COVID-19 + Cancer FAQ
COVID-19 + Cancer FAQ
Cancer doesn’t stop — not even for coronavirus disease 2019 (COVID-19).
The unknowns surrounding the novel coronavirus are leaving people concerned, especially cancer patients who suffer from weakened immune systems as a result of cancer treatment. Stay-at-home restrictions are beginning to lift in several areas across the United States, but immunosuppressed cancer patients are still at high risk of falling seriously ill from coronavirus disease 2019 (COVID-19).
In a series of webinars co-hosted by the UF Health Cancer Center’s Community Outreach and Engagement office, Christopher Cogle, M.D., UF professor of medicine, and Amar Kelkar, M.D., UF hematology and oncology fellow, and Merry-Jennifer Markham, M.D., FACP, FASCO, associate director for medical affairs at the Cancer Center, provided information for cancer patients, survivors, caregivers and providers on how to best navigate cancer treatment and survivorship during the coronavirus pandemic.
Here are some of their answers to COVID-19 questions cancer patients may have:
What is COVID-19? How can I contract it? How can I prevent it?
Coronaviruses are a family of viruses that typically cause respiratory illness. COVID-19 is caused by a novel coronavirus originating from an outbreak in Wuhan, China.
COVID-19 causes respiratory illness and spreads from person to person through droplets released into the air by infected individuals. These droplets can also live on surfaces for several hours to days. Other people contract the disease by breathing in the droplets or touching surfaces they land on and then touching their eyes, nose or mouth. Symptoms of this coronavirus include cough, fever, shortness of breath, muscle aches, sore throat and loss of taste or smell.
Currently, there is no vaccine for COVID-19, so prevention includes washing hands frequently, staying home and wearing a mask to prevent touching your face.
To learn more about COVID-19, check out the Centers for Disease Control and Prevention’s fact sheet.
Am I at higher risk of becoming critically ill from COVID-19 because I have cancer?
According to the American Cancer Society, cancer patients fall in the high risk category due to weakened immune systems caused by cancer and its treatments. Being high risk means cancer patients are more likely to become seriously ill from COVID-19, which could include pneumonia and multi-organ system failure.
Cancer survivors will likely have a recovered, normal immune system, but current and past cancer patients should consult their doctor regarding COVID-19.
The type of treatment a patient receives factors into their immunosuppression. So, what treatments cause immune suppression?
- Chemotherapy does. Immunosuppression can be measured by the white blood cell count, however, sometimes the immune system is weakened even if the white blood cell count isn’t lowered. There is no definite answer on how long immunosuppression from chemotherapy can last. It often depends on the type of chemotherapy and the type of cancer.
- Immunotherapy doesn’t. In some cases, this treatment option can actually strengthen the immune system. However, doctors are not sure what impact it has on COVID-19 infections or symptoms.
- Biologic agents may or may not. Many times, they don’t affect the immune system, but this may vary by medication. It is important to discuss your personal risk with your doctor.
- Radiation does. Radiation is known to cause immunosuppression for some period of time.
- Surgery does. Immunosuppression from surgery may last for about a month, but it also depends on the type of surgery. For example, a splenectomy (surgery to remove the spleen) may result in chronic immunosuppression to some degree since the spleen plays a large part in the body’s normal immune function.
When should I…?
Call my doctor?
You should call your oncologists as soon as you show symptoms, including fever, couch, fatigue, diarrhea, dehydration or worsening cancer symptoms, or if someone in your home tests positive for COVID-19.
Get tested?
Seek a COVID-19 test when you present with fever or cough. The COVID-19 Call Center is available 24/7 at 866-779-6121 or COVID-19@flhealth.gov. You can get tested at county health departments or drive-thru test sites (with referral from your doctor).
Go to the hospital?
Try to avoid the hospital unless you begin to experience shortness of breath, neutropenic or fever with a medical history of a transplant.
Why is or isn’t my doctor delaying my cancer treatment during this time?
If you are currently undergoing treatment for your cancer, you may notice some of your appointments or treatment plans being delayed, even if you aren’t COVID-19 positive.
If your doctor is delaying your treatment, they must have good reason to do so. Some reasons may include:
- You have COVID-19.
- Your post-surgical treatment can be delayed with low risk.
- Your long-term treatment can be delayed with low risk.
- Your treatment puts you at high risk of a weakened immune system.
- There is alternative oral treatment available.
If your doctor is not delaying your treatment, it’s because doing so would negatively affect your treatment outcomes. Some reasons may include:
- You have a disease with high-risk of progress.
- You may die without therapy in the next 2-4 weeks.
- There are no alternative treatments available.
- Your surgery is time sensitive.
- Your symptoms cannot be controlled by oral medications.
- You have life-threatening complications from the disease.
Is it safe to delay cancer screening test or risk-reducing surgery if I have a hereditary cancer?
For patients with an increased risk of cancer due to a hereditary syndrome, the safety of delaying a cancer screening or a risk-reducing surgery depends on the individual patient and their medical history. Patients and their doctors must weigh the risks associated with not delaying — the risk of becoming very ill with COVID-19 if exposed during a healthcare visit versus the risk of cancer being diagnosed through a screening test.
It is unknown how long is safe to delay preventative cancer surgery. However, it is important to note that your doctor will only suggest delaying screening or surgery if it is safe for you to do so.
When stay-at-home restrictions lift, what should I do?
Coronavirus is still circulating in our communities — some more than others. Just because the stay-at-home restrictions will begin to life soon does not mean that the risk of contracting COVID-19 has gone away. It is likely that we will see another wave of COVID-19 cases and deaths when nonessential businesses reopen.
Continue to stay at home and avoid public places as much as possible, especially if you are high risk and/or immunosuppressed.