1. How does coronavirus spread?

Coronavirus is thought to spread from person to person. The spread most commonly occurs through respiratory droplets produced when an infected person coughs or sneezes. These droplets can be spread to the mouths and noses of others that are nearby (less then 6 feet), or possibly inhaled into the lungs.

Individuals infected by COVID-19 may not be aware of their infection, and may not show any symptoms of the disease. Social distancing > 6 feet decreases the risk of infection.

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2. Who is at a higher risk?

According to the Centers for Disease Control and Prevention (CDC), individuals at a higher risk for severe illness resulting from contracting COVID-19 include:

• Older adults: People older than 65 years of age
• People with serious underlying medical conditions: This includes people who have diabetes, liver disease, serious heart conditions, moderate to severe asthma, chronic lung/respiratory disease, and severe obesity defined with having a body mass index (BMI) of 40 or greater. Individuals who are undergoing dialysis for chronic kidney disease are also at higher risk for severe illness.
• People who live in a nursing home: This includes people living in long-term care facilities.
• People who are immunocompromised: This includes people who have cancer or are undergoing cancer treatment, have poorly controlled HIV or aids, or have used immune weakening medications, such as corticosteroids for prolonged periods. Individuals who have had organ or bone marrow transplantation are also at a higher risk.

3. Are cancer patients at an increased risk?

Individuals receiving active cancer treatment, regardless of what type of cancer they have, may be at increased risk to develop a severe illness as a result of coronavirus than those in remission. Active treatment is typically defined as chemotherapy, radiation therapy, surgery, and other treatments, like immunotherapies.

Individuals in their first year after CAR T-cell therapy or stem cell transplantation could be at greater risk of complications if they develop COVID-19. Those beyond a year after transplantation and are immunocompromised may remain at a heightened risk for complications.

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4. What are the COVID-19 symptoms?

Individuals with COVID-19 have experienced mild to serious respiratory illness along with symptoms such as:

• Shortness of breath
• Worsening or new cough within the last 14 days
• Fever
• Muscle aches
• Tiredness
• Chest tightness
• Taste changes
• Fever >100.5

Other symptoms reported include headache and gastrointestinal effects. Severe symptoms, which indicate you should seek immediate medical attention, include: difficulty breathing, bluish lips or face, confusion, persistent chest pain, pressure or tightness.

Most COVID-19 patients experience mild symptoms. A small percentage of cases are serious and could involve pneumonia. It might take up to 14 days for symptoms of COVID-19 to appear.

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5. How long are patients immunocompromised following chemotherapy?

Cancer treatments can weaken the immune system. However, how long chemotherapy impacts the immune system depends on a number of factors, including: the type of treatment received, the length of treatment, treatment dosage, and overall health. Each patient’s immune system responds to, and recovers from, treatment differently, and each cancer treatment affects people in different ways.

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6. Should cancer patients delay cancer treatment during the COVID-19 pandemic?

Patients should discuss the timing of their cancer treatment with their oncology team. Patients, along with their oncologist, must weigh the benefits versus the risks. In many cases, the benefits of cancer treatment outweigh the risks of stopping or delaying therapy.

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7. Are people who are on endocrine therapies, such as for breast or ovarian cancers, at more risk for getting COVID-19 or having a more serious illness?

There is no specific evidence to suggest that endocrine therapies can raise the risk of being infected by COVID-19 or having a more serious illness. Most endocrine therapies do not suppress the immune system.

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8. What advice do you have for patients with cancer?

• Discuss with your oncologist the benefits and risks of continuing or delaying treatment.
• Ask if your oncologist has the ability to conduct videoconferencing or telemedicine versus in-person visits to promote social distancing.
• Be sure to have enough essential medications, both prescription and over-the-counter, to last at least 1 month.
• Stay connected to your support system – make plans to connect with your family and friends virtually, through video chat or phone calls.
• Get proper rest
• Maintain a balanced diet

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9. What precautions should cancer patients/immune-compromised patients take during the COVID-19 pandemic?

Cancer patients should follow the CDC guidelines to protect yourself and others.

This includes:

• Practicing social distancing.
• Washing hands frequently and for 20 seconds.
• Staying home.
• Covering mouth and nose when around others.
• Covering sneezes and coughs.
• Cleaning and disinfecting frequently touched surfaces daily.

Taking proper measures to protect yourself and others will minimize your risk of contracting COVID-19.

Michiana Hematology Oncology, PC, is a strong team of supportive and caring board-certified oncologists who can provide support. We recognize that this is a stressful time, and are here for you to treat your mind, body, and spirit.

Have general questions or want to set up a telehealth consultation? Contact us at (800) 860-8100 or complete our online form.

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