Health and the Cancer Vaccine Institute at the University of Washington, suggests that vaccine dosage and the timing are points of concern, especially in patients in active treatment. She also suggested that cancer patients avoid vaccinations containing an active form of the virus as this could lead to infection in immunocompromised patients29.
Recommendations and reminders for cancer patients
Currently, no COVID-19 vaccines containing live virus have been approved for administration, therefore there should be no risk of becoming infected by the vaccine itself29. As studies of the vaccine in cancer patients are lacking, it is uncertain if cancer patients are susceptible to side effects other than those reported in the general population. The overall recommendation for cancer patients is to receive the vaccine as the risk of contracting the virus is far greater than the possibility of the vaccine being less effective30. We recommend that patients actively on treatment discuss with their oncologist the timing of vaccine administration.
Dr. Jeffrey Farma, a surgical oncologist at the Fox Chase Cancer Center in Pennsylvania, recommends that cancer patients with upcoming surgeries schedule enough time between surgery and the vaccination. Furthermore, patients that have undergone a bone marrow transplant should consult with their hematologist to determine when their immune system will be able to respond to the vaccine. All cancer patients or survivors should consult with their physicians before getting vaccinated31.
Time will tell if current COVID-19 vaccines provide long-term protection and whether they are effective against new variants. Therefore, the advice given to all vaccination recipients is to continue adhering to social distancing and hygiene regulations. Cancer patients, especially, should continue to protect themselves from unnecessary exposure to COVID-19 and any other diseases32,33.
BIO
Dr Juneja joins Maryland Oncology Hematology’sWhite Oak Cancer Center after 13 years of practice in Northern Virginia and Bethesda. He has subspecialized in breast, gastrointestinal, lymphoma, and myeloma in his prior practices. He is very interested in clinical research and cutting edge as well as precision medicine. Previously, he has designed clinical trials with Bristol Myers Squibb, been a medical officer at the FDA, and has been an investigator in several clinical trials.
Having survived cancer himself, he completely understands what it is like to be a patient. He lives with his wife, 2 children, dog, and enjoys playing piano, tennis, running, bicycling, and sailing.
Sources:
Yuki, K., Fujiogi, M. & Koutsogiannaki, S. COVID-19 pathophysiology: A review. Clinical Immunology vol. 215 108427 (2020).
Singhal, T. A Review of Coronavirus Disease-2019 (COVID-19). Indian Journal of Pediatrics vol. 87 281–286 (2020).
COVID-19 situation update worldwide, as of week 5, updated 11 February 2021. https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases.
Expectations for a COVID-19 Vaccine – AP-NORC. https://apnorc.org/projects/expectations-for-a-covid-19-vaccine/.
Shah, A., Marks, P. W. & Hahn, S. M. Unwavering Regulatory Safeguards for COVID-19 Vaccines. JAMA – Journal of the American Medical Association vol. 324 931–932 (2020).
Hodgson, S. H. et al. What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. The Lancet Infectious Diseases vol. 21 e26–e35 (2021).
Le, T. The COVID-19 vaccine development landscape. doi:10.1038/d41573-020-00073-5.
Zimmer, C., Corum, J. & Wee, S.-L. Covid-19 Vaccine Tracker Updates: The Latest – The New York Times. https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html.
Government Accountability Office, U. GAO-20-583SP, Science & Tech Spotlight: COVID-19 Vaccine Development.
Zhou, P. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature579, 270–273 (2020).
Ou, X. et al. Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Nat. Commun.11, 1–12 (2020).
Mahase, E. How the Oxford-AstraZeneca covid-19 vaccine was made. The BMJ vol. 372 (2021).
RNA vaccines: an introduction | PHG Foundation. https://www.phgfoundation.org/briefing/rna-vaccines.
Dolgin, E. How COVID unlocked the power of RNA vaccines. Nature589, 189–191 (2021).
Dai, L. & Gao, G. F. Viral targets for vaccines against COVID-19. Nature Reviews Immunology vol. 21 73–82 (2020).
Callaway, E. & Ledford, H. How to redesign COVID vaccines so they protect against variants. Nature590, 15–16 (2021).
Oliver, S. E. et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine — United States, December 2020. MMWR. Morb. Mortal. Wkly. Rep.69, 1922–1924 (2020).
Information about the Moderna COVID-19 Vaccine | CDC. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html.
The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know. https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know?gclid=Cj0KCQiAyJOBBhDCARIsAJG2h5fDy4YPD3cz69Fqiff3ooH4F3065k93kC60SksUGHs-gU62LA16z38aAi6ZEALw_wcB.
Polack, F. P. et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N. Engl. J. Med.383, 2603–2615 (2020).
Mahase, E. Covid-19: Reports from Israel suggest one dose of Pfizer vaccine could be less effective than expected. BMJ372, n217 (2021).
Inc, P. Pfizer COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers. www.cvdvaccine.com.
Ribas, A. et al. Priority COVID-19 Vaccination for Patients with Cancer while Vaccine Supply Is Limited. Cancer Discov.11, 233–236 (2021).
ASH-ASTCT COVID-19 and Vaccines: Frequently Asked Questions – Hematology.org. https://www.hematology.org/covid-19/ash-astct-covid-19-and-vaccines.
Yap, T. A. et al. SARS-CoV-2 vaccination and phase 1 cancer clinical trials. Lancet Oncol.0, (2021).
Ayoola, A. et al. Efficacy of influenza vaccine (Fluvax) in cancer patients on treatment: a prospective single arm, open-label study. Support. Care Cancer28, 5411–5417 (2020).
Zhang, L. et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann. Oncol.31, 894–901 (2020).
Yri, O. E. et al. Rituximab blocks protective serologic response to influenza A (H1N1) 2009 vaccination in lymphoma patients during or within 6 months after treatment. Blood118, 6769–6771 (2011).
COVID-19 Vaccines and Cancer Patients: 4 Things to Know. https://www.medscape.com/viewarticle/942907.
COVID-19 Vaccines and Cancer. https://news.cancerconnect.com/treatment-care/covid-19-vaccines-and-cancer-FQLL1FPx7kyOUcSjmR2JNQ.
COVID-19 Vaccines: Here is What Cancer Patients and Survivors Need to Know Now | Fox Chase Cancer Center – Philadelphia, PA. https://www.foxchase.org/blog/covid-19-vaccines-here-is-what-cancer-patients-and-survivors-need-to-know-now.
What cancer patients need to know about COVID-19 vaccines | CTCA. https://www.cancercenter.com/community/blog/2020/12/covid-vaccine-cancer-patients.
Oncologists can allay COVID-19 vaccination concerns of patients with cancer, survivors. https://www.healio.com/news/hematology-oncology/20210208/oncologists-can-allay-covid19-vaccination-concerns-of-patients-with-cancer-survivors.