The following information is brought to you by Conquer Cancer affiliate, Cancer.Net, which provides free access to trusted, doctor-approved information for patients, caregivers and families dealing with cancer. More COVID-19 resources are available at https://www.cancer.net/navigating-cancer-care/managing-your-care/covid-19-resources-people-with-cancer.

What is COVID-19?

COVID-19, or coronavirus disease 2019, is a respiratory illness caused by a novel (or new) coronavirus that was first identified in an outbreak in Wuhan, China, in December 2019. 

Coronaviruses are a large family of viruses that can cause mild illnesses, such as the common cold, to more severe diseases, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Because the novel coronavirus is related to the SARS-associated coronavirus (SARS-CoV), it has been named SARS-CoV-2.

The disease can spread from person to person, through small droplets from the nose or mouth that may spread when a person coughs or sneezes. Another person may catch COVID-19 by breathing in these droplets or by touching a surface that the droplets have landed on and then touching their eyes, nose, or mouth. While research on COVID-19 is still emerging, the primary belief is that the disease is mainly spread through contact with these respiratory droplets that are spread through the air or land on surfaces we all touch.

Symptoms from COVID-19 can be mild to severe and can include fever, cough, and shortness of breath. Other symptoms may include aches and pains, nasal congestion or runny nose, sore throat, or diarrhea. Some people who are infected may not develop symptoms, however.

 Are there special precautions that people with cancer should take?

People with cancer, people who are in active cancer treatment, older patients, and people with other serious chronic medical conditions, such as lung disease, diabetes, or heart disease, may be at higher risk for the more severe form of COVID-19. The same rules apply for people with cancer as for those without cancer: Be sure to wash your hands well, and wash them frequently. Avoid touching your face, and avoid close contact with people who are sick.

People who are at higher risk of getting very sick from COVID-19 should avoid any non-essential travel during this time of COVID-19 outbreak. In most parts of the United States, a “shelter in place” or “stay at home” order is in effect. For people with cancer who live in these areas, do not leave your home unless it is absolutely necessary. For people who live in areas where there is not yet a “shelter in place” restriction issued by the government, it is best to live as if there is such an order in effect. Stay at home to reduce exposure to other people. Avoid any social gatherings. If you must leave your home, keep a distance of at least 6 feet between yourself and other people. Only leave your home for essential reasons, such as buying groceries or picking up medication from the pharmacy, and make your trip out as brief as possible.

Be sure to have enough essential medications, both prescription and over-the-counter, to last for at least 1 month. Create or update an emergency contact list that includes family, friends, neighbors, and community or neighborhood resources who may be able to provide information or assistance to you if you need it.

In order to stay connected to your support system, make plans to connect with your family and friends virtually, through video chat or phone calls. Some examples of technology that can be used for video or other live chats are FaceTime, Zoom, Google Hangouts, and social media platforms, such as Instagram and Facebook.

If you are scheduled for cancer treatments during the COVID-19 outbreak, have a discussion with your oncologist about the benefits and risks of continuing or delaying treatment. If you are not scheduled for cancer treatment but are scheduled for an appointment with your oncologist, it may be possible for the doctor to conduct the visit using videoconferencing or telemedicine. Be sure to check with your cancer care team to see if this is recommended for you.

Finally, it is always important to have your health care wishes in writing, in case you are too sick to make decisions for yourself. This way, your family and your medical team will know what is important to you and what your wishes are. If you have not yet done this, now is a good time. Cancer.Net has valuable information on this topic. Because some hospitals and clinics are limiting visitors, and some are allowing no visitors, having your health care wishes in writing is more important than ever. Here are some examples of important questions to ask yourself, to discuss with your loved ones, and to write down:

• What level of quality of life would be unacceptable to me?

• What are my most important goals if my health situation worsens?

• If I am unable to speak for myself, who is the person in my life who I would want to speak for me?

• Who should not be involved in making decisions for me?

• If my heart stops, do I want to have CPR (cardiopulmonary resuscitation) done?

Will anything change with my cancer-related medical visits?

Due to the COVID-19 pandemic and the increased risk of exposure to the virus by going out in public, many hospitals and clinics have changed their visitation policies. Some may allow 1 visitor per patient, and others may allow no visitors. Before heading to your medical appointment, check with the clinic or hospital for their current visitor policy.

Your cancer care team may switch some of your appointments to telemedicine. During a telemedicine appointment, you stay at home and visit with your doctor or other health care team member through video conferencing or by telephone. Your doctor’s office will let you know what system they are using for telemedicine appointments.

Your doctor may recommend delaying some treatments for supportive care, such as bone-strengthening treatments, for example, denosumab (Xgeva) or zoledronic acid (Zometa), or intravenous iron supplementation. They will only recommend delaying treatments if they feel it is in your best interest to do so. Cancer screening tests, such as mammograms or colonoscopies, and other tests, such as bone density tests, may also be delayed to reduce your risk of exposure to the virus.

Oncologists may recommend stretching out the length of time between cancer treatments using medications, such as chemotherapy or immunotherapy. Or they may recommend delaying starting these treatments, based on your cancer diagnosis and the treatment goals.

Where can I get the latest information about COVID-19?

Staying up to date on the latest information on the COVID-19 outbreak is important. The CDC and your local and state health departments will have ongoing information about whether the disease has been diagnosed in your community.

Access additional resources for cancer patients and survivors at the Cancer.Net blog.