What to Know About Cancer and COVID-19 (Coronavirus)

The spread of the novel coronavirus, COVID-19, has changed our daily lives. But people with a higher risk for illness from COVID-19 are wondering what they can do to stay healthy.

Cancer and its treatments weaken the immune system. This makes infections more likely, and increases the chance of health complications.

The best ways to prevent illness from COVID-19 are to minimize contact with people and follow sanitation guidelines. Communicating often with your doctor is also important. Your doctor can give specific advice on how to safely maintain continuous healthcare.

Does cancer put people at a higher risk for illness from COVID-19?

There is not much evidence yet on how cancer affects COVID-19 infection. An early observational study indicates that cancer and cancer treatments increase the chance of health complications.¹ Another observational study suggests that people with cancer and an additional underlying condition are at risk for poorer outcomes.²

These studies are too small to make assumptions. And it is important to remember that other countries and the U.S. have different healthcare systems, therefore observational studies may have limitations. We are also using different methods to contain COVID-19. This makes it difficult to compare risk levels.³

But it is clear that a weakened immune system puts people at risk for complications from COVID-19. We know this because elderly people are most at risk and tend to have weaker immune systems.⁴

Cancer weakens the immune system because cancer cells can steal nutrients from white blood cells. These are the immune cells that destroy germs. Treatments like chemotherapy and radiation temporarily reduce the number of white blood cells. And immunotherapy can change how white blood cells work.⁵

Because of this, people in active treatment and people with blood cancers are most vulnerable. People who have finished treatment may have a lower risk. But caution is still advised because the effects on the immune system can be long-term.⁴

What can I do now? What should I do if I get sick?

The best thing to do now is to avoid being exposed to COVID-19. Everyone should follow social distancing and sanitation guidance from the CDC.⁶ Here are some more actions for people at higher risk for infection:^4,7,8

• In areas with shelter-in-place or similar guidelines, do not leave home unless necessary
• In areas without such guidelines, stay home as much as possible
• Ensure access to several weeks of medications and supplies
• If someone in your home is sick, minimize contact and sanitize surfaces often
• Avoid crowds and public transportation
• Avoid all cruise ship travel and nonessential air travel

You can also take steps to keep your immune system strong:^4,9

• Get at least 6-7 (ideally 8) hours of sleep per night to help recharge the immune system
• Do exercises to get your heart pumping; here are exercises to do at home¹⁰
• Practice good nutrition to help the gut immune system; here are tips for eating healthy at home¹⁰
• Stay up-to-date on all vaccinations, including the flu shot
• Reduce stress by taking care of your wellbeing with some of these tips¹¹

If you begin to show symptoms of COVID-19 (such as fever, deep dry cough, fatigue, and shortness of breath), call your doctor immediately. They can advise you whether to self-isolate at home or give advice on how to protect yourself if you go to the ER. They can also instruct you on how to get tested. Always call ahead before vising your doctor or the ER.

What should I do if I have an appointment or treatment scheduled?

Call your doctor before going to your appointment and follow their advice. Your doctor can weigh the risk of missing treatment with the possibility of exposure to infection. Some treatments are safer to delay than others. And some follow-up visits are safe to delay or conduct through telemedicine. You may be able to have prescribed oral drugs sent directly to you. Or you may be asked to go to a clinic away from people treating COVID-19. As the situation changes daily, check in with your doctor often.⁷

What should I do if I participate in a clinical trial?

Call your clinical trial research team and follow their advice. Doctors and scientists are trying to continue clinical trials despite resources being diverted to fight COVID-19. They are also working to ensure the safety of people participating in clinical trials. And they are implementing measures to maintain care for participants. The clinical trial research team should be flexible with how you can complete treatments and do tests.^7,12

What are some questions I should ask my doctor?

Even now, you can call your doctor to get specific advice on how to stay healthy and maintain continuous healthcare. Some questions you may want to ask are:¹³

• In my current situation, how can I avoid getting COVID-19?
• In my current situation, am I at a higher risk of getting COVID-19? Why or why not?
• What should I do if I show symptoms of infection?
• How does this outbreak affect my routine care?
• Is telehealth available so I can get care virtually?
• Will starting/continuing treatment put me at a higher risk, or is it better to delay treatment?
• Is there a chance I could be exposed to COVID-19 if I come in for treatment?
• If I need to come in for treatment, what special precautions should I take?
• Are there any medications I can take during treatment to decrease my risk?

Editor’s note: This article was published on April 1, 2020. Further developments in what we know about COVID-19 are continuously emerging. For more information about COVID-19 and strategies for coping, visit Advanced Breast Cancer and COVID-19.