In an effort to provide reliable information for the SurvivorNet community about coronavirus we’ve been trying to find more nuanced answers. We think our conversation with Dr. Marc Braunstein from NYU’s Perlmutter Cancer Center is worth sharing. “We all have to take a deep breath,” he said, “and take more precautions than normal.” So what does this mean for cancer patients?
I have a doctor’s appointment coming up, could a COVID-19 patient be in the waiting room?
I would hate for patients to feel nervous about coming in for a necessary treatment, so I encourage a conversation with their oncologist. We do have protocols in place to quarantine those patients [who may be contagious] in a separate room, we have masks specifically for the purpose so that we can prevent the spread to anybody in the office. What is reassuring is that all of these measures that seem drastic are important. We'll figure it out…but the most important thing is to contain the spread.
What should I do if I develop a cough or fever?
Read MoreMaybe it’s just a cold, should I call my primary care physician, instead?
As oncologists, we often assume the role of primary care physician while you’re in treatment for cancer. There’s never a ‘bad’ reason to call the oncologist — even if it’s about a cold. We’re experts at managing the side-effects of chemotherapy and oftentimes that includes infections. If you have any symptoms that are concerning, call us.What Other Symptoms Are Cause For Concern?
Specifically symptoms like fever plus cough, muscle aches, sluggishness, fatigue. You want to be very vigilant. You want to be confident but concerned. Call the doctors' office.Dr. Waleed Javaid a public health expert at Mount Sinai on how the COVID-19 virus spreads.
Should I Wear a Medical Mask?
They're in short supply and really should be reserved for patients who have an active infection to prevent infection in others. The purpose of the mask is really to prevent the transmission of fomites, the particles that are infectious when we cough or sneeze and can linger on a surface for a little bit of time. The mask may partly help prevent that spread. I understand the concern, but if you don’t have an active infection, you don’t need to wear a mask.
Who’s At Highest Risk Right Now?
The one category of patients at the greatest risk are those recovering from stem cell transplants. Those patients are as immunocompromised as you could be. If you're in this group, when you visit your oncologist ask them to triage you right into the office, so you don't have to sit in the waiting room with other patients in the waiting room.
I Have An Important Family Event Coming Up. I Don’t Want to Miss It.
Delaying plans is especially difficult for people who have advanced cancer. They may feel they have limited time left, so it's disappointing to postpone an event. Find alternative ways to be present, even if it's online.
Most of the advice has been to avoid crowds. Try to avoid large gatherings. Everything we do in life is a risk, whether it's crossing a street or facing the COVID-19 virus, you have to decide the risk/benefit and your doctor can help you make that decision. .
This is Scary. How Do I Deal With The Uncertainty?
“Cancer patients know what it is like to face an unclear future. I have seen remarkable strength in my patients at times of vulnerability and uncertainty. This same optimistic outlook can be applied to the emotional challenges of a pandemic.
Most of my advice is similar to what I would normally give to my patients about avoiding infections while on chemotherapy, though perhaps telling patients to be even more obsessive about things like contact precautions and hand hygiene.
The reality is that every day we are learning more about the ways that the virus can affect people, as well as more about the means to prevent its spread and severity. This is public health in real-time, and nowhere on the battleground is it more important to provide critical information than to those individuals who lack the capacity to mount a robust anti-viral immune response.
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