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Cancer and COVID-19: Q&A With Dr. Dan Theodorescu

Dr. Dan Theodorescu

While the COVID-19 (coronavirus) pandemic is sweeping the globe, many have questions about what it means for them. For cancer patients and their loved ones, the condition might be even more troubling. 

We sat down with Dr. Dan Theodorescu, director of Cedars-Sinai Cancer, to discuss some of the most common questions cancer patients have during this rapidly evolving situation. 

Are cancer patients at higher risk for COVID-19 infections?

Dr. Dan Theodorescu: Overall, cancer patients are not at higher risk for contracting COVID-19. Today, many patients with cancer are receiving immunotherapy and targeted therapy without chemotherapy. That means that their immune systems are intact, which is good. 

However, patients undergoing chemotherapy or who have undergone bone marrow transplants may face a higher risk of getting COVID-19 and experience more serious symptoms of the illness.

The same is true of patients who have blood cancers such as lymphoma, leukemia and multiple myeloma. That's because they have compromised immune systems, which are weaker than those of the average healthy adult. Therefore, it's more difficult for their bodies to fight off infections.

Headshot for Dan Theodorescu, MD, PhD

Dan Theodorescu, MD, PhD

Physician Specialities

Dan Theodorescu, MD, PhD

Physician Specialities

If I experience early COVID-19 symptoms such as fever or cough, should I contact my medical oncologist or primary care physician?

DT: If you're undergoing active cancer treatment, contact your treating oncologist by phone. If you're not having active treatment, contact your primary care physician.

Should my treatment such as radiation therapy, oral therapy and immunosuppressive therapy be stopped, delayed or interrupted?

DT: Clinical decisions should be made on an individual basis. Talk with your cancer care team about whether you should make any modifications to your cancer treatment regimen and to determine the most appropriate course of action for your situation.

Do I have a higher risk of getting COVID-19 or having a more serious course of illness if I received chemotherapy or radiation in the past?

DT: There is no current evidence suggesting that any past cancer treatments increase your risk for getting COVID-19. But remember, patients getting cancer treatments interact with healthcare workers more frequently than the general population, so that added exposure may contribute to a higher risk.

Should a person about to start cancer therapy consider postponing treatment due to COVID-19?

DT: There are several factors to consider when making that important decision. Talk to your oncologist about the risks of postponing treatment versus the potential benefit of decreasing your infection risk.

Should cancer surgery be canceled or delayed?

DT: Physicians and patients need to make individual determinations based on the potential harms of delaying needed cancer-related surgery. Contact your oncology team to discuss options.

Should cancer patients, their family members or caregivers observe stricter preventive precautions, in addition to the standard guidelines most people are following?

DT: It's crucial to follow the guidelines provided by the Centers for Disease Control and Prevention, the World Health Organization and your local health department. Actions such as social distancing, frequent and proper handwashing, avoiding large crowds, keeping surfaces clean and disinfected, and not touching your face are even more important for cancer patients and survivors who may be immune-compromised.

How is Cedars-Sinai keeping cancer treatment areas, such as infusion centers, safe during the COVID-19 crisis?

DT: All patient interaction in cancer treatment areas is adhering to social-distancing guidelines of 6 feet. Individual treatment rooms, recliners and IV pumps are wiped down with disinfectant between patients. All nursing stations are wiped down with disinfectant. The clinical staff is adhering to hand-washing guidelines, per protocol.

It's hard to keep up with all the information and advice about COVID-19. What should cancer patients ask their doctors?

DT: The situation is fluid; what is true today might change tomorrow or next week. So, talk to your physician about the current risk for COVID-19 in your specific community. Also, before canceling an appointment, talk to your doctor about steps your health institution is taking to make sure cancer patients are safe and getting the care they need.