Cancer and Covid-19, What Cancer Patients Need to Know
In an article in Cancer Centers of America website, referencing frequently ask questions, What patients, caregivers and survivors need to know are addressed
What is COVID-19?
Coronaviruses, in general, are common viruses that may cause colds or more serious respiratory illnesses.
COVID-19 is caused by the coronavirus known as SARS-CoV-2. It is considered a new strain of the virus; it was discovered in China in December 2019; and has now spread around the world. It is not the same as the coronaviruses that commonly cause mild illnesses such as the common cold. For this strain, CO stands for corona, VI for virus and D for disease, and 19 because it was first discovered in 2019.
What are the symptoms?
The most common symptoms of the virus are fever, coughing, and shortness of breath. The virus can lead to more difficult respiratory complications, including pneumonia, especially in older patients and those with existing illnesses.
Symptoms can appear as soon as two days or as long as two weeks after exposure.
What should I do if I have symptoms?
Call your doctor immediately, especially if you have traveled recently or think you have been in contact with someone who is suspected of having the virus.
How does the virus spread?
According to the U.S. Centers for Disease Control and Prevention (CDC), the virus spreads mainly from person to person:
When somebody who is infected and coughs or sneezes, the virus can be spread in respiratory droplets.
These droplets might reach the mouths or noses of people who are in close contact (within about 6 feet), which could lead to an infection.
The droplets can also land on surfaces, which people might the touch, This could potentially lead to an infection if a person then touches his or her mouth or nose.
How will I be able to tell if I have COVID-19, a cold, or the flu?
It will be difficult to distinguish one viral infection from another when experiencing mild symptoms, especially with no recent travel or contact with someone known to have COVID-19. If your symptoms worsen or you develop shortness of breath, we recommend seeking medical attention and testing for flu and/or COVID-19.
About COVID-19 and cancer
As a cancer patient, am I more likely to get sick from COVID-19?
Symptoms vary widely in people with COVID-19, ranging from no symptoms to severe pneumonia. Cancer patients may be at a higher risk of more severe symptoms because of their lowered immune system due to medications and treatment. Like other healthy people, they should do their best to avoid infection. This includes:
Avoiding crowded public places
Washing hands frequently with soap and water for at least 20 seconds
Avoiding touching their face
Covering their mouth and nose when coughing or sneezing
Avoiding others who are unwell
Staying home when sick
Do we know how COVID-19 affects cancer patients?
We are still learning how this virus may impact those who have cancer. So far, data from China suggests that patients with cancer have a high risk of complications. The risk is higher in patients with more than one chronic medical condition.
Are all cancer patients at risk, or only those in active treatment?
Patients diagnosed with blood cancers, such as leukemia, lymphoma, and multiple myelomas may be at higher risk than those with other cancers. Blood cancers often start in the bone marrow and disrupt the normal production of immune cells. These cancers may also affect the lymph system, including the spleen, thymus, and lymph nodes, which help store immune cells and filter out impurities. And because COVID-19 attacks the lungs, patients with underlying chronic lung disease who develop lung cancer are at an increased risk of severe symptoms from the virus.
Cancer patients who are in active treatment for their disease may also have a higher risk, especially those on chemotherapy drugs. These drugs may cause side effects that decrease the body's ability to produce infection-fighting white blood cells. Should I keep my follow-up appointments, or is it better to avoid the hospital for the time being?
If you are doing well and have no symptoms, please contact your care team to determine if routine follow-up is necessary at this time. Avoiding a hospital visit may limit your risk. If you have mild symptoms such as runny nose or cough, please take the same precautions you would care for the common cold. If you have worsening symptoms or shortness of breath, call your primary care provider or your local department of public health. If you are unable to reach either of these, seek immediate medical attention.
Should cancer patients avoid public transportation and events? Is it safe to leave home at all?
Social distancing is recommended for patients to limit the risk of COVID-19 exposure. This includes limiting crowded and closed spaces such as buses, trains, airplanes, movie theaters, malls, restaurants, etc. This does not mean that you cannot leave home at all. When you do go out, the most critical aspect is prevention; hand hygiene is vital.
What else do cancer patients need to know about the coronavirus?
The COVID-19 outbreak is still new, so doctors do not have a lot of specific information on this virus for cancer patients. They do have a lot of information regarding the risk of infections in general for cancer patients. The American Society of Clinical Oncology (ASCO) recommends that cancer patients who think they may have been infected with the new coronavirus contact their doctor if they have a fever and other symptoms of respiratory illness, such as a cough or shortness of breath.
As a cancer patient, is it safe for me to travel by airplane right now?
