April 3, 2020

Caring for a vulnerable population during a global pandemic

Nearly every American has been impacted by the spread of COVID-19. From the way we work to our social interactions and the way we think about safety, each of our lives has been changed by the pandemic.

While we all face the social and economic impact of the virus, some of us have more to consider than others. Senior citizens and those with chronic diseases are at an increased risk. Cancer patients, who already face challenging diagnoses and treatments, are some of the most susceptible among us. We spoke with Gerold Bepler, M.D., Ph.D., president and chief executive officer of the Barbara Ann Karmanos Cancer Institute and chair of the Department of Oncology for the Wayne State University School of Medicine, about this vulnerable population to learn more about the impact COVID-19 has on cancer patients.

What effect does COVID-19 have on oncology patients? Are cancer patients at a higher risk of contracting COVID-19?

Yes, they are. We are hearing and seeing a lot of headlines about “pre-existing conditions” and this can mean many different things but it certainly applies to cancer.

Why are cancer patients at a higher risk?

The increased risk is due to a weakened immune system, which may result from the cancer itself or treatment a patient is receiving. Anyone who has immunosuppression is at an increased risk from Coronavirus.

What do we know about the outcomes of cancer patients who do get the virus?

Not very much. Because this virus has moved so quickly, we haven’t had time to observe the long-term trends in outcomes. However, The Lancet, a weekly medical journal, published a small study in which they found that cancer patients were more likely to be admitted to the intensive care unit due to complications from COVID-19 than those without cancer.

What message would you share with those who are fearful about seeing a doctor at this time, even if they may have symptoms that could indicate a cancer diagnosis?

Coronavirus or not, early detection saves lives. We know that outcomes are better across the board for patients who begin treatment in earlier phases of the disease. If you have a concern about cancer, call or go see your doctor. It is important that you take action in the same way you would if this pandemic was not occurring.

If a patient on active treatment for cancer tests positive for the Coronavirus, should they stop receiving treatment?

Every patient is different and it is up to his or her oncologist to recommend the best course of action so they can collectively make the right decision for the patient. In general, it is important for patients to continue their treatment and share any health concerns or symptoms with their oncologist.

What actions should cancer patients be taking to keep themselves safe?

Cancer patients, and everyone else, should be following the Centers for Disease Control and Preventino guidelines and practice good hand hygiene, avoid touching their faces, stay home if they are sick and practice social distancing. It is important for cancer patients to keep their appointments if they are receiving active treatment unless a physician deems it unnecessary at this time. I would also advise patients to try to minimize stress and get enough sleep.

What has been the response at Karmanos response?

I am very proud of the Karmanos Incident Response Team, which led the way in responding to this challenge. Our leaders are meeting daily to update plans and share communication. We have followed the guidance of the CDC, along with our local leaders and the McLaren Emerging Pathogen Response Team, in designing our response to this crisis. Patient safety is paramount to our mission and we are working hard every day to ensure that our patients receive the treatment they need in an environment that keeps them safe and well. We have adjusted our visitor policies, restricted access to facilities, limited contact and created algorithms for working with patients at various levels of risk. We are also utilizing telehealth technology for clinical appointments.

What is different about a cancer hospital’s response than the response of a general hospital?

Because our patients are at an increased risk, we have to take extra precautions. Our staff is adapting quickly as we respond to changes with our personal protective equipment supply, screening guidelines and other requirements. And with our specialization in cancer care, we are not accepting general patients presenting with Coronavirus symptoms.

There’s no doubt that it will take some time to understand the long-term impacts of the Coronavirus, but how is this pandemic affecting research now and how do you think it might influence research going forward?

You’re right about the long-term effects. I think we will be experiencing changes from this pandemic for many years to come. For some, it may change the focus of their research as we examine a shift in our perception of infectious disease control and treatment. Holistically, it is impossible to know what impact the virus will have.

​​​​​​Content courtesy of Karmanos Cancer Institute