Everyone is worried about coronavirus (COVID-19). But if you’re a cancer patient, you undoubtedly have specific concerns that others do not. We sat down with our Miami Cancer Institute expert to get more insight into cancer and COVID-19. Medical oncologist Leonard Kalman, M.D., Executive Deputy Director and Chief Medical Officer of Miami Cancer Institute, shared his knowledge on some important questions cancer patients, caretakers and survivors are asking related to their care and health during the COVID-19 pandemic.
Q: If I have cancer, am I more at risk of COVID-19?
A: Yes. Data from areas that began seeing COVID-19 cases earlier than the United States indicate that cancer patients are at a higher risk for contracting COVID-19 and for having more severe symptoms if they do get the virus.
Q: Are people with certain types of cancer more prone to COVID-19 than others?
A: Possibly. The data is still small. But in China, for example, the majority of cancer patients who contracted COVID-19 were lung cancer patients. We don’t know if this is because lung cancer is more common there and because smoking is so prevalent or for some other reason. We also don’t know yet that this will hold true in other parts of the world. But we do know that cancer patients, in general, and especially those undergoing chemotherapy and radiation therapy, are immunosuppressed and that the immunosuppression can last for months and long after treatment, depending on the type of cancer and the type of treatment. And immunosuppressed patients are more likely to have more severe illness if they contract COVID-19.
Q: What can I do to prevent catching COVID-19?
A: Shelter in place as much as possible. Practice social distancing at home as well, i.e., stay at least six feet away from others, wear gloves and/or wash your hands with soap and water for 20 seconds after any encounter, avoid touching your face, and cough or sneeze into a tissue and throw it away. Have someone else run errands for you if you can. If you must leave home to come to the doctor, pick up medications or get food, be vigilant about practicing social distancing as above. Obviously, do not travel, and of course, report any symptoms such as fever, cough or shortness of breath immediately to your doctor.
Q: I don’t have COVID-19 or any symptoms. Should I continue to receive treatment for my cancer?
A: Every patient is different and this is a clear discussion that you need to have with your physician. It’s likely that if you are at a stage in your cancer journey where your disease is not, at the moment, life-threatening and not causing significant symptoms, you may be able to wait and delay your visits and treatment. If your plan of therapy is curative, and the chance of cure could be diminished by a delay, you and your care team may want to continue treatment. If your care plan is not curative but designed to prolong your life with quality, you and your care team need to discuss the benefits and risks of treatment. Clearly if you have significant symptoms, therapy will need to continue until these symptoms are relieved. If you are without significant symptoms, you care most probably can be delayed.
Q: If I test positive for COVID-19, will my treatment continue?
A: Generally speaking, chemotherapy, radiation therapy or surgery should be delayed in patients who test positive for COVID-19. But a decision must be made by you and your care team based on the urgency of your medical situation. In those few cases where therapy must continue, most likely you would need to be hospitalized so that you could be closely observed for any worsening of your symptoms.
Q: Should caregivers and healthcare providers be taking special precautions so that I don’t contract COVID-19?
A: No, not additional special precautions, but meticulous adherence to those precautions mentioned above, including social distancing, handwashing, face touching and cough and sneeze precautions. In addition, all healthcare providers should be closely screened for COVID-19 so as to further protect you, both on the outpatient and inpatient sides.
Q: What else are cancer centers doing to ensure the safety of patients?
A: Most cancer centers, realizing the vulnerability of their patients and staff, have implemented additional specific safety measures. Some of these include reducing the number of people entering their building, screening patients and visitors as well as healthcare personnel, providing “visits” via telehealth, restricting the number of visitors accompanying the patient, and meticulous, deep cleaning of surfaces.
Q: Do those who have recently finished cancer treatment need to take any special precautions?
A: Because many cancer patients have an immune system that is compromised even months after treatment is complete, you should be on high alert and report any symptoms to your doctor immediately.
Because every individual’s circumstance is different, please connect with your oncologist or medical provider for answers to specific questions related to your cancer care.
For the latest updates on Baptist Health South Florida and Miami Cancer Institute COVID-19 news, click here.