What People With Cancer Should Know About COVID-19
An oncologist discusses the risks for those with cancer, how treatments are being adapted, and what patients can do to protect themselves.
People with cancer are among the groups at high risk for a serious illness from complications of COVID-19, according to the American Cancer Society. A new study published found that patients with cancer — especially blood and lung cancers and tumors that have spread throughout the body — have a higher risk of death or severe complications from COVID-19 compared with people without cancer.
“Cancer or its treatment can impair an immune system, causing patients to be immunocompromised, meaning their bodies are not as well equipped to fight off infection,” says Dr. Suzanne Lentzsch, an oncologist and director of the Multiple Myeloma and Amyloidosis Program at NewYork-Presbyterian/Columbia University Irving Medical Center.
Dr. Lentzsch has been adapting treatments and seeing her patients virtually so that many of them can stay at home to avoid the risk of exposure from going out in public. She spoke to Health Matters about the most important things cancer patients should know during the coronavirus pandemic and how they can protect themselves.
How has COVID-19 affected cancer treatments like chemotherapy?
We switched some chemotherapy treatments from hospital-administered intravenous chemotherapy to oral chemotherapy, meaning you can take the treatment in pill or capsule form at home. It has been important that patients stay at home to reduce their risk of COVID-19 infection. There are a lot of options for many types of cancer, so this is a good temporary solution.
After some of the restrictions are lifted, we will begin bringing patients back into the hospital for chemotherapy infusions, taking precautions and scheduling them at special hours to reduce density. It is an evolving situation, and we will be looking at it day by day, case by case.
How are you continuing to care for patients if you can’t see them in-person?
Even if our patients are not coming to the hospital, we are monitoring, treating, and caring for them, so we are not disconnected.
We are doing virtual visits through telemedicine. Patients can visit a local lab for blood work so that they do not have to come to the hospital. After we get the blood results, we can speak to the patient about symptoms and go over the results. I can even ask them to take their pulse and blood pressure, or check a rash over video. We have many tools to help get our patients safely through this crisis.
Elective surgeries are limited right now, but if it is a lifesaving surgery or a life-threatening situation, patients will get surgery.
How do virtual visits compare to in-person visits?
The patients are happy about them, especially after getting used to the technical aspects. They have said it is a huge relief for them to connect with their healthcare providers without leaving their house. On a personal level, I was surprised what we can do via telemedicine — it’s not 100% the same as an in-person visit, but it is close.
What happens if you have cancer and contract COVID-19?
Though people with cancer may be at greater risk, I have seen many patients with cancer recover well from COVID-19.
If patients contract COVID-19, we stop the cancer treatment, but for the majority of patients, we already halted treatment when the pandemic began. This allowed at least a partial recovery of their immune systems and prepared for a better immune response in case patients contracted the virus.
If you are worried you’ve been exposed, look for symptoms. Take your temperature twice a day and monitor if you have a sore throat, cough, fever, night sweats, chills, or loss of smell or taste. If you have family members or people living with you and you develop symptoms, you should isolate yourself by staying in a separate room and wearing a mask when around other people. If you feel that your symptoms are worsening or you develop shortness of breath or chest tightness, seek medical attention by calling 911.
What specific steps can someone with cancer take to reduce their risk?
Follow the Centers for Disease Control and Prevention recommendations. Patients who are at high risk should take extra precautions. Stay home unless it is a medical emergency, and don’t underestimate the risk. That guidance extends to your caregiver and members of your household as they should also not be exposed to COVID-19. In terms of grocery store shopping or other essential errands, schedule a delivery or see if someone outside of your household can do the shopping for you and leave the items at your doorstep. Then clean your groceries or whatever boxes you bring inside. It’s important to wash your hands after doing so.
If you have to leave the house, wear a mask. It’s important you cover your mouth and nose. If you live in a building with an elevator, don’t get in the elevator if someone is in there because you must keep a distance of 6 feet. Use a wipe to touch doorknobs — small things make a difference.
How can patients with cancer also care for their mental health?
This is one of the most difficult times this country has experienced in the last century, and it’s important to care for your emotional well-being. I would suggest focusing on what is most important for you and your safety. Try to get your news from reliable sources and only watch the news once a day so as not to overwhelm yourself with potentially negative information. Maybe now is the time to focus on good books and hobbies. If you feel depressed or anxious, please let your doctor know. We can help, and have a dedicated psychiatrist who can also assist. We offer counseling and treatment via telemedicine to help cope with anxiety.
What else is important for patients to know?
Even in times of social distancing, we as healthcare providers are here for our patients. We are available 24/7. Video visits and phone calls are great tools to stay connected with your physician. I also recommend our patients be involved in their care and that they actively follow up with their team and caregiver on the next steps of treatment when we start to return to “normalcy.” Stay on top of follow-up appointments and blood work, and know that your care team is doing all they can to keep patients safe through the pandemic.
Suzanne Lentzsch, M.D., Ph.D., is an oncologist and director of the Multiple Myeloma and Amyloidosis Program at NewYork-Presbyterian/Columbia University Irving Medical Center and a professor of clinical medicine at Columbia University Vagelos College of Physicians and Surgeons.