Hello, I am Jessica Croley. I am a medical oncologist with CHI Saint Joseph Health – Cancer Care here at Saint Joseph East. Thank you for joining us today for Let's Break to Educate. The topic for today is cancer care in the COVID era. I am happy to field a few questions that I am addressing daily with my own patients to help us all prioritize our chronic health maintenance while minimizing exposure to COVID-19. Let's dig in.
Our first topic is cancer screening. Is it safe to undergo mammogram, pap smears, colonoscopy, prostate exams, or CT lung screening studies? And my answer would be ‘yes.’ At CHI Saint Joseph, we have instituted countless measures to make sure that our screening activities can continue with minimal risk. Last March and April, we halted all screening activities, redesigned our testing and treatment areas to ensure social distancing; instituted routine use of personal protective equipment; initiated routine preoperative COVID testing; and, in the last few weeks, vaccinated our staff to decrease the risk further.
If you have any questions about safety practices, please feel free to contact your screening facility directly for more information. One thing we do ask is that if you're experiencing symptoms of COVID, a cough, a fever, body aches, loss of taste or smell, or you have had a known exposure to COVID, please reschedule any of these routine studies to 14 days later.
Am I at Higher Risk?
Our second question: If I have cancer, am I at a higher risk of getting COVID-19 or having severe complications? And for this there is a graded response.
Cancer survivors who are not receiving immune-suppressing chemotherapy – for example when your cancer is in remission – have only a slightly increased risk of contracting COVID or more severe disease course if infected. However, there are a number of risk factors that predict COVID severity in relation to cancer patients, and unfortunately these risks are additive. They include having active cancer or being on active treatment, having metastatic cancer or cancer that has spread throughout the body, age over 70. Some cancer sites, such as lung cancer or blood cancers, have higher risk; smokers – higher risk; and those with other pre-existing chronic health conditions.
Impact on Cancer Treatment
Question number three: What impact is COVID having on the ways that we treat cancer? In general, we are using oral medications, pill treatments and telehealth visits when possible to minimize the frequency of in-office visits. In some cases, the interval between treatments can be extended. And in others, the risks of ongoing treatment outweigh the benefit, and they may even be suspended for a time. However, each case is unique and warrants a discussion between the patient and your provider to determine the risk level.
How Can I Protect Myself?
Finally, what other ways can I protect myself? Until vaccines become widely available, the most effective way to prevent COVID-19 is to avoid exposure to the virus that causes it. This includes limiting in-person interactions and following diligent hand hygiene. Although neither FDA-approved vaccine has been studied extensively in cancer patients, guidance from the CDC and the American Society of Clinical Oncology is for cancer patients to consider vaccination unless there is a true contraindication, such as a known allergy to a component of the vaccine.
Adult cancer patients are included in Phase 1c of vaccination efforts. I have personally recommended that all my patients register with www.kycovid19.kentucky.gov to be alerted when vaccination is available in their area.
Thank you again for joining us today for Let's Break to Educate. If you have additional questions, please don't hesitate to call us at our office, 859-629-7110 or visit our website at www.chisaintjosephhealth.org.
Resources for our discussion today came from the American Society of Clinical Oncology. Thank you.