Coronavirus and cancer

At this stage, is it risky for me to go to the hospital for my radiotherapy or chemotherapy treatments?

If you need to go to the hospital for your radiotherapy or chemotherapy treatment, precautionary measures have been put in place in the oncology departments to reduce the risk of exposure for patients and healthcare professionals. Although these measures are specific to each healthcare center, they include the following:

• The patient should come alone, without their caregiver
• Visits are limited
• The patient's temperature and the lack of symptoms - characteristic of COVID-19 infection - are checked before the patient enters the hospital
• Hand washing with soap or hand sanitising gel is mandatory at the entrance*
• A mask may be given to the patient if the department has a sufficient supply of masks. Wearing a mask is recommended for cancer patients in general, however, in the face of the current shortage, health staff in contact with patients may be given priority
• Recommended distances must be maintained between patients in the waiting room

You may be vulnerable to coronavirus infection when you come off your radiation therapy, especially if it affects the chest cavity. However, there is not enough data available at this time to determine this level of risk, either for radiotherapy or chemotherapy. It is important to adopt barrier gestures respect the self-isolation measures in all cases.

My treatment or surgery has been postponed, is this bad for the progression of my cancer?

In some cases, in order to reduce the risk of exposure to the virus, your health team may decide to postpone your operation or cancer care. This is a decision that is adapted to each patient, following a mutual agreement between the medical staff and the patient. If your doctor has decided to delay, it is because he or she does not think it poses a risk for the progression of your cancer within the time frame of the health crisis. Operations and care are not systematically postponed.

It is also possible that your care will be modified to avoid the greatest amount of travel. For example, chemotherapy treatment can be taken orally at home instead of intravenously in hospital. But beware, this is not possible for all treatments!

Tele-consultation may also be encouraged to follow up with your oncologist and receive all the necessary explanations for your treatment.

Many oncology departments also provide psychological support for patients, which is especially important when the fear of infection and a change in care is added to your cancer.

Is it bad if my screening is postponed?

Screening can be safely rescheduled, again within the time frame of the health crisis, if you do not experience any particular symptoms that are suggestive of the cancer being screened.

However, if you do have symptoms, it is vital that you have an investigative examination as soon as possible! Don't hesitate to ask your doctor or oncologist any questions you may have, by telephone or tele-consultation.

Does my immunotherapy or hormone therapy make me more vulnerable to the coronavirus?

It is important to distinguish the concept of immunodeficiency from that of immunotherapy!

Immunodeficiency in the context of cancer is often due to treatment (chemotherapy, immunosuppressants, biotherapy, corticosteroids in immunosuppressive doses) and may increase the risk of developing complications following a coronavirus infection.

Immunotherapy (such as KEYTRUDA, YERVOY, OPDIVO) involves stimulating certain immune cells to make them more effective or make the tumor cells more recognizable to the immune system.. There is currently no scientifically proven evidence that immunotherapy increases the risk of coronavirus complications. The same is true for hormone therapy (such as ELIGARD, NOLVADEX, FEMARA).

Whatever treatments you are taking, under no circumstances should you stop or modify your treatment without the advice of your oncologist. Get a medical opinion before taking non-prescription drugs and products.

If you have previously undergone cancer treatments and have not been treated in several years, your risk of coronavirus complications is the same as in the general population.

I have lung cancer, am I more at risk for complications from COVID-19 infection?

Given the recent discovery of the SARS-coV-2 (coronavirus), we do not have enough evidence and data to confirm that lung cancer is a risk factor. However, according to the CDC, people undergoing cancer treatments are at greater risk of developing a serious form of coronavirus infection. 

Should my self-isolation be more restrictive if I have cancer?

Although barrier gestures and isolation measures apply to the entire population to achieve optimal individual and collective protection, cancer patients should limit their movements as much as possible. 

Do not hesitate to have your groceries delivered to your home if possible, and ask someone close to you to help you with everyday tasks to avoid going out (avoiding close contact).

If you have been advised to do some kind of physical activity, do not hesitate to do it at home! For example, the University of Texas MD Anderson Cancer Center, Massachusetts General Hospital Cancer Center and other cancer centers offer exercise videos adapted to the needs of cancer patients on YouTube.

I have cancer, do I need to stop working? What is the procedure?

At this time employers should have taken every possible step to facilitate their employees working from home, if the form of work allows. If you are well enough to work and can do so from home, you can continue working if you so wish. 

The Families First Coronavirus Response Act (FFCRA or Act) requires certain employers to provide their employees with paid sick leave and expanded family and medical leave if the employee is unable to work (including telework) because he or she:

1. is subject to a Federal, State, or local quarantine or isolation order;
2. has been advised by a health care provider to self-quarantine;
3. is experiencing COVID-19 symptoms and is seeking a medical diagnosis;
4. is caring for an individual subject the conditions described in (1) and (2);
5. is caring for his or her child whose school or place of care is closed (or child  care provider is unavailable)
6. is experiencing any other substantially-similar condition specified by the U.S. Department of Health and Human Services.

You can find more information here. 

The Employment and Training Administration announced new flexibility to state's administration of unemployment insurance programs. States may now pay benefits where:

• An employer temporarily ceases operations due to COVID-19, preventing employees from coming to work;
• An individual is quarantined with the expectation of returning to work after the quarantine is over; and
• An individual leaves employment due to a risk of exposure or infection or to care for a family member.

You can check your state's unemployment insurance program here and discover the procedure for filing for unemployment insurance here.

Who can I contact if I have questions about my care?

In general, you should be contacted and informed by the oncology department that provides your care. If this is not the case, or if you have additional questions, please do not hesitate to contact the department by telephone, or to arrange a tele-consultation with your oncologist.

Feel free to share your own or your loved one's experience with cancer by commenting on this article.
Best wishes to all, take care!