FAQs for Cancer Patients on the Coronavirus (COVID-19)

Medically Reviewed By: Candace Hsieh, RN; Sarah Hammond, MD; Craig Bunnell, MD, MPH

The 2019 novel (new) coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes the disease COVID-19, a respiratory illness. The spread of COVID-19 is disrupting life — for those who have been infected with the virus as well as those who haven’t — on a global scale.

The coronavirus outbreak may pose special risks for some cancer patients. To answer some common questions and provide insight, we spoke with Sarah Hammond, MD, an infectious disease specialist at Dana-Farber and Brigham and Women’s Hospital, and Craig Bunnell, MD, MPH, chief medical officer at Dana-Farber. They address some of the specific challenges cancer patients may face at this time, how to protect yourself, and more.

The situation regarding COVID-19 is rapidly evolving; for the latest information, be sure to seek out reputable sources of information, such as the Centers for Disease Control and Prevention (CDC).

Questions and answers for patients

What steps should I take to protect myself and others from the virus?

The advice for patients with cancer is basically the same as for the general population:

  • Wear a mask. If you have to leave the house, stay at least six feet away from other people and cover your mouth and nose with a face mask (cloth or surgical). The cover serves a dual purpose: It protects you from others who may be infected and keeps others safe in case you are infected yourself. The CDC strongly recommends that anyone who is two years old and above wears a mask in public settings and when you are around people who don’t live in your household. Your county, city, or state may also have rules and regulations in place regarding masks.
  • Stay home as much as possible. If someone in your household has tested positive for the coronavirus, try to self-quarantine from the sick individual and keep the entire household at home.
  • Avoid contact with people known to be infected with the virus or with those showing symptoms of infection.
  • Wash hands frequently with soap and water for at least 20 seconds, especially after being in a public place or after blowing your nose, coughing, or sneezing, and before touching your eyes, nose or mouth. If soap and water aren’t readily available, use a hand sanitizer* that contains at least 60% alcohol.
  • Avoid touching your face as much as possible.
  • Clean and disinfect frequently touched surfaces such as doorknobs, light switches, handles, phones, keyboards, and faucet handles daily. Most common EPA-registered household disinfectants are adequate.
  • Upon entering your house, immediately wash your hands: This will help to keep the household free of outside germs. You should also ask others entering your home to Purell or wash hands upon entering.
  • Use public transportation only when necessary and wash hands after using any public facility. If you need to take public transportation, be sure to wear a mask and maintain physical distancing (6 feet) whenever possible.
  • Monitor your health daily and take your temperature if you develop symptoms.

*The U.S. Food and Drug Administration (FDA) has been testing various hand sanitizers for efficacy and safety and has a list of products that consumers should avoid.

Are all patients with cancer at equal risk for infection? What does it mean to be immunocompromised?

Patients with a weakened immune system — in other words, patients who are immunocompromised — may be at increased risk because their defenses against infection are lowered. This includes patients with blood-related cancers such as leukemia, lymphoma, or multiple myeloma, which directly affect cells of the immune system, and those undergoing chemotherapy treatment.

Patients over the age of 70 are more likely to develop severe cases of COVID-19, as are those with underlying medical conditions such as:

  • Cardiovascular disease
  • Lung disease (such as emphysema or severe asthma)
  • Diabetes
  • Kidney disease
  • Obesity
  • High blood pressure

Active tobacco smokers are more likely to develop severe cases as well.

The increased risk does not necessarily end at the conclusion of cancer treatment. Research is underway to better understand if long-term cancer survivors remain more susceptible to infection. As a general rule, as patients get further out from the time of their treatment, their immune system gradually reconstitutes.

For these reasons, it is especially critical for patients with cancer to follow the necessary steps to protect themselves from the virus.

Does coronavirus infection produce different symptoms in cancer patients than in other people?

For the most part, the symptoms of COVID-19 are the same in cancer patients as the general population.

One exception might be patients who are taking steroids or other medications to treat leukemia or lymphoma. These treatments can suppress the development of fevers. As a result, patients with COVID-19 who are taking these types of medications may not register a fever — or as high a fever — as others with the infection.

What should I do if I have symptoms of COVID-19?

Call your treatment center to report your symptoms. If you need to be seen and are symptomatic, your care team will help you take steps to ensure that we can see you in a way that is safe not just for you, but for other patients and our staff members.

Under normal circumstances at Dana-Farber, patients who come down with respiratory infections during cancer treatment are given a mask upon arrival and directed to specific rooms outside of general waiting areas. With the spread of COVID-19, we keep symptomatic patients separated from other patients and direct them immediately to rooms with negative pressure that don’t expel air into other rooms.

