Cancer Treatment in the Age of COVID-19


Many patients are wondering if they should continue their cancer treatment in light of the current COVID-19 pandemic. The answer for most is “yes.” But there are some things to think about and plan for before going to your center.

Should I still go to treatment?

Currently, the American Society of Clinical Oncology (ASCO) states that “at this time, there is no specific evidence or published guidance to support delaying or interrupting adjuvant chemotherapy.”

As of today, the only treatment ASCO is recommending for the potential delay (especially if your disease is currently under control) is for a planned allogeneic stem cell transplant. Donors may need to be screened for COVID-19 prior to collection as well. Patients with stable disease who are considering autologous stem cell transplant should also talk to their team about a potential delay in this procedure. The European Society for Blood and Marrow Transplantation (EMBT) is recommending delay of transplant procedures for at least three months.

What can I expect at the treatment center?

  • Confirm your appointment. Always check in with your healthcare team BEFORE traveling to your cancer treatment in case there are changes to the schedule.
  • You will most likely be screened for fever and symptoms of COVID-19 upon arrival. 
  • If you are feeling sick DO NOT come to the treatment center. Call your team for personalized planning and instructions. 
  • Write down your symptoms and concerns before you call so you are organized and can stay on track when talking to your team.

Remember that hospitals and treatment centers have shifted their primary focus to “detect, test, treat, isolate, trace and mobilize” for COVID19. Healthcare workers are being stretched in many different directions. Give them space and time to respond. 

  • Centers are also staggering appointments to limit the number of people in the waiting area at any given time. 
  • The number of people permitted to come to appointments with you will also likely be limited. Many centers are allowing one family member or support person to accompany patients. Think about using technology (calls, Facetime, Skype) if other family members want to participate in a provider visit.
  • Treatment centers are also using space differently – moving chairs six feet apart, setting up screening areas in hallways/entryways, removing magazines and other materials from the waiting areas that could harbor the virus. Be prepared for change when you come to your visit.
  • Be sure to continue to wash your hands throughout your time at the treatment center. Be sure to have sanitizer and wipes in your car or your bag. 
  • Continue to practice social distancing. Stay about 6 feet away from others. Try to avoid crowded elevators and touching escalator railings. 

What about follow-up appointments?

If you do not need to go to your treatment center now, don’t. Most of these appointments are being rescheduled or moved to telemedicine (phone calls, SYKPE, Zoom). It’s OK if you aren’t tech-savvy. Just communicate this with your healthcare team if the phone is more comfortable for you.

How about getting to my treatment center?

If at all possible, avoid public transportation. If you must use public transportation, practice social distancing and don’t sit near folks who appear sick or who are coughing. Try not to touch surfaces and carry wipes and sanitizer with you. If you use Lyft, Uber or other car-sharing services, you have no idea of who was in the car before you. Ask your driver, before getting in the car, if you can wipe surfaces down before you get in the car. They may have preferred products to use. Try to touch as little as possible. The same goes for taxis.

What if I’m feeling sick?

Call your team if you are having symptoms. Stay home. Sick caregivers should also stay at home.

If a family member develops symptoms, it’s important to practice social distancing within the home. Your family member should isolate themselves from you and other family members. They should sleep in a separate area. Be sure to wipe down surfaces, doorknobs, faucet handles and other common areas. Wash your hands frequently and try to avoid touching your face, nose, and eyes. 

Know that your cancer team is working hard to keep things on track and to keep you safe. If you have questions, reach out to them.

References and Resources

CDC Coronavirus (COVID-19) website

https://www.cdc.gov/coronavirus/2019-ncov/index.html

World Health Organization

https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Cancer Support Community

What cancer patients, survivors and caregivers need to know about the coronavirus.

https://www.cancersupportcommunity.org/blog/2020/03/what-cancer-patients-survivors-and-caregivers-need

American Society of Clinical Oncology(ASCO)

Coronavirus Resources.

https://www.asco.org/asco-coronavirus-information

Leukemia and Lymphoma Society

Coronavirus: resources and what you should know.

https://www.lls.org/public-health/coronavirus

European Society of Blood and Marrow Transplantation

Coronavirus Disease COVID-19: EMBT Recommendations.

https://www.ebmt.org/ebmt/news/coronavirus-disease-covid-19-ebmt-recommendations-update-march-16-2020

Fred Hutchinson Cancer Center

Coronavirus: what cancer patients need to know.

https://www.fredhutch.org/en/news/center-news/2020/03/coronavirus-what-cancer-patients-need-to-know.html

American Cancer Society

Common questions about the new coronavirus outbreak.

https://www.cancer.org/latest-news/common-questions-about-the-new-coronavirus-outbreak.html

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