Cancer patients are considered at higher risk from COVID-19. For your safety, we advise that you limit unnecessary travel. When necessary, it is recommended that you travel by car and avoid large crowds. Please call your care team to determine the next steps in your treatment. Protecting yourself and others from COVID-19
What can I do to protect myself from the virus?
Wash your hands frequently with warm water and soap for at least 20 seconds.
Avoid touching your mouth, eyes, and nose.
For disinfection, diluted household bleach solutions, alcohol solutions with at least 70 percent alcohol, and most common EPA-registered household disinfectants should be effective. The approved list of products can be found on the EPA website.
Use a disposable towel or tissue to cover your nose and mouth when you sneeze or cough, and wash your hands after.
Avoid people who are sick—and stay home if you're sick.
Disinfect countertops and door handles, telephones, and other frequently touched objects.
Be vigilant about avoiding exposure to illnesses such as influenza and measles and require the same of your family and caregivers. (Remember: While vaccines may help curb the spread of those diseases, there is no vaccine for COVID-19.)
If you had COVID-19 and recovered, can you still transmit the disease?
According to Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Diseases, just because someone who had the coronavirus is feeling better does not mean they can't spread the disease.
"You can become infected, get symptomatic, resolve the symptoms, feel well, and still share the virus," Fauci said. "You can go back to your normal life when you have two consecutive tests for the coronavirus that are negative, separated by 24 hours. Just because you feel better or feel well does not mean you are not sharing the virus."
If you get the COVID-19 once, can you contract it again?
The answer to that is not yet evident, according to Dr. Maria Van Kerkhove, an infectious disease epidemiologist with the World Health Organization. What should I do if a family member develops symptoms?
If family members develop an illness, they and you must wash hands frequently with soap and water for at least 20 seconds each time. To reduce the risk of infection, keep surfaces clean, and maintain distance from them if possible–CDC recommends at least six feet.
How can I know the health of my immune system? Is there a test?
A blood test can determine whether you have a healthy amount of white blood cells and immunoglobulins, or antibodies, which help fight infection. But there is no reliable test to determine the overall strength of your immune system. However, cancer patients, especially those diagnosed with blood cancers, such as leukemias or lymphomas, or who are on certain medications, such as chemotherapy drugs or hormone therapy, may have compromised immune systems and should take steps to avoid exposure to infections.
How can I keep my immune system healthy?
Here are some tips to help support a healthy immune system:
Eat a diet rich in colorful fruits, vegetables, nuts, and legumes.
Eat lean meats and fish in moderation.
Avoid processed and charred meats.
Reduce or eliminate alcohol.
Avoid all tobacco products, including cigarettes, cigars, pipes, and chew.
Get plenty of restful sleep.
Exercise and stay active. Consult your doctor before starting a new exercise plan.
Is there a vaccine against the novel coronavirus?
Although several pharmaceutical companies are working on vaccines and treatments, there's no vaccine available yet against the virus that causes COVID-19.
Can I get COVID-19 from a blood transfusion, infusion, or injection?
There is no evidence that COVID-19 can be transmitted through a transfusion, injection, or infusion. COVID-19 is spread from aerosol droplets sprayed into the air by sneezing or coughing. A person may become infected when these droplets are inhaled or otherwise reach their nose, mouth, or eyes. A person may also be infected if he or she touches droplets that land on surfaces, such as a table, keyboard, or phone, then touches the mouth, nose, or eyes.
Should people still get screened for cancer during this national emergency?
The U.S. Centers for Disease Control and Prevention (CDC) recommends that all non-emergency medical visits and procedures be postponed to allow doctors, hospitals, and related services to focus on the COVID-19 outbreak. This includes tests or procedures sued to screen for cancer, such as a scheduled colonoscopy or an annual mammogram. However, diagnostic and staging procedures for cancer may be necessary, in some cases, especially if a patient has symptoms, such as bleeding or pain. Talk to your doctor about whether your screening or diagnostic procedure is necessary or can be rescheduled. Should I wear a face mask to protect myself from COVID-19?
The CDC now recommends everyone wear cloth face coverings in public places, such as grocery stores, where social distancing may be difficult. The CDC says these coverings may help slow the spread of COVID-19 by people who may have the virus but are not yet exhibiting symptoms. The agency suggests making masks from old clothing or other household materials. Still, it does not recommend using surgical masks or N95 respirators, since health care workers need those supplies.
Is it OK to use valet parking, ride-sharing services, and rental cars?
If you need to use these services, we recommend you use antibacterial wipes to clean the steering wheel (if you're driving), door handles, gear shift, and any other buttons or levers that might have been touched by someone else. And importantly, don't forget to wash your hands for at least 20 seconds with warm water and soap at your next opportunity.