Are you getting cancer treatments during COVID-19?

Posted by Colleen Young, Connect Director @colleenyoung, Thu, Mar 26 4:46pm

Are you getting cancer treatments at the moment? What about diagnostic tests, like blood tests, CT scans, mammography, PET scans etc? Is your surgery going ahead as planned or postponed?

I’d like to hear from you. What is like being in treatment during the COVID-19 crisis? How are you doing?

@roch

Not sure if this has been posted, I just saw today and thought I would share:

Specific questions and answers about COVID-19 for cancer patients
https://www.mayoclinic.org/patient-visitor-guide/covid-19-faqs/cancer
Laurie

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@roch– Hello. Mayo Clinic has such wonderful, up-to-date information on COVID-19. Thanks for passing this a long!

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@elizm– Information has been very confusing, and especially about masks. My recommendation is to be overprotective. Since all of here on Connect has some sort of illness or disease we need to be very vigilant. Right now the CDC is advocating to wear masks BUT to also stay 6' apart from anyone.
https://www.marketwatch.com/story/this-might-be-the-simplest-no-sew-diy-coronavirus-mask-2020-04-03.
I also suggest adhering to wearing gloves and washing much-used surfaces down with an antiseptic. Also, if you receive packages wipe them down thoroughly before opening them and bringing the contents inside your h

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I have mentioned before that you subscribe to CUre Magazine. It is free to all cancer patients. It's a wonderful, up-to-date encyclopedic magazine that covers so many cancers and medicines, articles and patient stories. Below is today's up-date about COVID-19 and having cancer treatments. This is why it is so important to protect yourself! It's not a pretty picture I'm afraid.

How COVID-19 Affects Patients with Cancer https://www.curetoday.com/articles/how-covid19-affects-patients-with-cancer
"Researchers from China examined the impact that coronavirus has on patients who are receiving anti-cancer treatment.
BY Katie Kosko
PUBLISHED March 31, 2020
As the new coronavirus, called COVID-19, continues to spread across the world, it has many experts trying to determine how it affects patients with cancer.

From what is currently known, patients with the disease are a highly vulnerable group. However, just how vulnerable remains to be unknown. Researchers from China conducted a small study using data from 28 patients who were infected with COVID-19 and being treated at three different hospitals in Wuhan, China, from Jan. 13, 2020, to Feb. 26, 2020.

“There is an urgent need to answer the following questions, including whether COVID-19-infected cancer patients will have distinct clinical courses and worse outcomes, such as death from the infection or severe pneumonia, and whether cancer patients should receive
anti-tumor treatments as usual in epidemic areas,” the researchers wrote.

They examined risk factors that are associated with severe events, which they defined as a condition requiring admission to an intensive care unit (ICU), the use of mechanical ventilation or death.

The patient population consisted of mostly men (60.7%) who were a median age of 65 years old. Lung cancer was the most frequently seen diagnosis in 25% of patients, followed by esophageal (14.3%) and breast (10.7%) cancer, and 35.7% of patients had stage 4 disease. In addition, 39.2% of patients had at least one or more coexisting chronic diseases.

The researchers learned that eight patients (28.6%) developed COVID-19 while undergoing therapy in the hospital and 20 (71.4%) contracted the virus from their communities — most (67.9%) were from Hankou, the starting point of the outbreak. Within two weeks of a COVID-19 diagnosis, 21.4% of patients received at least one type of cancer treatment, such as chemotherapy (10.7%), targeted therapy (7.1%), radiotherapy (3.6%) or immunotherapy (3.6%), and one patient received combination chemotherapy and immunotherapy.

Upon admission, more than 80% of patients experienced fever, dry cough, abnormally low levels of lymphocytes in the blood and high levels of high-sensitivity C-reactive protein, which measures levels of inflammation in the body. Nearly 90% of patients showed hypoproteinemia, a condition where there is an abnormally low level of protein in the blood. Three-quarters of the population had trouble breathing and half showed signs of anemia.

The researchers discovered that patients with cancer showed deteriorating conditions and poor outcomes from COVID-19. More than half (53.6%) developed severe events, 21.4% were admitted to ICU, 35.7% had life-threatening complications and 28.6% of the patients died.

“Patients with cancer are particularly susceptible to respiratory pathogens and severe pneumonia because they are at an immunosuppressive state due to malignancy and anti-tumor therapy,” the researchers wrote. “It was found that within 14 days, anti-tumor therapies were significantly associated with the occurrence of severe clinical events in COVID-19 infection.”

However, the researchers noted, increased rate of death could be attributed to delayed hospital admission and a shortage of medical resources at the start of the coronavirus outbreak.

They recommended the following for patients with cancer who are undergoing therapy: vigorous screening for COVID-19 infection, avoiding treatments that cause immunosuppression or having dosages decreased in the case of COVID-19 co-infection."

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I had my prostatectomy at the Mayo Clinic in Rochester, scheduled for the end of April, cancelled. Caused a good bit of stress and anxiety for me. Thankfully, my cancer was caught early and the my doctors tell me the wait will likely not be an issue.

