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Cancer Care Chronicles
May 7, 2020

Cancer and Coronavirus Disease 2019 (COVID-19)—Facing the “C Words”

Author Affiliations
  • 1Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
JAMA Oncol. Published online May 7, 2020. doi:10.1001/jamaoncol.2020.1848

Until now, most people feared a diagnosis with the dreaded “C word”—cancer—owing to its associated physical, emotional, and financial hardships as well as its social stigma. However, the rapid progression of coronavirus disease 2019 (COVID-19) from a local issue to a global pandemic has quickly made it a competitor for the spot of the most feared disease, and rightly so, given the intense strain it is placing on us individually and as a society at every level. For me, having been diagnosed with both diseases 4 years apart, COVID-19 has brought back memories of being confronted with my own mortality.

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    2 Comments for this article
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    Between fear and work commitment, COVID-19 and hematological cancer
    Humberto Martinez Cordero, Hematologist - Internist | Instituto Nacional de Cancerología. Colombia
    Between fear and work commitment, COVID-19 and hematological cancer.

    I am a hematologist and I was diagnosed with early stage classic Hodgkin lymphoma just under two years ago, I received chemotherapy and radiation therapy. The interim PET-CT was negative, as well as the one at the end of the treatment. My cancer prognosis is excellent (1). While receiving the treatment, I had to be absent from work for a few months. At the end of chemotherapy and during radiotherapy, I decided to go through the hospital wards with the strict use of personal protection elements and hand washing. Finally
    I had no infection and everything went well. A couple of months later I was appointed head of the Hematology and Bone Marrow Transplant unit at the National Cancer Institute of Colombia.

    The arrival of COVID19 this year in our country has given me back the feeling of living the imminent risk of infections, complications and death, with the latent fear of being absent in my home, to my wife and my two young children. A high percentage of the population is expected to become infected and it is clear that oncohematological patients are among the highest risk population. (2). Now I am concerned about myself and my patients and good things have happened in this regard, such as having led 2 consensuses in Latin America for patients with lymphomas and multiple myeloma, in addition to having participated in the national consensus for the treatment of patients with COVID-19 (3,4,5). Adverse situations have also occurred to me, such as the appearance of anxiety, insomnia and a mental dilemma that moves between the fear of getting covid-19 and the commitment to patients who depend on my care, this has already been studied in studies qualitative in health workers. (6). As I said, my cancer prognosis is excellent, but now the uncertainty is around the concept that acquiring COVID-19 infection means, in my case, a high risk of death.



    References

    1. Gallamini A, Kostakoglu L. Interim FDG-PET in Hodgkin lymphoma: a compass for a safe navigation in clinical trials? Blood. 2012;120(25):4913-20.

    2. Williamson E, Walker AJ, Bhaskaran KJ, Bacon S, Bates C, Morton CE, et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv. 2020:2020.05.06.20092999.

    3. [Internet]. 2020 [cited 10 May 2020]. Available from: https://www.researchgate.net/publication/340543700_Consenso_del_Grupo_de_Estudio_Latinoamericano_de_Linfoproliferativos_GELL_para_el_manejo_de_Linfomas_en_estado_de_Pandemia_SARS_CoV-2_COVID_19

    4. [Internet]. 2020 [cited 10 May 2020]. Available from: https://www.researchgate.net/publication/340543700_Consenso_del_Grupo_de_Estudio_Latinoamericano_de_Linfoproliferativos_GELL_para_el_manejo_de_Linfomas_en_estado_de_Pandemia_SARS_CoV-2_COVID_19

    5. [Internet]. 2020 [cited 10 May 2020]. Available from: https://www.researchgate.net/publication/340543700_Consenso_del_Grupo_de_Estudio_Latinoamericano_de_Linfoproliferativos_GELL_para_el_manejo_de_Linfomas_en_estado_de_Pandemia_SARS_CoV-2_COVID_19

    6. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control. 2020:S0196-6553(20)30201-7.
    CONFLICT OF INTEREST: None Reported
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    Cancer Patients and COVID-19
    Michael McAleer, PhD (Econometrics), Queen's | Asia University, Taiwan
    The oncologist author of the contribution to Cancer Care Chronicles has presented a sensitive and detailed account of a hazardous journey that deals with cancer, a disease in which abnormal cells multiply uncontrollably and leads to the destruction of body tissue.  

    Only those who have personally experienced a life-threatening cancer diagnosis, such as the author of the chronicle, who has fortunately recovered from both cancer and coronavirus, as well as their close family members, friends, and healthcare providers, including oncologists and nursing staff who administer chemotherapy and radiotherapy treatments, would have the capacity to appreciate fully the significant
    impact of any type of cancer on the quality of life, and on the preservation of life itself.

    A common side effect from chemo and radio therapies is the loss of (all) bodily hair in a short period of time, which can lead to many confronting issues for patients.

    Some patients don wigs, which can be appealing, but yours truly embraced the Yul Brynner / Bruce Willis follicly/follically-challenged sartorial look as economical and expedient.

    Unlike cancer, where members of the general public free of the disease are seemingly not concerned about possible infection, the SARS-CoV-2 virus that causes the COVID-19 disease would almost certainly be on the minds of every human being, especially as the chances of infection and transmission are far from negligible.

    Cancer patients have diminished immune systems, and so are more susceptible to contracting COVID-19, and suffering severely from such an infection.

    Whether cancer patients with COVID-19 are more likely to transmit the disease to healthy humans does not yet seem to have undergone serious clinical trials.

    A simple fact that every cancer patient understands presciently is that it is impossible to survive and enjoy quality of life without the continuous and selfless support of family, friends, oncologists, and nursing staff, especially with triweekly chemotherapy sessions lasting for more than six years, and counting.

    Acknowledgement of gratitude does not come close to expressing just how much cancer patients, as well as patients infected with COVID-19 or any other disease, truly appreciate the comforting support of family, friends, oncologists, and nursing staff, when their selfless help is needed the most.
    CONFLICT OF INTEREST: None Reported
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