Cancer treatments, and some cancers on their own, can suppress the immune system, which means the cancer patients may not be able to fight infections, including COVID-19. However, continuing cancer treatment is essential in some patients to fight the disease, even during this pandemic.
COVID-19 is short for Coronavirus Disease 2019. It is an illness caused by fast-spreading Coronavirus called SARS-CoV-2 (severe acute respiratory syndrome). Coronaviruses are spherical, with protein spikes protruding from their surface. These spikes can latch onto the human cells and allow the viral particle to join with the human cell. The genes from these viruses will then enter the human cell and reproduce to form more viruses. As a result, Coronaviruses can cause respiratory tract infections in humans. The Coronavirus cases are increasing again, globally with episodic decrease. The resulting disease, COVID-19, can cause severe and life-threatening illnesses, particularly in older people (for example, over 65 years) and those with other underlying health conditions.
According to the data available, older people above the age of 60 are more vulnerable to complications from COVID-19, especially when they have any underlying health conditions, such as chronic lung disease, chronic kidney disease, diabetes, cardiovascular disease, and active cancer.
If anyone has cancer, they may be at higher risk of severe illness from COVID-19 if they are:
Patients having chemotherapy or have received chemotherapy in the last three months.
Patients who are receiving extensive radiotherapy.
Patients who had a bone marrow transplant or stem cell transplant in the previous six months or under immunosuppressive drugs.
Patients who have blood or lymphatic system cancer that damages the immune system (for example, chronic leukemia, lymphoma, or myeloma).
Visiting a hospital during this COVID-19 pandemic can put anyone at risk of infection. Therefore, to be safe, cancer care may be modified while the pandemic is ongoing.
The patient with cancer should not stay around people who are sick or venture out of the house.
They should maintain good personal hygiene and clean or disinfect objects that they may frequently touch.
They should not exert themselves and take rest as much as possible.
They should avoid touching their face, nose, and mouth if they have not washed their hands.
If their family members are sick, they must ensure that they cover their mouths while coughing or sneezing.
They should restrict visitors at home.
They must dispose of the tissues used to cover the mouth while sneezing or coughing.
They should maintain social distance at home by staying six feet away from people.
They should not believe in rumors and avoid reading news that is distressing.
If any patient with cancer has trouble cooking or getting food, they must contact their local authority, who will help them. They can receive nutritional supplements and support from a dietician.
To stay fit and healthy, they should do as much exercise as possible. This can be challenging when confined to home, but they can walk in their garden, up and downstairs, or follow any online exercise classes. Anyway, moving around will help them to stay strong and fit.
They must maintain personal hygiene and contact their doctor or nurse if they have problems washing or bathing; they will provide them with advice to make these tasks easier.
It is essential to look after their mental health during this pandemic. They should regularly contact friends and families via phone, email, video calls, and social media. They should also contact their doctor or nurse if they need additional emotional support from a psychotherapist or counselor.
Due to this COVID-19 pandemic and the increased risk of exposure to the virus by going out in public places, most hospitals and clinics have changed their visitation policies to reduce the time spent in a hospital setting while still receiving the care. The patient will be offered telephone or video consultations, mainly for pre-treatment meetings and follow-up appointments, to avoid in-person contact. If they usually have their blood tests done at a hospital, they may relocate them to a local center instead. And medication might be delivered to them or maybe arranged via a drive-through pick-up point. Electronic prescriptions are also being issued in many areas to allow patients to access their home-based cancer treatment (for example, oral treatments) without the need for additional appointments during the pandemic.
A guide that helps the patient and their friends, family, and caregivers to understand the impact of the COVID-19 pandemic on their cancer care will be provided. It provides information on COVID-19 and its symptoms and measures to lower their risk of becoming infected. It will also provide information on the impact of the COVID-19 pandemic on various aspects of cancer care, including the potential chronic kidney disease, changes to their treatment plan, and appointments, which may be necessary to keep them safe from infection.
Oncologists may also suggest stretching out the length of time between cancer treatments using medications, like chemotherapy or immunotherapy, or recommending a delay in starting these treatments based on their cancer diagnosis and the treatment goals.
Early in the pandemic, there were delays in the cancer screening tests, like mammograms or colonoscopies, and other tests like bone density tests to reduce the risk of exposure to the virus. However, it is still necessary to receive regular cancer screening, even during this pandemic. For people at high risk of cancer, such as those with hereditary cancer syndrome, the doctor may recommend delay in some cancer risk-reducing procedures. They will suggest this only if they feel safe for the patient, based on the virus transmission rates where they live. It is always best for the patients to discuss the timing of these tests and procedures with their doctor.
The patients might be required to wear a mask when they visit their doctor in person. For example, their temperature can be checked at the clinic or hospital entrance and be asked about their symptoms.
Doctors may try to carefully consider the risks of cancer against the risks associated with the virus that causes COVID-19 to choose the cancer treatment that is best for you. Changes to the treatment might be necessary to limit the number of in-person appointments or invasive procedures the patients may need to reduce their risk of COVID-19. Meanwhile, hormone therapy, chemotherapy, or other treatments might be their initial treatment if the surgery is postponed due to the COVID-19 pandemic. For some cancers, it might be possible to alter chemotherapy or radiation therapy schedules so that the patients may require fewer treatment sessions. For example, they can take chemotherapy drugs in pill form without any infusions. For certain slow-growing cancers, they can safely delay the treatment for weeks or months.
As far as the COVID vaccines are concerned in patients with cancer or those who have survived cancer, the vaccine's safety is not the factor to be considered. Instead, the vaccine's efficacy is the point to be noted because, with chemotherapy, radiotherapy, and other cancer treatments, the body's immune system becomes less effective. Thus, reducing the efficacy of the vaccine. However, most experts agree that vaccination is essential in patients with cancer since even the slightest immune response obtained with vaccination is beneficial in reducing the severity of the COVID-19 infection.
Most of the population has already got vaccinated. Few have even started getting the booster shots. People with a weaker immune system are suggested to get a booster shot to combat infection in a better manner. All the approved vaccines are effective and people with cancer can take any of the approved vaccines available. People undergoing cancer-related treatments can talk to their doctor, and fix the right time to get vaccinated.
Access to health care during the COVID-19 pandemic may be challenging for many cancer patients, and care for people who have recovered from cancer has also been less of a priority. Still, it should not be neglected, especially on the severe effect of the pandemic on the mental well-being of patients and their caregivers, including potential fears of a recurrence of cancer and a sense of abandonment by the healthcare system. Similarly, palliative and end-of-life care have been limited, with face-to-face contact restricted. Therefore, additional research to evaluate this impact at the patient level is required.
Last reviewed at:
11 May 2022 - 5 min read
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