What Is a Coronavirus Pandemic?
Coronavirus is a respiratory illness that is officially called COVID-19 that has changed many lives. This pandemic is a highly stressful event that may lead to significant psychological symptoms, especially in patients with cancer who are at greater risk of contracting viruses. These have generated many delays and disruptions in cancer care for people with breast cancer. Whether newly diagnosed, in active treatment, long-term survivorship, or living with metastatic breast cancer, they add extra anxiety and risk to an already challenging journey.
This article will tell about the frequency of stressors experienced concerning the ongoing Coronavirus pandemic and its relationship with psychological symptoms, such as anxiety, depression, insomnia, and fear of cancer recurrence in patients with breast cancer.
What Is Breast Cancer?
Breast cancer is a lump or mass in the breast that appears different from the surrounding tissue. Women above 50 years are commonly affected, and in addition, the family history can increase the likelihood of the disease. If a woman has felt any lump in her breast or experience any soreness in or around her breast or discharge from her nipple, she should get her symptoms evaluated right away.
Is There Any Link Between COVID-19 and Breast Cancer?
Breast cancer has one main intention to spread. Often, the first stop is in the lymph nodes, and as it advances, metastases can occur in distant parts of the body like the bones, lungs, liver, and brain. There may be swollen lymph nodes, bone pain, shortness of breath, or yellow skin in those with a distant spread of the disease. Some breast cancer treatments, including chemotherapy, immunotherapy, and targeted therapies, can weaken the immune system and cause lung problems. These people have a higher risk of acquiring severe complications if they become infected with this virus. For most people, the immune system improves within a couple of months after performing these treatments. But recovery time of the immune system can vary and may depend on several factors. And if someone has received these treatments in the past, it is unclear whether they are at higher risk of acquiring severe complications from COVID-19. People with breast cancer with metastasis (spread) to the lungs can also get lung problems that may worsen if they contract COVID-19.
How Has COVID-19 Changed Breast Cancer Care?
People diagnosed with breast cancer and people at high risk for breast cancer have found themselves in a uniquely challenging and sometimes frightening position since the Coronavirus crisis began.
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Many of them wondered if it is safe to go to regular medical appointments or whether to postpone treatments or screening.
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At the beginning of this pandemic, many hospitals and healthcare facilities delayed or canceled elective procedures, like screenings, surgeries, and other treatments that were not considered urgent.
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This was a distressing situation, but the healthcare facility made these tough decisions to protect people from the risk of contracting COVID-19 and ensure that the healthcare providers had the necessary resources to treat people with severe cases of COVID-19.
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Therefore, people often took appointments with oncologists through the telemedicine platform rather than in person. And oncologists had postponed some appointments if they felt it was safer to do so.
What Are the Widespread Delays and Interruptions in Breast Cancer Care During COVID Waves?
The COVID-19 has caused delays in many aspects of breast cancer care, including routine clinical visits, surveillance imaging, regular mammograms, reconstruction, radiation therapy, hormonal therapy, mastectomy, and chemotherapy in the first wave. Patients also delay or change their treatment plans due to concerns about contracting COVID-19. And due to these interruptions in their care, many people were worried about their cancer growing or recurring. In addition, financial problems affecting their ability to pay for maintenance and losing their health insurance are the other concerns of people with breast cancer.
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The change or delay in the surgical treatment plans in the past year also ended in some people requiring more surgeries overall. For example, patients who had to get a lumpectomy and a breast reduction in one operation had them done in two separate operations. And some patients needed a second procedure because they could not get the surgery they wanted at the beginning of the pandemic.
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Breast reconstruction, which is considered elective surgery, was also postponed to preserve hospital resources and protect patients.
What Are the Risks of COVID-19 on Patients With Breast Cancer?
The virus has widely spread to many countries globally. However, since the number of cases differs in different regions, the immediate risk of coming into contact with the virus depends on the location. In addition, the risk of infection will continue to change over time as cases increase and decrease in different localities. Many women were not getting their mammography done, not going to the gynecologist, and not having a regular physical examination due to this pandemic.
