I Have Lung Cancer: Should I Skip Some Treatments in Light of COVID-19? Everyday Health MenuNewslettersSearch Coronavirus: Must-Know InfoLung Cancer Patients With Lung Cancer All Have the Same Question About COVID-19 Should I Skip Treatment Is it riskier to skip treatment or go to treatment and risk exposure to COVID-19? By Melba NewsomeMedically Reviewed by Thomas Urban Marron, MD, PhDReviewed: April 6, 2020Medically ReviewedIs lung cancer treatment necessary during the pandemic?Andrea Obzerova/AlamyEdward B. Garon, MD, says the hematology and oncology clinic at the UCLA Medical Center in Los Angeles has been flooded with calls from anxious cancer patients who want to know how COVID-19, the coronavirus disease that has grown into a pandemic, will impact them and their treatment protocols. “Many patients are afraid to come in to the clinic, and many are asking, ‘Do I need my chemo or immunotherapy?’” says Dr. Garon, an oncologist. These are normal and relevant questions and concerns, particularly for people with cancer. Patients with lung cancer, in particular, tick all the risk boxes: They tend to be older, have compromised immune systems, and have existing respiratory issues. Any infection they contract is likely to be more severe, according to the American Cancer Society. The COVID-19 virus is no exception. “It’s an anxiety-provoking time … that can lead to great emotional and psychological distress,” said Zosia Piotrowska, MD, an oncologist at Massachusetts General Hospital in Boston, during in a webinar for LUNGevity on March 16. Should You Interrupt Treatment It Depends Dr. Piotrowska cautioned that the unprecedented nature of this pandemic makes it difficult to issue blanket statements of advice for all lung cancer patients, and treatment decisions must be individualized to fit the patient. “It depends on what type of treatment you’re on, how’s it working, can it be held up for a while, what are the risks? In some cases, it's safer to skip a dose or two, but that may be too risky for other situations,” she said. Garon factors in the age of the patient and the anticipated benefit of that intervention when making treatment decisions. “I’m more likely to pause treatment in a patient who is older,” he explains, because those patients are at higher risk from COVID-19, which disproportionately threatens the lives of the elderly. If a patient is newly diagnosed, he’s less likely to skip treatment. “In the case of a new diagnosis, particularly of advanced disease when we know that without any treatment the disease course tends to be quite aggressive, it’s very important that the patient get the appropriate management for that.” “Patients who have an earlier stage disease may still be curable by surgery or other modalities,” says Garon. In these cases, because lung cancer can be such an aggressive disease, it’s best to not wait on treatment, because time is of the essence. The best odds lie with prompt treatment of early disease. Location may dictate some of the options, as well. In New York City, the heart of the pandemic in the United States, for instance, operations can’t take place at the moment. Many oncologists who specialize in lung cancer there are now opting to do neoadjuvant chemotherapy (chemotherapy given before surgery) in many patients to delay the surgery until operating rooms are open again. Avoiding Infection All people, whether or not they have cancer, should follow the basic safety guidelines provided by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO):Wash your hands frequently with soap and water for at least 20 seconds. It’s one of the best ways to kill germs on your hands and prevent the spread of germs to others. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 70 percent alcohol.Avoid touching your eyes, nose, and mouth. If your hands have made contact with the virus, you could infect yourself by allowing it to enter your body.Avoid close contact with anyone, staying six feet from others, and avoid all contact with people who are sick, especially those who are coughing or sneezing. Patients battling lung cancer should take extra precautions, say experts. “Lung cancer often comes along with other lung conditions, including COPD and emphysema, so that puts [patients] at higher risk,” said Piotrowska. “That doesn’t mean that everyone who has this illness is going to become ill, but our patients have to be extra careful to keep themselves healthy.” Japal Singh, MD, the director of pulmonary oncology at Atrium Health, stresses that the primary focus should be on minimizing exposure to the disease. “The infection-prevention piece is extremely important. So avoid crowds and practice good hygiene,” says Dr. Singh. “If there are sick [people in your life], try to avoid direct contact with them and maintain social distance. Stick with your medical treatment plan as much as possible. Maintain your physical, emotional, and spiritual health so that if the infection comes, you are better prepared to deal with it.” Getting Ahead of the Game Patients should also be proactive. The American Society of Clinical Oncology (ASCO) recommends that all patients with cancer call their doctor if they meet any of the following criteria: have a fever and other symptoms of a respiratory illness, such as a cough or shortness of breath; have been in close contact with a person known to have COVID-19; and live in or have recently traveled to an area known to have an outbreak of the disease. Symptoms generally develop within 2 to 14 days of exposure. If you feel you’re developing symptoms, you should get in touch with your physician at once. Finally, a note of encouragement. “Patients should be heartened to know that the medical community is very interconnected. Lessons learned in China or South Korea or Italy will be transmitted to physicians in this country,” said Garon. “Physicians throughout the world are working to do whatever they can to optimally manage patient care.” NEWSLETTERS Sign up for our Cancer Care Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. The Latest in Lung Cancer The Price of Being Invisible How One Black Woman Fought for Her Lung Cancer Diagnosis Nichelle Stigger thought she had lung cancer. Doctors didn’t believe her. Six months later, she learned she was right.By Susan K. TreimanOctober 7, 2022 Standing Up for Better Lung Cancer CareWith the support of his family, Walter Pearsall spoke up about his lung cancer treatment and was able to get the care he deserves.By Lambeth HochwaldOctober 6, 2022 Building Trust Is Key to Breaking Barriers in Lung Cancer CareEnid Harding is helping marginalized communities get access to lung cancer screenings. 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