As we come to the end of the long summer of 2020, we’ve now been dealing with the COVID-19 pandemic for roughly six months here in the United States. We still don’t know when it will end. Vaccines and treatments are under development, but when they will be available remains uncertain.
In the meantime, cancer isn’t going away. And delays in treatment that occurred early on may be part of the collateral damage from this pandemic.
At this stage, are cancer patients still viewed as being at increased risk for severe illness if they become infected with COVID-19? What extra precautions, if any, are recommended for cancer patients?
Impact of Delays in Treatment
During the early months of the pandemic, the health care system understandably focused on managing the pandemic itself and the care of COVID-19 patients. Cancer treatments and other surgeries and medical treatments deemed “non-essential” were often delayed.
A survey of about 600 individuals being treated for breast cancer found that almost half have experienced delays in receiving treatment as a result of the pandemic. Delays were reported in all aspects of cancer care among this group.
The National Cancer Institute estimates that delays in cancer screening and treatment as a result of COVID-19 will lead to 10,000 additional deaths in the United States from breast cancer and colon cancer over the next decade.
Risks for Cancer Patients from COVID-19
Early on in the pandemic, the limited information available suggested that cancer patients were at increased risk for more serious illness or death if they contracted COVID-19. A widely-publicized analysis of Chinese COVID-19 patients with cancer found a higher rate of severe outcomes compared to patients without cancer.
However, more recent data suggests that not all cancer patients are equally at risk for more severe illness if they get COVID-19.
For example, a recent study of 121 patients in New York who had gynecologic cancer and COVID-19 found that standard cancer treatments did not seem to increase the risk of hospitalization or death due to COVID-19 for these patients.
On July 31, the European Society for Medical Oncology issued guidance to oncologists worldwide not to delay cancer treatment that has the potential to impact overall survival. They also urged that all cancer patients should not be viewed as equally vulnerable to coronavirus infection.
The NCI is conducting a study to learn more about the risk factors for serious illness from COVID-19 in people who are receiving treatment for cancer. Knowledge gained from the study will help improve the management of cancer treatment in the future for people who have COVID-19.
Cancer Treatment and Staying Safe
In the meantime, if you need treatment for cancer, what steps should you take to stay safe during this pandemic without delaying needed treatments?
Until more is known and until there is a vaccine and/or specific treatment for COVID-19, the National Cancer Institute’s guidance for cancer patients includes the following:
- Follow the US Centers for Disease Control and Prevention recommendations for people at high risk for developing serious illness from COVID-19. (That guidance includes basic measures such as frequent hand washing, avoiding touching your eyes, nose and mouth, and staying home as much as possible.)
- If you must go out in public, stay at least 6 feet away from other people, avoid crowded places and wear a cloth face covering.
- Talk with your health care provider regarding when and how your cancer treatments can be carried out to minimize your exposure risk.
- If you take oral cancer drugs, you may be able to have prescribed treatments sent directly to you so you don’t have to go to a pharmacy.
The NCI’s information for people with cancer about clinical trials during the pandemic notes that changes are being made to increase flexibility to better protect patients. Some of the changes include the following:
- If the risks of exposure to COVID-19 outweigh the benefits of an in-person visit, a visit may be delayed, skipped or held by phone or videoconference.
- Local health care providers may carry out some of the care normally provided by the clinical trial team, such as physical exams and blood draws.
- Trial sites may send some oral treatments that are being tested in clinical trials directly to participants so they don’t need to go to the hospital to pick them up.
Researchers continue to learn more about COVID-19, including how it’s spread and who is at risk for serious illness. We’ll continue to follow those developments as they relate to cancer treatment while we navigate through this pandemic.
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