The current pandemic is driven by a respiratory infection, the novel coronavirus that causes COVID-19. Quite naturally, patients with lung cancer may be particularly worried. The question comes to mind: Does my personal health history put me in even greater danger than other patients if I’m infected with coronavirus?
“We know that patients with cancer, including lung cancer, appear to be at higher risk for complications of coronavirus,” said lung cancer specialist Tingting Tan, M.D., Ph.D., assistant clinical professor of medical oncology at City of Hope. “However, it’s not entirely clear that people with lung cancer are at significantly higher risk than others with cancer. There’s just too little data to say that with any authority.”
Likewise, the exact reason why cancer patients face peril in the pandemic is not entirely clear.
It may be the underlying cancer itself. The fact that the average age of cancer patients is higher than that of the general public could be the cause. Or the culprit might be other medical issues that tend to cluster with cancer such as lung-related injuries, lung disease or heart disease. The reason might even be a mix of all of the above.
Tan, who practices in Newport Beach, offers good advice for lung cancer patients concerned about COVID-19.
“This infection is driven by exposure, and that’s something that can largely be controlled by patients, their families and their health care teams taking maximum precautions,” she said.
How to Protect Yourself
Some of Tan’s advice for lung cancer patients will be familiar because it’s broadly applicable these days. Nonetheless, these cautions bear repeating:
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Stay at home as much as possible.
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Wash your hands regularly and thoroughly.
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Avoid touching your face.
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Observe social distancing when you must be in public.
Additionally, Tan notes that treatment decisions may be reshaped by the pandemic.
“There are patients who should have careful discussions with their physicians about whether a therapy that may cause immunosuppression offers more benefit than risk in this new and different environment,” she said.
One more element of Tan’s counsel similarly requires that you consult with your oncologist.
“Consider altering the logistics of your care if appropriate,” she said. “It might be possible to space out visits or do telemedicine or telephone visits, but it really depends on what the individual patient needs. It’s not about devaluing care, but rather that the threat of infection has changed the game.”
This is why advice from doctors is key — they’re best positioned to evaluate the risks and benefits, and advise accordingly. Some patients need chemo infusions on a specific schedule, for instance. Meanwhile, others could delay a follow-up appointment by a month, or do it via phone or webchat.
Clinical Care in the Coronavirus Era
Tan notes that as a National Cancer Institute-designated comprehensive cancer center, City of Hope’s infectious disease protocols are second to none. While other hospitals are delaying screenings, surgeries and other procedures, City of Hope is continuing to provide world-class care in a safe environment. She encourages patients not to delay their care or screenings.
Some of the measures she listed that are in place at City of Hope:
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Clinical visits are limited based on careful, individual assessments of each patient’s case.
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City of Hope utilizes telemedicine, sparing the need for a clinical visit.
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The care team wears masks and eye protection for all patient encounters.
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Staff and patients are checked for fever — which is evidence of infection — through thermal screening.
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In waiting rooms and treatment areas, people are spaced to practice social distancing.
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For the time being, visitors are not allowed for both inpatients and outpatients.
Tan emphasizes that precautionary measures — at City of Hope, and also society-wide — help provide patients with a modicum of safety.
“The coronavirus is a serious issue not just for people with lung cancer, but for all folks with cancer and even the broader population,” she said. “The health care community takes it seriously, and the citizenship increasingly is cooperating to minimize risk for everybody. And that is especially beneficial for patients.”