The co-authors, from China, Singapore and the United States, found that cancer patients who developed covid-19 had a death rate from the virus almost three times higher than the rate from 2 to 3. % estimated for the general population. People with cancer were also more likely to experience “serious events”, such as admission to intensive care units and mechanical ventilation, than people without cancer. Risk factors included not only age, but also type of cancer, stage and treatment.
“These results suggest that cancer patients are a much more vulnerable population in the current covid-19 outbreak,” the authors concluded.
The study was published at the American Association for Cancer Research’s annual virtual meeting and published in the organization’s peer-reviewed journal, Cancer Discovery. The only previous study in cancer patients and covid-19 included only 18 patients.
J. Leonard Lichtenfeld, deputy chief medical officer of health for the American Cancer Society, who was not involved in the study, called it “significant,” adding that it “reflects what we heard previously.” – that cancer patients are more susceptible to the virus, and that the course of infection is worse and the results are worse. He said the study was still relatively small and thousands more patients needed to be examined.
The seemingly higher risk of death and other serious complications from the virus are among the dangers faced by cancer patients trying to overcome a pandemic that has forced delays in certain treatments, the closure of many clinical trials to new patients and the shortage of critical pain. drugs, said Howard Burris, chief medical officer and executive director of the Sarah Cannon Research Institute in Nashville and president of the American Society of Clinical Oncology.
“We face daunting challenges for optimal patient care,” he said in a press conference with ASCO last week. He noted that some hospitals “have effectively deemed all cancer surgeries elective,” demanding that they be postponed. While such delays make sense for some patients with early stage disease, they can be devastating for “patients with rapidly progressing or difficult-to-treat cancers,” he warned.
According to the American Cancer Society, more than 1.8 million new cases of cancer are expected to be diagnosed in the United States in 2020, and more than 606,000 people are expected to die from the disease.
Lichtenfeld said he expects some health care systems to start treating more non-covid-19 patients in the weeks and months to come. “It will not be the same in all parts of the country,” he said, “but we are starting to move forward. This does not mean that we are not in a difficult situation yet, but health systems are trying to find the best way to loosen the reins of some elective surgeries. “
The recently published study on cancer patients and covid-19 found that patients with leukemia, lymphoma and myeloma – all of the diseases in which cancer attacks the immune system – were among those with the highest rates serious problems. Patients with lung and gastrointestinal cancers were also at higher risk for poor outcomes.
In addition, cancer patients who underwent surgery as part of their treatment were likely to have poorer results than those without cancer, while those who received radiation therapy had similar results. People with early stage disease – localized malignancies – have had similar results to those in non-cancer patients.
Deborah Silverman, 29, MD / PhD candidate at the MD Anderson Cancer Center in Houston, said the epidemic had a direct impact on her treatment. Diagnosed last year with triple negative breast cancer, one of the most aggressive breast cancers, she underwent chemotherapy, surgery and radiation therapy and is now restarting chemotherapy. Despite this, Silverman has residual disease and a 50-60% chance of recurrence, she said.
To reduce her risk, she planned to participate in a clinical trial of immunotherapy, which triggers the immune system to attack cancer.
But the trial, like many across the country, is not recruiting new patients following the pandemic, so it extends its chemotherapy regimen. A side effect was blisters on her feet and toes, which made yoga or even walking painful.
Silverman hopes she will soon be able to switch to immunotherapy, which has fewer side effects than chemotherapy. “This is the only trial currently available for someone in my position,” she said. “We want to have all the shots on goal that we can. “