NASHVILLE, Tenn. (Ivanhoe Newswire) — Delivering care to cancer patients during the COVID-19 pandemic has proved to be a challenge. Clinical trials have been postponed, cancer screenings have been missed, and the uncertainty of whether a treatment will increase their risk of severe COVID has left cancer patients in the dark. But, there are some questions you need to ask to get the best care.
Nearly two million Americans will be diagnosed with cancer this year and more than 600,000 will need chemotherapy. So, what happens when you add COVID-19 to the mix?
“Does getting chemotherapy a week ago and then if you get this disease, is that going to be really bad?” stated Jeremy Warner, MD, MS, Associate Professor of Medicine at Vanderbilt University Medical Center.
Researchers from Vanderbilt University created a multinational database of COVID-19 patients who also had or have ongoing cancer to find this out. They found cancer patients who contracted COVID-19 had a 16 percent death rate. But that number was not the same for all cancer patients.
“If you’ve got older patients, such as those over the age of 75, especially those who have multiple comorbidities, we’re seeing death rates over 50 percent,” shared Dr. Warner.
While patients who did not have any other comorbidities, besides cancer …
“At least on our registry, there’ve been no deaths at all,” Dr. Warner continued.
They also found people who had recent surgery or chemotherapy were not at an increased risk for contracting COVID-19.
“It tells me as a treating oncologist that if patients need treatment for cancer, they need to get it,” said Brian Rini, MD, Chief of Clinical Trials at Vanderbilt University Medical Center.
So, what questions must you ask doctors when considering the risks and benefits of getting treatment?
“What’s the best thing that can happen? What’s the worse thing that can happen? What are the potential benefits and risks? Is there anything to think about differently now versus six months ago? Can I delay the start of treatment safely?” Dr. Rini shared.
Also talk about whether you want resuscitation attempts or mechanical ventilation and who you would want to make decisions if you are unable to. Finding the answer to these questions now will allow for the best care later.
Dr. Warner said some additional questions to consider is whether you would feel comfortable going to an intensive care unit or hospice care earlier than you might have thought.
Contributors to this news report include: Milvionne Chery, Producer; Roque Correa, Editor; and Bruce Maniscalco, Videographer.
CANCER CARE DURING COVID
BACKGROUND: Research is still being done on cancer patients who may contract COVID-19. However, there is information regarding the risk of infections in general for cancer patients. When the body’s white blood cells, which fight infections, are low or do not function well, the body is unable to fight infections effectively. Some treatments, such as chemotherapy and radiation therapy, can cause side effects that decrease the body’s ability to fight infections. For this reason, cancer patients who are in active treatment may be at a higher risk for COVID-19. Those diagnosed with leukemia, lymphoma or multiple myeloma, may have a higher risk of getting the coronavirus than those with other cancers. Blood cancers often disrupt the normal production of immune cells and affect the lymphatic system, which stores immune cells. And, because COVID-19 attacks the lungs, those with lung cancer may also be at an increased risk for severe symptoms.
IMPACT OF COVID-19 ON CANCER PATIENTS: Cancer patients remain vulnerable if they are over age 65 and have other existing health problems like diabetes, hypertension, and cardiac disease among other ailments. There are about 1,000 cases collected from cancer centers and studies to see what the risk to patients is. It was concluded that the mortality rate of COVID was 10% out of those 1,000 cases. Compared to the rate of the general population, this means it’s at least a hundred times higher for patients on chemotherapy. What this means for doctors is they must consider; do I want them to come back for extra blood tests? Do they want us to have them come back for extra radiology procedures? Currently at City of Hope Medical Center in California, there is an active program in place where if a patient needs therapy, they will get it, and they will get it in a safe environment. Oncologists need to know that they have provided safe environments for their patients, or they can refer them to a comprehensive cancer center that has put various safety measures in place that goes beyond just masks, face shields, and gloves.
TREATING CANCER DURING COVID: The Fred Hutchinson Cancer Research Center in Seattle is considered ground zero for the U.S. coronavirus outbreak. From genetic maps and models, to serology work, to the launch of two new national COVID-19 cancer registries, the Cancer Research Center and its partners, are leading the scientific charge in both research and clinical response to this pandemic. “It’s very important to protect our staff and our immunosuppressed patients,” said Fred Hutch’s Dr. Gary Lyman, a lead investigator on the COVID-19 cancer registry study. “If cancer patients get infected, they’re more at risk for life-threatening complications.” Lyman said oncologists across the country are reinventing cancer care such as, rescheduling noncritical procedures, surgeries and visits, using telemedicine where possible, opting for oral medications over infusions if doable, and rewriting policy on the fly to help keep high-risk cancer patients out of the ER and harm’s way. “These are desperate times which require desperate measures,” Lyman said.
* For More Information, Contact:
Brian I. Rini, MD, SASCO Craig Boerner, Media Relations
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