Cancer Patients, Survivors and COVID-19
By Patricia Thangaraj
What is COVID-19 or coronavirus?
This is part of a larger group of viruses that are present in both people and animals. Known as SARS-CoV-2, it is the new coronavirus that has resulted in a global pandemic, the likes of which we haven’t seen since the HIV/AIDS pandemic first emerged in the 1980’s. COVID-19 is a respiratory illness that emerged in 2019, hence the abbreviation, COVID-19.
Cancer and COVID-19: What You Need to Know
Persons who currently have cancer or who have previously had it have a “pre-existing condition” or “underlying medical condition” that places them at a greater risk for serious health complications if they become infected with COVID-19.
This is because their immune system is weaker than it was before they had cancer. Several cancer treatments reduce the immune system’s ability to fight diseases. They are also likely to have complications if they do become infected. The worsens when you factor in things like dietary changes, stress and sleep problems.
The situation is even more dire for persons with blood cancers. These persons are more likely to have higher risks of elongated infections and possibly even death from COVID-19 than those persons with solid tumours. This is due to the fact that blood cancer patients have depleted or irregular levels of immune cells that produce antibodies against viruses.
Cancer patients and survivors should therefore consult their oncologist or other physician to discuss their risks of COVID-19.
Cancer Treatments and the Immune System
Cancer patients and survivors face a catch-22 situation when it comes to COVID-19 because the same drugs used in chemotherapy that help to kill cancer cells are also the same ones that lead to a decrease in the amount of white blood cells. This weakens the immune system and the rest of the body because these cells play a key role in fighting infection. During treatment cycles when a patient’s white blood cells are at their lowest is when they are most at risk for infection. An oncologist and the rest of the medical care team can inform cancer patients when their blood counts are at their lowest, thereby putting them at the greatest risk, as they regularly monitor them during their treatment cycle.
Radiation, immunotherapy, targeted therapy, surgery and other types of treatment also affect the immune system. Therefore, it is advised that cancer patients speak with their medical team about a treatment plan that would help to reduce their risks from infections and extra precautions they need to take to protect themselves from COVID-19 and its variants.
Getting Cancer Treatments
Hospitals, clinics, doctors offices and other health care facilities are doing their best to ensure that coronavirus does not spread even further. Naturally, this can have an impact on a cancer patient’s treatment plan.
This can range anywhere from rescheduling a patient’s treatment so that fewer people are getting treatment at the same time, having to answer a series of questions before they can enter the building and not being able to bring a support person with them during treatment.
Cancer and the COVID-19 Vaccine
The Centers for Disease Control (CDC) and Prevention recommends that everyone 5 years and older get a primary COVID-19 vaccine series. That includes cancer patients and survivors.
There are different types of primary vaccine series available so it is best the cancer patients and survivors consult their doctor to find out which one is the most suitable for them.
Cancer patients who have recently received chemotherapy, a bone marrow transplant, cell therapy, a stem cell transplant or any other type of cancer therapy tend to have a weaker immune system. Hence, their oncologist may recommend that they wait until their immune system has fully recovered before they get vaccinated or they may counsel persons to wait a couple of weeks after getting vaccinated to get immunosuppressive treatment. Cancer patients should therefore consult their doctor on the best treatment plan for their specific needs.
The CDC also suggests that persons get an additional vaccine dose and/or the booster shot and that their family members and caregivers also get vaccinated. This serves as just one of the precautionary methods that cancer patients and survivors must take to protect themselves from coronavirus.
Breast Cancer Screening and the COVID-19 Vaccine
A COVID-19 vaccine may cause temporary swelling of the lymph nodes in the armpit, according to research. Since this can be mistaken for a sign of breast cancer, oncology teams advise that persons wait 4‒6 weeks after completing the COVID-19 vaccination before getting a mammogram.
Persons who have already been vaccinated should inform their oncology team about the date and time of their vaccines and any swelling they may have occurred after getting vaccinated so that their oncologist does not confuse these swollen lymph nodes with signs of cancer. This is even more imperative if it occurs around the same time that they are scheduled for a mammogram, a MRI, a CT scan or any other type of imaging test.
Cancer and Getting an Additional Dose of the COVID-19 Vaccine
Persons with certain cancers and those who are receiving treatment that suppresses the immune system tend to have moderately to severely compromised immune systems that reduce their response to COVID-19 vaccines.
The CDC advises that these persons get an additional vaccine dose to strengthen their response to the primary vaccine series, which would help to effectively protect them from coronavirus. The CDC states that these persons include those who:
- Are being treated for blood cancer (leukemia, lymphoma, or multiple myeloma).
- Have received a stem cell transplant within the past 2 years.
- Are taking medicine that may suppress the immune response.
There are different types of vaccines available. This author advises that persons contact their medical oncology team to discuss which one is best suited for their needs.
Cancer and Getting the COVID-19 Booster Shot
While an additional vaccine dose is given to some immunocompromised persons who likely did not mount an adequate immune response after primary vaccination, a booster shot is given to persons whose response to the primary vaccine series would have waned overtime due to their compromised immune systems.
Likewise, cancer patients and survivors should consult their oncologist to discuss which one is most appropriate for them.
References:
https://www.cancer.gov/about-cancer/coronavirus/coronavirus-cancer-patient-information
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