Dana-Farber has also implemented a number of new protocols and procedures to ensure the safety of our patients, their family members, and staff. Measures include:

  • COVID-19 screenings: Prior to each visit, patients and visitors are screened first over the phone and then once again when they arrive. In addition, all Dana-Farber staff are screened daily.
  • Universal mask policy: All patients, visitors and employees are provided a surgical mask when they arrive at Dana-Faber. These masks must be worn throughout their entire time at the Institute.
  • Physical distancing: Everything from infusion chairs to tables in the Lavine Family Dining Pavilion in the Yawkey Center for Cancer Care have been rearranged in order to comply with physical distancing recommendations.
  • Appropriate PPE: All staff have been outfitted with the appropriate personal protective equipment (PPE).
  • Limiting foot traffic: Dana-Farber is restricting all incoming business or community visitors. Appointments are being staggered to limit the number of people in each building, ensuring that elevators, waiting rooms and all clinical and non-clinical areas are not over-crowded.
  • Additional cleaning: Environmental Services are working around-the-clock to reach every inch of the Institute. Exam rooms are cleaned and wiped down after each use, and “high-touch” areas including handrails and elevator buttons are cleaned and disinfected regularly.

If there anything I can do to strengthen my immune system?

As a general rule, it’s important not to let yourself get run-down — so be sure to get plenty of sleep, drink enough fluids, and eat a balanced diet with plenty of fruits and vegetables. Other tips for strengthening your immune system include:

  • Exercising regularly
  • Limiting alcohol consumption
  • Taking steps to minimize stress

This can include creating a new routine to provide structure to your day and increase your sense of control, staying connected to those you care about through virtual meetings, and limiting your media exposure.

For more tips on coping with the day-to-day uncertainty of the rapidly evolving COVID-19 situation, be sure to review the following comprehensive tip sheet created by the Department of Psychosocial Oncology and Palliative Care at Dana-Farber.

What precautions should cancer patients take when they come in for treatment?

Upon arriving for an appointment at Dana-Farber, patients will be guided through the many precautions that have been put in place to keep everyone safe. Patients and staff are routinely screened and asked about any health problems or symptoms they are experiencing. Everyone is provided with a face mask (if they do not have their own), which they will wear throughout their time in any of Dana-Farber’s buildings. Patients should continue to stay six feet away from others and to follow the same hygiene measures — frequent handwashing, avoiding touching one’s face, etc. — described in the first section of this article.

Learn more about precautions that Dana-Farber is taking during this challenging time.

If I test positive for COVID-19 while undergoing cancer treatment, do I need to stop treatment until I recover?

This depends on a variety of factors, including the type of cancer you have, the type and stage of treatment, and the severity of your COVID-19 symptoms. It isn’t unusual for patients who develop the flu, for example, to have a pause in treatment, and the same approach may be appropriate for some patients with COVID-19. Ultimately, your care team will work with you to determine the best options for you.

I am a caregiver. How can I make sure my home is as safe as possible?

If you’re caring for someone who is at a higher risk for serious illness from COVID-19, the CDC recommends the following steps:

  • Contact the patient’s healthcare provider to ask about possibly obtaining extra necessary medications. If this is not possible, see if you can have the medications mailed to you instead of picking them up in person.
  • Be sure to have over-the-counter medical supplies on hand that can be used to treat fever and other symptoms.
  • Have enough household items and groceries available so that you limit the time you need to be outside or at the store.
  • Clean and disinfect frequently touched surfaces such as doorknobs, light switches, handles, phones, keyboards, and faucet handles daily. Most common EPA-registered household disinfectants are adequate.

More general advice for caregivers of patients with cancer

For people caring for family members or others with cancer, it is especially important to take precautions. Because some cancer patients have lowered immune system function, they may be especially susceptible to contracting COVID-19. Consider taking the following measures:

  • Practice good hygiene. It is an important part of keeping patients safe from infection.
  • Have everyone who enters the house wash their hands upon arrival, and make sure visitors also wear face masks.
  • If you are a caregiver for a high-risk patient, consider staying home whenever possible. Staying home is the best way to protect yourself and others from COVID-19.
  • When you are outside of your home, wear a mask and put 6 feet of distance between yourself and others. Remember, some people who do not show symptoms may still be carrying the virus.

Additional information everyone should know about COVID-19

How does COVID-19 spread?

The virus spreads by respiratory droplets released when an infected individual coughs or sneezes. These droplets can then land in the eyes, mouth, or nose of those nearby. Droplets can also land on other parts of the body and then spread through contaminated hands into the eyes, mouth, or nose.

