Coronavirus and COVID-19: What People With Cancer Need to Know

What is COVID-19?

COVID-19, or coronavirus disease 2019, is an illness caused by a novel (or new) coronavirus that was first identified in an outbreak in Wuhan, China, in December of last year, and although the exact source of SARS-CoV-2, which causes COVID-19, is not certain most likely it originated in bats.

What can I do to avoid getting COVID-19?

The most important ways to protect yourself and avoid being exposed to COVID-19 includes staying at home as much as possible, avoiding areas where people gather, unnecessary travel, and following the guidelines issued by the government.

Another critical way to protect yourself is to wash your hands often with soap and water for at least 20 seconds – about the amount of time it would take to hum ‘Happy Birthday’. If there is no soap and water available, use a hand sanitizer that contains at least 60% alcohol.

In addition to washing your hands frequently, it’s important to:

  • Avoid touching your eyes, nose, and mouth.
  • If you must cough or sneeze, use a tissue. Or, cough or sneeze into your elbow rather than your hands.
  • Avoid close contact with any people who are sick.
  • Clean frequently touched objects and surfaces with household cleaning spray or wipes. These include doorknobs, countertops, toilets, keyboards, tablets, phones, light switches, and more.

Because some people with COVID-19 show no symptoms and don’t know they have the virus, it is recommended wearing cloth face coverings when you are out in public. Cloth face coverings won’t necessarily protect you from developing COVID-19, but they can help to prevent the spread of the virus in the community. If you are out in public, you should also practice physical distancing of at least 2 metres from other people.

Are there any special precautions that people with cancer should take?

Recent data have shown that people with active or progressing cancer may be at higher risk than those whose cancer is in remission. But, whatever the case, remember the same rules apply for people with cancer as for those without cancer, and they are, stay at home to reduce exposure to other people, be sure to wash your hands well, and frequently. Avoid touching your face, avoid close contact with people who are sick, and stay away from any social gatherings.

If you must leave your home, keep a distance of at least 2 metres between yourself and other people. But, only leave your home for essential reasons, such as buying groceries, going to the doctor, or picking up medication from the pharmacy. When outside make sure to wear a cloth face covering or mask, and make your trip out as brief as possible. Another alternative is to have your food and medications delivered, so you do not have to leave the home.

If you are scheduled for cancer treatments, have a discussion with your oncologist about the benefits and risks of continuing or delaying treatment. If you are not scheduled for cancer treatment but are still scheduled for an appointment with your oncologist, it may be possible for the doctor to conduct the visit via videoconferencing. Be sure to check with your cancer care team to see if this is recommended for you.

Will anything change with regards to my cancer-related medical visits?

As a result of the COVID-19 pandemic and the increased risk of exposure to the virus by going out in public, the majority of hospitals and clinics have now changed their visitation policies. Some may allow one visitor per patient, while others may not allow any visitors, so before heading off for your appointment, check with the clinic or hospital.

So that you can stay at home and visit with your doctor or other health care team members using your phone or computer, your cancer care team may switch some of your appointments to video conferencing. Your doctor’s office will let you know what system they are using for these appointments, and they will give you instructions on how to have your visit this way.

Your doctor may also suggest delaying some treatments for supportive care, such as bone-strengthening treatments, for example, denosumab (Xgeva) or zoledronic acid (Zometa), or intravenous iron supplementation. However, they will only recommend delaying treatments if they feel it is in your best interest to do so.

Other treatments, such as cancer screening tests, mammograms or colonoscopies, and other tests, such as bone density tests, may also be delayed to reduce your risk of exposure to the virus.

Your Oncologist may also recommend stretching out the length of time between cancer treatments using medications, such as chemotherapy or immunotherapy. Or they may even recommend delaying starting these treatments, based on your cancer diagnosis and the treatment goals. It’s important to remember that your oncologist will only do this after weighing the risks and benefits for your situation.

For people who don’t have a cancer diagnosis but are at high risk of cancer, such as those with a hereditary cancer syndrome like Lynch Syndrome or a BRCA mutation, your doctor may recommend delaying some screening tests or cancer risk-reducing procedures.

If you do have any concerns about your particular risk, talk with your doctor about the risks and benefits of delaying any procedures.

What should I do if I think I may have COVID-19?

Call your health care team and let them know if you think you may have COVID-19, they will ask you questions about your symptoms, travel history, exposure, and medical risk factors to find out if you should be tested for COVID-19. They will then give you instructions on how to get tested in your community.

If you are receiving cancer treatment that suppresses the immune system and you develop a fever and respiratory symptoms, call your oncologist as you usually would if you develop a fever while on treatment. Be sure to follow their guidance on when to come into the office or hospital and when it’s safer to stay home.

Testing for COVID-19 is relatively simple and pain-free, it involves inserting a 15 cm long swab, similar to a Q-tip, deep into the nasal cavity for at least 15 seconds. The swab is then inserted into a special container and sent to a laboratory for testing.

If it is possible that you have COVID-19, you should stay at home and isolate yourself while you are tested and waiting for your test results. Staying home when you are sick is always the best way to prevent transmitting the novel coronavirus and any other respiratory viruses, such as the flu, to other people.

If you are concerned that you’ve been exposed to someone with COVID-19, closely watch for developing symptoms. Check your temperature regularly for fevers. If you have active cancer or are currently in cancer treatment, let your medical team know about your possible exposure.

If I’ve been diagnosed COVID-19, will I be able to continue my cancer treatment?

If you have been tested positive for COVID-19, you should have a discussion with your oncologist about how this will impact on your cancer treatment.

At many centres, a negative COVID-19 test is required before chemotherapy or other cancer treatments can start again. However, some patients with COVID-19 do continue to test positive even after recovering from their symptoms.

For some treatments, especially those that do not impair on the immune system, treatment may well be able to continue, especially if you have tested positive for the virus but are not showing the symptoms or have only mild symptoms.

Whether your cancer treatment resumes or recommences, you must continue to wear a mask when going to the infusion clinic or cancer treatment centre, and continue to practice good hand hygiene by using hand sanitizer or hand washing before and after each visit.

When will things return to normal?

It is very difficult to say when and what normal might look like in the future. Public health experts continue to work with local health departments and governments offices to help answer this question.

So the best way to stay safe is to continue to stay at home and avoid being in public as much as possible. If you must leave home continue to wear cloth face masks or face coverings, continue to wash your hands thoroughly and frequently and stay at least 2 metres away from areas where groups of people gather.

If you have questions about your risk due to your cancer or cancer treatment, be sure to speak with your doctor for their guidance.

Where can I get the latest information about COVID-19?

Staying up to date on the latest information on the COVID-19 outbreak is important. Your local, regional and state health departments will have ongoing information about whether the disease has been diagnosed in your community.

Learning more about living with Cancer.

To learn more about living with Cancer and the available support visit, Cancer Pro is the voice of the world’s cancer physicians and oncology professionals and is one of the top cancer information resources in the wider ASEAN region.