Some Cancer Patients are More Vulnerable to COVID-19

Not really a surprise, but it is still disturbing to read confirmation that some cancer patients are more vulnerable to becoming seriously ill if infected by COVID-19. A multi-center study, just released at the American Association for Cancer Research's virtual meeting, included 105 cancer patients and 536 age-matched non-cancer patients who all had confirmed cases of COVID-19. The results indicated that the people with cancer had more severe cases and outcomes. Those who had hematological malignancies, lung cancer, or other forms of metastatic/Stage IV cancer had the highest frequency of serious outcomes. Of note, patients who were receiving radiation therapy did not fare worse than their non-cancer counterparts. Cancer patients who were receiving chemotherapy or recovering from surgery did worse.

The co-authors, from China, Singapore, and the United States, found that cancer patients were almost three times more likely to die from the coronavirus than the general population. They were also more likely to have severe infections and to be admitted to Intensive Care Units, and sometimes put on ventilators.

The reasons are fairly obvious. People receiving chemotherapy have lowered blood counts and are immunosuppressed and more vulnerable to any kind of infection. Cancer by itself can depress the body's immune system, and more cancer patients are older which is also a risk factor. Since COVID-19 can attack the lungs and result in acute respiratory failure, it also makes sense that people with lung cancer are at higher risk. That is, their lungs are already functioning at a less than optimal level.

The third group, those with metastatic or Stage IV cancers, is more complicated. There is a huge range of people and problems within this population, and their risk is variable and dependent upon the specific situation. For example, someone with metastatic prostate cancer to the bone is going to be less vulnerable than someone with metastatic breast cancer to the lungs. It seems harder to generalize here, beyond just acknowledging the increased worry and risk.

Now that we have all taken a deep breath and seen this information, what can we do about it? The unfortunate answer is: Not much. Please note that the increased risk was for people, especially these three groups of people, who were actively being treated for cancer. If your cancer and treatment were in the past, you are back in the general population's risk pool. There might be a few exceptions to that, but most of us regain our pre-cancer baseline health and immunity. It is not necessary and completely unhelpful to panic about this if your cancer is behind you. If you do fall into one of the higher risk groups, you likely are already paying close attention to all the directions on how to keep yourself safe. Pay even more attention. Stay home.

When you do have to go to the hospital or treatment center for care, be reassured that they are being extremely vigilant and careful to protect patients and staff from exposure to the virus. I am confident that it is actually much safer to visit a Cancer Center than a grocery store right now. If you need to be there, and all patients who can be seen virtually or have their appointments delayed are being managed that way, your risk of not appropriately treating the cancer is much greater than the risk of being exposed to COVID-19.