Fearing the deadly combination of cancer and COVID-19
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Fearing the deadly combination of cancer and COVID-19
Cancer patients and survivors fear the combination of cancer and COVID-19 places them at a greater risk of death than the general population.
Three Tuesdays each month, Katherine OβBrien straps on her face mask and journeys about half an hour by Metra rail to Northwestern Universityβs Lurie Cancer Center.
What were once packed train cars rolling into Chicago are now eerily empty, as those usually commuting to towering skyscrapers weather the pandemic from home. But for OβBrien, the excursion is mandatory. Sheβs one of millions of Americans battling cancer and depends on chemotherapy to treat theΒ breast cancerΒ that has spread to her bones and liver.
βI was nervous at first about having to go downtown for my treatment,β said OβBrien, who lives in a suburb, La Grange, and worries about contracting the coronavirus. βFamily and friends have offered to drive me, but I want to minimize everyoneβs exposure.β
While her treatment hasnβt changed since the novel coronavirus spread across the United States, the 54-year-old is at high risk of severe complications should she become infected. Those risks havenβt declined significantly for her despite the Illinois governorβs loosening of COVID-related restrictions.
Sheβs not alone in fearing the deadly combination of Covid-19 and cancer.Β One study, which reviewed records of more than 1,000 adult cancer patients who had tested positive for Covid-19, found that 13% had died. Thatβs compared with the overall U.S. mortality rate of 5.9%, according toΒ Johns Hopkins.
On βTreatment Tuesdays,β as she has dubbed them, Katherine OβBrien makes the trek into Chicago by commuter rail from her home in the suburb of La Grange, Illinois, for chemotherapy.
Beyond the concern of cancer patients β with their already depleted immune systems β catching the virus, many doctors worry about people delaying their scans and checkups and missing time-sensitive diagnoses. A KFF pollΒ found thatΒ nearly half of Americans had skipped or postponed medical care because of the outbreak. Cancer patients seeking care face an array of obstacles as states reopen, such as heavily restricted in-hospital appointments and new clinical trials on hold.
βCancer doesnβt care that thereβs a coronavirus pandemic taking place,β said Dr. Robert Figlin, chair in hematology-oncology at Cedars-Sinai in Los Angeles. βWe donβt want people who have abnormalities to delay having them evaluated.β
In late March,Β Megan-Claire Chase, 43, of Dunwoody, Georgia, got laid off from her job as a project manager for a staffing company, losing the health care benefits that came with it. Her chief concern was paying for a diagnostic mammogram and MRI, still on the calendar for two days before her benefits were to end. Currently, in remission from stage 2A breast cancer, Chase schedules scans for every six months well in advance at Breast Care Specialists in Atlanta.
βWhen I got there, it was really unsettling. You almost feel like a leper,β said Chase, noting the socially distanced waiting room and heavily sanitized clipboards. Already hyper-careful since her days of chemotherapy, Chase carries her own pens in her purse, along with gloves and extra masks.
Cancer centers across the country are taking extra precautions. At Northwestern, patients are funneled through a single entryway, where masks are required and are met by a security guard and a temperature check before signing in with receptionists seated behind plastic shields, OβBrien said. No visitors or accompanying family members are allowed inside the building, and the cafeteria and waiting rooms are devoid of unnecessary germ-spreading agents β no magazines or coffee machine in sight. The cubicle where she receives infusions of Abraxane used to seat four patients; now, only two sit in the space.
Cancer patients and survivors fear the combination of cancer and Covid-19 places them at a greater risk of death than the general population.CLICK TO TWEET
Where they can, many doctors are turning to telemedicine to limit cancer patientsβ trips to the hospital. In Salt Lake City, Dr. Mark Lewis, director of gastrointestinal oncology for Intermountain Healthcare, a 23-hospital system serving Utah and surrounding states, says about half his patient visits are now virtual. Heβs also making some patientsβ treatments less intense and less frequent. As at Northwestern, patients must arrive at the hospital solo for appointments unless assistance is physically necessary. Itβs a significant shift for Lewis, whoβs had up to 30 family members in his office for appointments alongside his patients for mental support.
βWe are writing the rules as we go, trying to keep patientsβ immune systems up and cancer at bay,β said Lewis. Still, heβs concerned about a later spike in cancer mortality due to the coronavirus pandemic. The coronavirus aside, the National Cancer InstituteΒ estimatesΒ over 600,000 Americans will die of cancer this year.
New clinical trials have also largely ground to a haltΒ in this new eraΒ when traveling long distances for treatment is less of an option.Β Linnea Olson, who lives in Amesbury, Massachusetts, and has stage 4 lung cancer, worries there may be far fewer treatment options for her, as trials have been her βlifeline.β
Linnea Olson stands in front of a photo of herself on the βwall of hopeβ at Massachusetts General Hospital in Boston.
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About four months ago, Olson, 60, enrolled in her fourth phase 1 clinical trial at Massachusetts General Hospitalβs Termeer Center for Targeted Therapies. The treatment has been accompanied by intense side effects, such as a sore mouth and throat from mucositis, also a sign of Covid-19. Before a recent infusion, nurses with plastic shields ferried Olson up a back entryway for a COVID test. It was negative.
The intensity of her treatment, coupled with the extreme social distancing measures, has left Olson, who lives alone, feeling depressed and unsure if she should continue the trial.
βItβs too much all at once β the isolation and the difficult side effects,β Olson said.
Rudy Fischmann, a brain cancer patient and former true crime TV producer, battles balance issues that started after his first set of surgeries two years ago. Daily walks and physical therapy are part of his treatment regimen. Yet strolls around his Knoxville, Tennessee, neighborhood are already becoming more stressful as the state begins to open up.
βItβs getting harder and harder, with more and more people outside every day,β said Fischmann, 48. βI donβt enjoy walking laps around my kitchen, so Iβm finding myself having to change my routes almost daily.β
A father of two young children who are now home round-the-clock, Fischmann finds all the family time-draining his limited energy. He also fears what germs they will bring back from school come fall.
βThe thought of, if I were to contract the virus, would I get a different standard of care?β he said. βIβm used to staying home and not doing that much, but itβs more nerve-wracking now.β

Kaiser Health News
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.