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@mike1367

I had my prostatectomy at the Mayo Clinic in Rochester, scheduled for the end of April, cancelled. Caused a good bit of stress and anxiety for me. Thankfully, my cancer was caught early and the my doctors tell me the wait will likely not be an issue.

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@mike1367 – Welcome to Mayo Connect Mike. I bet you felt stress and anxiety over not having your cancer treated. I think that before learning about COVID-19 I would have wanted to have any treatment possible. But after learning the stats (posted above) I'm with you. If you can wait it looks like a better option. Meanwhile, how are you keeping healthy? Have your doctors started any type of hormone therapy while you wait?
Here's some information you might be interested to read.
https://www.mayoclinic.org/diseases-conditions/prostate-cancer/care-at-mayo-clinic/mac-20353097

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@merpreb

@mike1367 – Welcome to Mayo Connect Mike. I bet you felt stress and anxiety over not having your cancer treated. I think that before learning about COVID-19 I would have wanted to have any treatment possible. But after learning the stats (posted above) I'm with you. If you can wait it looks like a better option. Meanwhile, how are you keeping healthy? Have your doctors started any type of hormone therapy while you wait?
Here's some information you might be interested to read.
https://www.mayoclinic.org/diseases-conditions/prostate-cancer/care-at-mayo-clinic/mac-20353097

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Thank you for the information. I currently, no treatment or therapy planned. I will be contacting my team this week to see if there is anything they suggest while I wait.

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@mike1367

Thank you for the information. I currently, no treatment or therapy planned. I will be contacting my team this week to see if there is anything they suggest while I wait.

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@mike1367– That's a great idea. It's always best to be pro-active. It makes me feel more in control. That's tough to feel when you have been told that you have cancer- like being rolled over with a boulder. Are you doing better with your anxiety?

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@merpreb

@mike1367– That's a great idea. It's always best to be pro-active. It makes me feel more in control. That's tough to feel when you have been told that you have cancer- like being rolled over with a boulder. Are you doing better with your anxiety?

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I am good, a bit of anxiety once in a while but nothing to bad.

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@mike1367

I am good, a bit of anxiety once in a while but nothing to bad.

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@miike1367- That's to be expected with cancer and COVID-19! Try and enjoy this time because chemo will change your body. Any treatment for cancer has to involve either surgery or radiation or chemicals. They all change our bodies, but so has cancer. We can talk about that later if you wish. Are you on the men's prostate group? https://connect.mayoclinic.org/group/prostate-cancer/

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@merpreb

@miike1367- That's to be expected with cancer and COVID-19! Try and enjoy this time because chemo will change your body. Any treatment for cancer has to involve either surgery or radiation or chemicals. They all change our bodies, but so has cancer. We can talk about that later if you wish. Are you on the men's prostate group? https://connect.mayoclinic.org/group/prostate-cancer/

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Yes, I am on the prostate cancer group. It's crazy what Covid-19 is doing to some cancer treatment. Fortunately my sister and uncle are both continuing their treatments at this time.

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@merpreb

I have mentioned before that you subscribe to CUre Magazine. It is free to all cancer patients. It's a wonderful, up-to-date encyclopedic magazine that covers so many cancers and medicines, articles and patient stories. Below is today's up-date about COVID-19 and having cancer treatments. This is why it is so important to protect yourself! It's not a pretty picture I'm afraid.

How COVID-19 Affects Patients with Cancer https://www.curetoday.com/articles/how-covid19-affects-patients-with-cancer
"Researchers from China examined the impact that coronavirus has on patients who are receiving anti-cancer treatment.
BY Katie Kosko
PUBLISHED March 31, 2020
As the new coronavirus, called COVID-19, continues to spread across the world, it has many experts trying to determine how it affects patients with cancer.

From what is currently known, patients with the disease are a highly vulnerable group. However, just how vulnerable remains to be unknown. Researchers from China conducted a small study using data from 28 patients who were infected with COVID-19 and being treated at three different hospitals in Wuhan, China, from Jan. 13, 2020, to Feb. 26, 2020.

“There is an urgent need to answer the following questions, including whether COVID-19-infected cancer patients will have distinct clinical courses and worse outcomes, such as death from the infection or severe pneumonia, and whether cancer patients should receive
anti-tumor treatments as usual in epidemic areas,” the researchers wrote.

They examined risk factors that are associated with severe events, which they defined as a condition requiring admission to an intensive care unit (ICU), the use of mechanical ventilation or death.

The patient population consisted of mostly men (60.7%) who were a median age of 65 years old. Lung cancer was the most frequently seen diagnosis in 25% of patients, followed by esophageal (14.3%) and breast (10.7%) cancer, and 35.7% of patients had stage 4 disease. In addition, 39.2% of patients had at least one or more coexisting chronic diseases.