It is important to note that the virus can also spread via virus particles (known as fomites) on surfaces, though this is less common. When an individual touches such surfaces and then touches their face or mouth, the particles can gain access to the individual’s airway and lungs. A recent study found that the virus can remain on plastic and stainless-steel surfaces for several hours.

Lastly, it is also possible that the virus spreads through airborne transmission. This occurs when an infected patient releases tiny aerosols that linger in the air and are eventually inhaled in the lungs of someone else. While additional information is needed, most experts believe that airborne transmission is not the dominant mode of transmission.

What are the general symptoms of COVID-19?

The following symptoms may appear 2-14 days after exposure, according to the CDC (please note that this list does not include all possible symptoms):

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

If you develop emergency warning signs for COVID-19, the CDC encourages you to get medical attention immediately. Emergency warning signs include:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

Remember: practice physical distancing

It’s up to each individual to take steps to avoid exposure to the coronavirus and to reduce the chances of spreading it to others.

One of the best ways to protect yourself and others from COVID-19 is known as physical distancing (also called social distancing). This involves avoiding mass gatherings or settings where large numbers of people are present and maintaining a distance of at least six feet from others when possible.

This can significantly reduce the potential for mass transmission of the virus — a scenario that could overwhelm hospital facilities needed to treat patients seriously ill with COVID-19.

Do I need to practice physical distancing even if I don’t have symptoms or even if I’m young and healthy?

Yes. People who are infected but show no symptoms can still transmit the virus.

Are there any treatments that work for the virus?

Potential treatments for COVID-19 are in various phases of ongoing clinical trials. There are currently no FDA-approved products available to treat COVID-19, though there are some clinical management steps that clinicians can take.

Investigators at Dana-Farber and Brigham and Women’s Hospital are also actively studying potential treatments. In July, Dana-Farber researchers, along with Colleagues at Columbia University and the National Institutes of Health (NIH), identified a diverse set of antibodies that effectively neutralize the coronavirus responsible for COVID-19. This is another key step in the development of agents to treat and prevent the disease.

What about travel?

Travel increases your chance of getting and spreading COVID-19. Staying home is the best way to protect yourself and others from the virus. Do not travel if you are sick or have been around someone with COVID-19 in the past 14 days. If you must travel, please consider the following:

  • What is the current case number at your destination, and is it spreading? A higher number of cases increases your chance of being infected and possibly spreading the virus to others upon your return.
  • Does your destination have requirements or travel restrictions? Many areas have implemented visitor restrictions for those either visiting to, or returning from, a specific area. Be sure to check state and local public health websites for information before you travel. Many times, these restrictions do not apply for those coming to an area for medical treatment.
  • If you must travel, be sure to follow the precautions already outlined in this article to protect both yourself and others.

Be sure to check the CDC’s website for the latest regarding travel during COVID-19.

Coping with uncertainty

We are currently living in a very uncertain world. Here are some basic tips for ways you can address your emotional health and well-being.

15 thoughts on “FAQs for Cancer Patients on the Coronavirus (COVID-19)”

  1. Hi. I had a allogeneic stem cell transplant at Dana-Farber 1.5 years ago. I am still on immunosuppressant meds to treat gvhd. I currently take precautions to avoid infection. My question is am I more at risk with coronavirus than the average person? One thought is that I am just as likely to contract the virus as any other person since nobody has antibodies to resist the virus. On the other hand if I do contract the virus I would have a more difficult time recovering than a person with a healthy immune system. Do I need to take extra precautions because of Corona virus? I have a scheduled visit with my providers next week and plan to raise this question.

  2. I am a 75 year old male. I feel great, healthy and strong. But I have all the risk facts. I am avoiding public contact except as needed. I am avoiding physical contact and expanded communication distance between myself and conversational distance. What else?

  3. I was a patient at Dana Faber (Dr. Wendy Chen) and had a double mastectomy for breast cancer. I am now approaching 3 years cancer-free but I wonder if my immune system is still compromised and should I be more cautious than most regarding the coronavirus?

    Thank you for your time.

  4. This is important information focused specifically on cancer patients. While there is a growing amount of virus-related information available to the public virtually everywhere, this is one of the first publications that I have seen solely devoted to cancer patients.

    Good job Dana-Farber. I hope that your affiliated organizations are encouraged to transmit this information to their patients as well! As I am a Dana-Farber patient and New England Cancer Specialists, I am also involved in a cancer information group called Answer Cancer Foundation (AnCan) where I help moderate a virtual support group for Blood Cancer Patients. I will be sure to share this information.

  5. “Eat Right” is your recommendation to strengthen the immune system. It is vague and open to ones preferences. Therefore it would be very helpful if you would be very specific about this recommendation.

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