Experiencing Chemo vs. Living in a COVID-19 World

Over the past few weeks, as the world has turned upside down and we are all changing and adapting daily to new guidelines and restrictions, I have talked with many people who are currently coping both with chemo and our COVID-19-affected world. There seem to be some similarities in the situations, and those who are contending with both are facing tough challenges.

Cancer survivors with whom I have spoken are remembering their chemo days and comparing them to what days are like now. Many of them feel that a past chemo experience has been rather helpful preparation for these days of living in a COVID-19 world. Any of us who have been through cancer know what it is like to feel vulnerable and isolated from others and out of control. We know that the world can be a risky place, and we know that we eventually come out the other side.

With chemotherapy, we usually know how long the difficulties will last. Many treatment plans are organized around X number of cycles, so we know that we need to hang in until June or November or whatever is the projected conclusion. With the coronavirus, there is no such timetable, and that is one of the very hardest parts.

Let me try to summarize what I have been hearing and learning from both current and past chemo patients.

Comparing Chemo with the COVID-19 World

• During chemo, it is only you who are directly affected. Those around you, no matter how much they love you, can go about their daily business per usual. Now, the whole world is impacted and restricted.
• Chemo is somewhat predictable. It is always scary to begin a new drug because you don't know how your body will react. After a couple of infusions, however, you know what to anticipate and can plan around your better and worse times. Now, we have no idea how to plan.
• During chemo, our friends and family can support and distract us. They can bring us soup or drive us to appointments or just visit for company. They can also help with needed tasks or take our kids for a fun afternoon away. Now, we are all limited to virtual contacts and most of the practical kinds of assistance are impossible. My patients, currently on chemo, tell me that this is one of the hardest parts. They feel much more on their own.
• During chemo, we are not feeling our most energetic and, sometimes, are feeling pretty poorly. Spending the afternoon on the couch seems appealing. Now, it just seems boring to be shut in with Netflix or a stack of magazines.
• During chemo, an excellent strategy is to plan ahead and look forward to things. I spoke today with a woman receiving chemo for recurrent ovarian cancer, and she is despondent because, for the first time, she can't plan a reward for herself at the end of treatment. She describes the feeling of struggling through without the glitter of a trip or a treat at the end.
• During chemo, we worry about our cancer health and consider all sorts of possible problems and outcomes. Now, we add the possibility of viral infection to the list of cancer issues. One woman spoke with me about her musing whether it would be better to die quickly from the virus or to linger with a slow cancer death. Now, we have an endless supply of dire circumstances to imagine.
• During chemo, we are prepared by our doctors for what to expect. There is a list of possible side effects and promises of ways to manage them. Now, no one can predict anything.
• During chemo, we learn to live day to day and to live with uncertainty. We learn that sometimes we live half day to half day, or even hour to hour. Now, we are re-learning those lessons and understanding that they work in many situations.
• During chemo, we rely on hope and on those whom we love. The same is true now.