The researchers learned that eight patients (28.6%) developed COVID-19 while undergoing therapy in the hospital and 20 (71.4%) contracted the virus from their communities — most (67.9%) were from Hankou, the starting point of the outbreak. Within two weeks of a COVID-19 diagnosis, 21.4% of patients received at least one type of cancer treatment, such as chemotherapy (10.7%), targeted therapy (7.1%), radiotherapy (3.6%) or immunotherapy (3.6%), and one patient received combination chemotherapy and immunotherapy.

Upon admission, more than 80% of patients experienced fever, dry cough, abnormally low levels of lymphocytes in the blood and high levels of high-sensitivity C-reactive protein, which measures levels of inflammation in the body. Nearly 90% of patients showed hypoproteinemia, a condition where there is an abnormally low level of protein in the blood. Three-quarters of the population had trouble breathing and half showed signs of anemia.

The researchers discovered that patients with cancer showed deteriorating conditions and poor outcomes from COVID-19. More than half (53.6%) developed severe events, 21.4% were admitted to ICU, 35.7% had life-threatening complications and 28.6% of the patients died.

“Patients with cancer are particularly susceptible to respiratory pathogens and severe pneumonia because they are at an immunosuppressive state due to malignancy and anti-tumor therapy,” the researchers wrote. “It was found that within 14 days, anti-tumor therapies were significantly associated with the occurrence of severe clinical events in COVID-19 infection.”

However, the researchers noted, increased rate of death could be attributed to delayed hospital admission and a shortage of medical resources at the start of the coronavirus outbreak.

They recommended the following for patients with cancer who are undergoing therapy: vigorous screening for COVID-19 infection, avoiding treatments that cause immunosuppression or having dosages decreased in the case of COVID-19 co-infection."

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Have not received my CURE subscription yet but thank you for sending this. I have my labs and infusion Thursday and to be honest, I am scared to death. As I had said previously, Mayo was not wearing masks and asking patients not to wear mask unless they were sick. This was last Monday and Tuesday when I went for brain radiation. Now that masks have been allowed by the CDC, I wonder if they will wear them. Because I have had progression, I am hesitant to cancel my infusion. I did receive a message on my portal that my PA will have a phone conversation with me instead of the office visit but that they feel I need to have the labs and infusion done on time. Not a great feeling. I plan on wearing a N90 mask and they will have to deal with it although I feel like I have already been exposed by 4 of them last week.

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@seaspray

Have not received my CURE subscription yet but thank you for sending this. I have my labs and infusion Thursday and to be honest, I am scared to death. As I had said previously, Mayo was not wearing masks and asking patients not to wear mask unless they were sick. This was last Monday and Tuesday when I went for brain radiation. Now that masks have been allowed by the CDC, I wonder if they will wear them. Because I have had progression, I am hesitant to cancel my infusion. I did receive a message on my portal that my PA will have a phone conversation with me instead of the office visit but that they feel I need to have the labs and infusion done on time. Not a great feeling. I plan on wearing a N90 mask and they will have to deal with it although I feel like I have already been exposed by 4 of them last week.

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@seaspray– I have no idea why magazines take so long to be mailed. It seems as if that's prevalent throughout magazineland. Here's the link to their on-line mag. https://www.curetoday.com/

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@merpreb

@seaspray– I have no idea why magazines take so long to be mailed. It seems as if that's prevalent throughout magazineland. Here's the link to their on-line mag. https://www.curetoday.com/

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@merpreb I have their online subscription, so that works for me. I am better able to choose what I want to read, without a lot of print ads that distract me. I have only one print subscription, and that one has no ads.

To keep on topic for this discussion, I was able to get my MOHS procedure done on Fri for skin cancer. There were 6 other patients there that day. One couple, not masked, complained loudly for having to wait longer than they felt they should have had to. With an abbreviated work day/week, and minimum staffing, I was happy to be there at all! Fortunately my next appt with oncologist is not until end of May, so hopefully things will be a new normal by then.
Ginger

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@colleenyoung

@elizm I believe that the one silver lining of this pandemic is that is has forced healthcare systems around the world to fast-track their developments for virtual healthcare. That said, all the kinks are not worked out. I agree with @roch and @gingerw that one should always check with their insurance company and provider about compensation for the service.

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@colleenyoung @gingerw @roch
Following-up on my telemedicine question, I just came across an article from MedPageToday which indicates that CMS has relaxed rules on telemedicine during the pandemic, BUT (and this is an important BUT) it won't preempt limits imposed by states. Interesting, huh….
https://www.medpagetoday.com/infectiousdisease/covid19/85702

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@colleenyoung

Hi @texastee59, may I ask what cancer you're taking treatment for? Are the spine issues cancer-related or unrelated?

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Nancy Shortahot) Hi Colleen, news is….I have had all the radiation that I can have for the rest of my life. Possibility of chemo or? I don't know. Cat scan showed growth in my right lung . They removed a liter of fluid from my left lung. Am able to breathe a litttle better. I will have a filter put in some vein on Tuesday 4/7 at OHSU surgery time 4+ hours. Doesn't sound fun! This is to stoop blood clots from getting to my heart or lung. I'm not looking forward to this at all. Necessary to be done. Will get back here when I can. Please let Teresa know. Thanks Nancy

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