How does breast cancer affect COVID-19 risks?

As the Centers for Disease Control and Prevention (CDC) note, undergoing cancer treatment can weaken the immune system.

This can increase a person’s vulnerability to infection — including infection with SARS-CoV-2, the virus that causes COVID-19.

Specifically, chemotherapy, targeted therapies, immunotherapy, and radiation can weaken the immune system.

However, in most people, the immune system recovers a few months after the end of these treatments. This may mean that the increased risk of infection only affects people who are currently undergoing cancer treatment and people who completed it very recently.

Also, people with breast cancer who seek care at a hospital face a higher risk of developing the infection that causes COVID-19. This is due to the likelihood of increased proximity to people with the infection.

A World Health Organization (WHO) report on the effects of coronavirus cites the death rate among people with any type of cancer as 7.6%. The authors also note that people over the age of 60 have the greatest risk.

Overall, detailed information is very limited. Because COVID-19 has emerged so recently, researchers have yet to investigate its impact on people with breast cancer.

A person who is receiving treatment for breast cancer — or who has recently completed the treatment — likely has an increased risk of developing SARS-CoV-2, the virus that causes COVID-19.

Below, we describe other ways that breast cancer can increase risks associated with the new coronavirus.

Worsened symptoms of COVID-19

A person with a weakened immune system — due to cancer treatment, for example — may be more likely to experience severe symptoms of COVID-19.

According to the charity breastcancer.org, this risk may be higher in people with breast cancer that has spread to the lungs, as COVID-19 is a respiratory disease.

Delayed or cancelled surgery and screenings

Many hospitals and other health centers have recommended delaying elective surgeries, including some cancer surgeries.

Doctors and other healthcare providers face very high exposure to SARS-CoV-2. Going to a doctor’s office, clinic, or hospital can be dangerous, especially for people with weakened immune systems.

For the same reason, some oncologists and other healthcare providers may be delaying cancer screenings.

Prescription drug concerns

Some people may have difficulty getting palliative prescriptions filled.

According to Angela Rasmussen, Ph.D., a virologist at Columbia University, there appears to be a disruption in the supply chain of medications and the raw materials for them.

Overall, it is important to plan ahead and ask about the possibility of getting more medication with each refill, in order to stock up.

Increased isolation

Those who help care for people with breast cancer may need to stay away, to reduce the risk of spreading the virus.

The American College of Surgeons recommend delaying elective surgeries during the COVID-19 outbreak. Doctors must weigh the benefits of surgery against the risks of hospitalizing a patient during a pandemic.

People with breast cancer should discuss the possibility of delayed treatment with their healthcare providers.

Some questions to ask may include:

• Do the benefits of delaying treatment outweigh the risks?
• How long can I safely delay treatment?
• Would treatment at a different hospital with fewer COVID-19 patients be safer?
• What are some alternatives to treatment in a hospital?
• What symptoms would warrant immediate or emergency treatment?

For nonemergency care and routine follow-ups, telemedicine may be a good option. It is usually possible to evaluate new symptoms, ask questions, and coordinate care online or via the phone. Ask healthcare providers whether routine appointments can continue remotely.

Also, ask an oncologist about the options for scheduling cancer screenings and checkups. They can provide specific information about the risks of delays to each person.

When deciding whether an in-person screening is appropriate, a doctor will take a person’s symptoms into consideration. For this reason, it is important for each person to monitor their own symptoms carefully and to share this information with the doctor.

The following strategies can help a person with cancer stay safe:

• Do not visit a doctor’s office, hospital, or emergency room unless it is absolutely necessary, and ask about switching to telemedicine for routine visits.
• Wash the hands frequently with warm water and soap.
• Stay home whenever possible, and try to have food and other essentials delivered.
• If any symptoms of COVID-19 arise — including a fever, a dry cough, and difficulty breathing — contact a doctor.
• Before visiting a clinic or emergency room, call ahead to allow healthcare professionals to prepare for the visit.

It is especially important to wash the hands:

• before eating
• after using the bathroom
• before touching the face
• after any contact with people outside of one’s household
• after touching any public surfaces

Learn about the most effective way to wash the hands here.

People with cancer should discuss how the virus may affect their health with their healthcare team.

Ask about the circumstances in which it is advisable to visit an emergency room and about strategies to reduce the likelihood of getting sick.

Some people with cancer may want to discuss the risks and possible benefits of treatments that weaken the immune system.

Call a doctor if any of the following issues arise:

• symptoms of an infection, such as a fever or a persistent cough
• trouble breathing, chest pain, or shortness of breath
• cancer symptoms worsening

If a person suspects that they have symptoms of COVID-19, it is crucial to drink plenty of fluids and rest.

If symptoms grow more serious, call the doctor again. If the symptoms become severe, a person may need ventilation in a hospital.

Infection with SARS-CoV-2 can cause COVID-19, and the symptoms of this illness can be severe.

A person who is receiving treatment for cancer may have a higher risk of developing the infection, and the resulting illness may be more serious for someone with cancer.

However, the overall risk of dying from COVID-19 appears to be low.

People with cancer should continue their treatment, when possible. Compared with COVID-19, cancer presents a much higher overall risk to health and the quality of life.

It is important for everyone with cancer to consult their oncologists for specific guidance.