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The Coronavirus and Cancer: What You Need to Know Now

Those already battling a chronic health condition are at higher risk of infection and complications from COVID-19

spinner image A black senior woman with cancer is wearing a scarf on her head and drinks tea.
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The majority of people who become sick with COVID-19, the respiratory disease caused by the new coronavirus, experience mild symptoms of fever, cough and shortness of breath. But severe illness is also a possibility, especially for older adults and people with chronic health conditions. And those battling cancer are at higher risk for complications from COVID-19.

Here's what you need to know about cancer and the coronavirus.

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How can cancer increase your risk for COVID-19 complications?

There are a number of reasons why people living with cancer have a more difficult time fighting off infections, and it all boils down to the disease's impact on the immune system.

Cancer itself can interfere with the body's normal immune response. Some cancers, for instance, change the way the immune system's blood cells work. Others can damage the body's tissues, making them more prone to infections.

Then there's cancer treatment. Common therapies, including chemotherapy and radiation, weaken the immune system by lowering the number of white blood cells in the body. This makes it more difficult to fight off any infection, including a coronavirus infection, explains Eric Winer, an oncologist and chief clinical strategy officer at Dana-Farber Cancer Institute in Boston.

If you received cancer treatment in the past (not counting a bone marrow transplant), your immune system is likely no longer compromised, Winer points out. The risk is highest for those who are currently receiving treatment and those who recently stopped. Because everyone's experience with cancer is different, however, the American Cancer Society (ACS) encourages patients and survivors to talk with a doctor most familiar with their medical history, in order to evaluate their individual risk.

The other piece of it, Winer explains, “is that people who are sick typically have a less robust immune function. So to the extent that someone is sick from their cancer — even apart from chemotherapy and apart from the underlying illness — they may also have compromised immune function, and that just makes it ever so much easier for the virus to pose a greater threat to them.”

Study: Cancer patients at higher risk for COVID-19 complications

A study published in the journal Cancer Discovery on April 28 finds that cancer patients have a higher risk for developing severe complications from a coronavirus infection that could lead to ICU admission — even death — compared to those without cancer.

Using patient information from 14 hospitals in China, researchers found that people with blood cancers and COVID-19, the illness caused by the new coronavirus, have the highest disease severity and death rates; lung cancer was second.

“Although COVID-19 is reported to have a relatively low death rate of 2-3% in the general population, patients with cancer and COVID-19 not only have a nearly three-fold increase in the death rate than that of COVID-19 patients without cancer, but also tend to have much higher severity of their illness,” the researchers wrote.

“Altogether, these findings suggest that patients with cancer are a much more vulnerable population in the current COVID-19 outbreak.”

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Is there anything people with cancer can do to protect themselves?

There is no magic immune booster, Winer says. And without a vaccine for the coronavirus, the best advice for someone living with cancer is “to do what we're all doing” and what the Centers for Disease Control and Prevention (CDC) recommends, he adds. This includes washing your hands often, staying home as much as possible and maintaining a distance of at least 6 feet between yourself and other people when you go out. It's also a good idea to make sure you have adequate supplies of your medications on hand and to clean and disinfect your home regularly. The CDC recommends that people wear cloth face masks or face coverings in public when proper physical distancing is difficult to maintain. But if you are undergoing treatment, your doctor may recommend another type of face mask, to help lower your exposure to germs.

The ACS has advice on how to prevent infections in people with cancer, and the National Cancer Institute has tips on how to best prepare for any emergency while living with cancer.

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Are treatments being delayed?

Cancer patients may experience a disruption in routine care during the coronavirus pandemic, as hospitals and health care facilities across the country postpone nonurgent appointments and surgeries. Cancer treatment plans are also being revised at some centers, including Dana-Farber.

"From a chemotherapy and radiation standpoint, we're thinking longer and harder about our treatments,” which can compromise the immune system but also potentially expose someone to the virus by bringing the person into the hospital and in close contact with health care workers, Winer explains.

"Anything that gets you out of your house and in contact with other people puts you at greater risk [of catching the coronavirus],” he adds.

Make sure you check in with your doctor for the latest updates on your care.

Should I still get my cancer screening?

No. The ACS recommends that no one go to a health care facility for routine cancer screenings, such as mammograms and colonoscopies, at this time.

When restrictions ease, however, it's important to reschedule your screening appointment. “Remember, these screening tests save lives,” Richard Wender, M.D., chief cancer control officer at the ACS, said in a statement. “Getting back on track with cancer screening should be a high priority.”

Screening tests, though, are different from the tests your doctor would order if you were experiencing cancer symptoms, the ACS points out. Be sure to reach out to your health care provider if you have any concerns.

"We're going to get past all of this,” Dana-Farber's Winer says. “It's going to result in some changes in the way we approach cancer care,” including a shift toward more video visits and virtual consults, “but I don't know that all those changes are bad.”

Coronavirus symptoms

Mild COVID-19 cases:

  • Fever
  • Cough
  • Shortness of breath

4 new symptoms people may also experience:

  • Chills
  • Muscle pain 
  • Sore throat
  • New loss of taste or smell

Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea, the CDC says. 

COVID-19 emergency warning signs:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Source: Centers for Disease Control and Prevention

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