COVID-19: Changing the Face of Cancer Care

The healthcare systems have shifted their attention to COVID-19. Unfortunately, patients with chronic conditions such as cancer have had to make tough decisions.

MD, Chief medical officer and executive president of ASCO(American Society of Clinical Oncology) said, “Patients undergoing cancer treatment have had to make difficult choices to interrupt or modify their cancer treatment to decrease their risk of COVID-19 but thereby increase their risk of cancer progression or to continue their cancer treatment, risking a greater likelihood of COVID-19 disease or complications.”

Healthy individuals have had to postpone their screening, and newly diagnosed patients have not yet started their treatment. Clinical trials for new therapies have slowed down due to the pandemic. 

When COVID-19 was first reported, reports indicated that people with a weak immunity had the worse COVID-19 outcomes. However, as researchers compiled more information and results, there were varying trends. For example, earlier on, showed that 28% of cancer patients who had COVID-19 died. However, as physicians’ experience in treating COVID-19 improves, the rate is decreasing.

The TERAVOLT registry for lung cancer patients, ASCO survey on COVID-19 in Oncology Registry, and the CCC19 ( COVID_19 and Cancer Consortium) are some of the initiatives that have been set up to pool accurate data.

Various studies have proved that cancer patients are at an increased risk of contracting COVID-19.

According to recent research, older cancer patients, those with pre-existing health conditions, or are Black or Latino have the worst outcomes. When you compare the results for cancer patients with those who have cardiovascular disease or diabetes, the outcome ‘pales in comparison.’

According to information by the American Association for Cancer Research COVID-19 and Cancer Virtual Meeting in July, 60% of the COVID-19 cancer patients were hospitalized, 16% were in the ICU, 45% required oxygen, 12% were on ventilators, and 16% passed away. 

The rate of risk varies with the type of cancer. Patients with lung cancer have the worst outcome,followed by lymphoma, then colorectal cancer. Patients with breast, prostate, or gynecological cancers are at a lower risk of cancer.

The treatment option determines the level of risk. Some studies show that people who are undergoing chemotherapy are at high risk- because chemo destroys the body’s white blood cells affecting the immune system. However, other studies have varying results.  The effect of immunotherapy is also unclear.

The pandemic has altered screening, preventive, diagnosis, follow-up, treatment, and cancer clinical trials.

Cancer patients and clinicians have developed strategies to continue cancer care. Clinicians have found flexible ways of administering treatment, such as giving patients infusions or radiation less often. Clinicians put patients on medication as they await surgery. Doctors suggest treatments that do not suppress the immune system and do not have serious side effects that could warrant hospitalization. Patients also are learning to use home care and telemedicine alternatives whenever possible.