As the coronavirus pandemic continues to disrupt everyday life for Americans, patients in particular have been upended as the health care system has increasingly been repurposed to handle the rising number of COVID-19 cases. Patients with cancer, already vulnerable from their condition and many dependent on regular treatment appointments, are facing significant adversity.  

At the end of February, the Centers for Disease Control and Prevention (CDC) issued guidance for all U.S. health care facilities to reschedule or delay non-urgent outpatient appointments and elective procedures in an effort to reduce the spread of COVID-19 and protect patients at risk of severe complications from COVID-19.

Patients currently undergoing cancer treatments have seen a range of responses from their health facilities, from delayed chemotherapy or surgeries to outright cancellation of appointments for the foreseeable future. Many physicians are having to decide on a case by case basis which patients can risk COVID-19 infection by coming in for treatment and which can stay at home until conditions improve. For patients with severe cancer diagnoses, catching COVID-19 might mean a high chance of death, but going without regular treatment might mean rapid progression of the cancer beyond a point of no return.  

According to a February report published by the WHO-China Joint Mission on Coronavirus Disease, the case-fatality rate for patients in China with COVID-19 and cancer as a comorbidity was 7.6%, compared to the overall rate of 3.6%. Other comorbidity rates include cardiovascular disease 13.2%, diabetes 9.2%, hypertension 8.4%, chronic respiratory disease 8.0%, and no comorbidities 1.4%. 

Patients receiving treatment for cancer tend to have weakened immune systems, which is already a disadvantage for fighting off COVID-19. But some treatments can also cause lung issues, adding another layer of risk, as the coronavirus targets the respiratory system.

Many routine cancer screening procedures or check-ups have also been delayed or canceled while health care resources have been directed towards “raising the line” for increased capacity for handling the pandemic. Dr. Richard Wender, Chief Cancer Control Officer for the American Cancer Society, recommended that patients should stay home even if health care facilities are still offering screening services, until social distancing restrictions are widely lifted. 

COVID-19 is a novel virus, and more data and studies are needed to create a full picture of its threat. What is clear so far is that patients with cancer must take all precautions to protect themselves and maintain an appropriate dialogue with their physician about their condition. 

With no indication of a definitive timeline of when the pandemic will end and when the federal and state governments will deem it safe enough to begin reopening the country, it is critical that both patients and non-patients should adhere to the CDC guidelines on social distancing, what to do if you or someone who lives with you is sick, and general recommendations for people who need extra precautions. 

The CDC has also issued these guidelines for patients with cancer to follow to avoid infection, and patients should continue to consult their physicians for further recommendations and plans moving forward based on their unique situations.