Coronavirus: Steps to Take for People With Breast Cancer
The coronavirus, also called COVID-19, has become a major concern as more people have been diagnosed in the United States and around the world. Those in active cancer treatment may be at a higher risk for severe symptoms and complications as a result of an infection with this virus. Members of our community who are receiving chemotherapy and other breast cancer treatments report being concerned about their risk.
Tips to prepare for COVID-19 for people in breast cancer treatment:
- Prepare your home with medicine and supplies for several weeks, and limit contact with people you don’t know.
- Ask your healthcare team how precautions against COVID-19 might affect how you get care.
- If you feel sick, call your doctor first before exposing yourself to other people.
- Check in with the CDC and your local health department for updates.
- Limit exposure. Avoid close contact with people outside your household. Anyone who you must be in contact with should take the same precautions.
What Is the Coronavirus?
“Coronavirus” is a broad term that refers to a family of viruses that includes some common infections and past viruses such as SARS. The coronavirus present now is a new strain called SARS-CoV-2. The disease it causes is COVID-19, which can cause fever and respiratory problems like coughing, shortness of breath, or trouble breathing.
Serious cases of COVID-19 can lead to pneumonia or even death. Early reports suggest about 2 percent of people who get COVID-19 die from it, but the research is emerging and not everyone has the same risk. People over 65, people with chronic health problems such as heart, lung, or kidney disease, and people with weakened immune systems have a greater risk of serious symptoms and complications from COVID-19 that could lead to death.
If you are in active treatment for breast cancer, or just finishing treatment, your immune system may be weakened, leaving you at risk for complications if you contract COVID-19. Your risks may be higher if you:
- have metastatic breast cancer
- are being treated with chemotherapy
- are being treated with a targeted therapy that lowers your blood count
- finished treatment with one of these medicines in the last 2 months, and your blood counts are still low
Dr. Mehta says to talk to your oncology team if you are unsure whether your treatment can affect your immune system.
According to the CDC, COVID-19 is mainly spread through close contact — defined as spending time within 6 feet of someone with the disease — and through droplets in the air from coughing and sneezing that you may breathe in if you are close by. It is possible the virus can be picked up from surfaces as well.
Preventing Coronavirus in People With Breast Cancer
The key to prevention is avoiding exposure to COVID-19, Dr. Gefen says. If you receive chemotherapy or a targeted therapy that weakens the immune system, you can take actions now to keep yourself safe.
The CDC has recommendations on how to prevent the spread of COVID-19 and protect yourself from exposure.
- Limit contact with people outside your household.
- Clean frequently touched surfaces.
- Wash your hands regularly for 20 seconds.
- Avoid touching your eyes, nose, or mouth (especially in public).
- Avoid large crowds.
- Ask anyone you might come into contact with about their exposure to COVID-19. If they have been sick recently or around someone who has been sick, or if they have not been able to limit contact with others, ask to talk by phone or video call instead of visiting for now.
- People who do visit should follow the CDC recommendations as well: wash their hands frequently, cover coughs and sneezes, and not touch their face.
Other people in your household should follow the same guidelines as you, limiting contact with others and following CDC recommendations. If they are exposed to COVID-19, they can pass it to you and anyone else in the household.
A note on facemasks: The CDC does not recommend facemasks if you are well. Facemasks are important for people who have COVID-19 to keep it from spreading and for healthcare workers and others who are working closely with people who have the infection. Unless you have been instructed to by your doctor, you do not need to wear a facemask.
[UPDATE: In the weeks after this article was published, the CDC changed its guidance on facemasks. It is now reccomended that you wear a facemask whenever you are in a public setting.]
Other ways you can prepare for COVID-19:
- Stock your house with supplies that won’t go bad.
- Limit the trips you have to make out of the house. Once you are stocked with any medicines you take at home, water, non-perishable foods, toilet paper, tissues, soap, and any other goods you might need in the coming month, stay in as much as you can. Use delivery services if available.
- Check plans for the places you and your family frequent. Ask your employer if you can work home. Check for updates from schools and municipal offices. If you haven't seen information, try the website or call the office directly.
- Speak to your oncology team about what plans your treatment center has to deal with COVID-19. Will there be any changes to your process for getting treatment? What should you do if you get COVID-19?
Dr. Gefen directs people to the CDC website on ways to protect themselves from COVID-19, but adds, “Doing it earlier, doing it sooner, doing it now is really important for people with breast cancer.”
COVID-19 has been identified in communities across the country and is likely in many places even if no cases have been reported. A person can spread the virus before they feel symptoms. Once you hear reports of people testing positive in your community, the virus will already be there.
Even if your state or town has not yet taken precautions, you should do what you can to limit contact between the people in your household and anyone else.
“Someone with breast cancer needs to act now and not wait for the spread. Because the spread is coming,” Gefen says. “So I would limit exposure now.”
What If I Think I Have Symptoms of COVID-19?
As with preparing, Dr. Gefen recommends taking extra caution if you have concerns about your health. If you suspect you may have COVID-19, stay home and tell people not to visit.
“The best thing to do is start with calling your physician and getting advice on next steps,” Dr. Gefen says.
Include this information when you speak to your doctor:
- How severe the symptoms are.
- If you or someone you have been in close contact with someone who traveled recently, especially to an area where COVID-19 has spread.
- If you been in close contact with someone who has been diagnosed with COVID-19.
Calling is preferred for the first step so you can keep from getting or passing germs. It saves you from risking contact with other people who may be sick in the doctor’s office or in transit.
Don’t go anywhere except to get medical care and don’t take visitors until you can get cleared by a doctor.
Keep your oncology team informed. If you haven’t had a conversation with them about plans for COVID-19, now is the time to ask how this may affect your treatment and what should happen if you test positive.
Marisa Gefen, MD, is senior medical director at Oak Street Health in Philadelphia. She is a former member of Living Beyond Breast Cancer's Board of Directors.
Pallav Mehta, MD, is director of integrative oncology and director of practice development at the MD Anderson Cancer Center at Cooper in Camden, New Jersey. He is a member of Living Beyond Breast Cancer’s Board of Directors.