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Most people with COVID-19 infection will have no symptoms or will have only mild to moderate respiratory symptoms and may recover without special treatment or hospitalization.
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But for people with cancer, it may increase their risk of having severe complications if they get infected with COVID-19.
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This higher risk for severe complications from COVID-19 for people currently diagnosed with cancer is because cancer stresses the body and specific treatments can cause people to become immunocompromised or have lung problems.
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Some chemotherapy medicines and targeted therapies given during breast cancer treatment can also cause lung problems, putting people at risk for severe COVID-19 complications.
What Are the Facts of COVID-19 Vaccines on Patients With Breast Cancer?
The first COVID-19 vaccines approved by the U.S. Food and Drug Administration (FDA) in December 2020 for emergency use are the Pfizer-BioNTech COVID-19 vaccine, Moderna COVID-19 vaccine, and Johnson & Johnson’s Janssen vaccine.They are considered to be safe to administer in immunocompromised patients because they do not contain live viruses, including people being treated for cancer. Experts have also suggested most people with cancer or a history of cancer get a COVID-19 vaccine. Still, it would be best to talk to their doctor about whether getting vaccinated is the right decision for their situation.
The side effects of the COVID-19 vaccines include:
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Pain or soreness in the arm where you receive the injection.
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Muscle or joint pain.
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Tiredness.
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Fever.
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Chills.
Side Effects of COVID-19 Vaccine Associated With Breast Cancer:
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Research has shown that women may experience worse side effects than men from the COVID-19 vaccines.
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Some vaccinated people have experienced swollen lymph nodes, including the axillary lymph nodes on the side where they got injected, called axillary adenopathy.
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If anyone has had breast cancer, particularly if the underarm lymph nodes are removed, they could experience lymphedema as a side effect of the COVID-19 vaccines.
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To reduce the risk, people with a history of breast cancer can request to put the vaccine injection in the opposite arm of the body where the breast cancer was present.
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And if they have breast cancer in both breasts, they can talk with their doctor to decide which arm they should choose for the injection.
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This swelling of the axillary lymph nodes after vaccination can be harmless for patients with no history of breast cancer, but they can feel it like breast lumps and cause some women to worry that it could be a sign of breast cancer.
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These swollen lymph nodes can be shown on a mammogram, even if they cannot feel them, and could give a false-positive result when a mammogram shows an abnormal area that looks like cancer, but it turns out to be expected.
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A false-positive mammogram result can lead to undesirable stress and additional testing. Hence, experts suggest people wait for four to six weeks after all doses of the COVID vaccine before getting a mammogram.
What Is the Role of Telemedicine in Breast Cancer Care in This Pandemic?
Attempts to prevent the spread of COVID-19, the disease caused by Coronavirus, concentrate on limiting how much you communicate with people outside your household. However, one way the condition has changed life for many people with breast cancer is by offering telemedicine, a term for medical appointments conducted over the phone or video calls. Telemedicine affords a safe and consistent environment for routine monitoring and prescribing non-infusion therapies for low-risk patients with well-managed diseases. In addition, oncologists specifically feel more comfortable using telemedicine for early-stage and specific subsets of patients with breast cancer, indicating a less complex decision-making process. Teleoncology, like other telehealth services, has several applications across different industries. For example, telepathology involves remote analysis and diagnosis based on television microscopy and such. It also provides remote supervision, palliative care, and tele-education.
Conclusion:
Battling breast cancer can cause significant stress and anxiety for both men and women, especially during the Coronavirus outbreak. But people need to overcome this with courage and strength. On the other hand, cancer type and cancer treatments did not show any risk of mortality from COVID-19. But, if anyone is very concerned about how the specific breast cancer treatments may affect the ability to recover from COVID-19, they should talk to their doctor and decide on a treatment plan that gives both of them peace of mind. In the past few years, cancer care has undergone some positive changes, one of which is the rise in telemedicine.