As of July 2021, 4 million people1 around the world have died from COVID-19 related complications.
According to an analysis of patients2 in Italy, one in five of those who died from COVID-19 had active cancer.
During this time of a worldwide pandemic, cancer patients are highly susceptible, already severely immune compromised due to both cancer and its treatment.
This puts oncologists in a vulnerable position as they continue to provide their cancer patients with the best medical care.
Cancer Patients and a Weakened Immune System
Patients with cancer are more susceptible to infection3 than those without cancer.
This is because of the weakening of the immune system caused by cancer itself, as well as the anticancer treatments, such as chemotherapy or surgery.
Compared to those without cancer, the immunosuppressed cancer patients have an increased risk of infection of COVID-19.
Immunosuppression may also expose cancer patients to serious complications from an infection, which may result in treatment delay and unnecessary exposure to COVID-19 due to hospitalization.
A poor diet due to lack of appetite, coupled with the loss of muscle mass, will also contribute to a weakened immune system.
How has Covid-19 Affected the Cancer Patient?
Cancer patients seem to be more vulnerable to worse outcomes4 from the COVID-19 infection.
- Patients with cancer have an increased risk of severe infections, with a 3.5 times greater risk4 of needing mechanical ventilation or ICU admission or dying compared with patients without cancer.
- A cancer diagnosis may be delayed as screening programs and diagnostic services have been decreased or suspended in many countries.
- Cancer patients, worried about exposing themselves to the risk of infection, may be more reluctant to get the healthcare that they need.
- Many clinical trials have been suspended, affecting possible therapy options for patients who might have participated and jeopardizing longer-term therapy development.
- Many cancer patients are older and also visit medical facilities frequently, further increasing their risk of coming into contact with COVID-19.
- Many countries are opting to suspend certain surgeries. In the case of cancer, a delay in surgery could well mean that a patient’s cancer grows and metastasis, worsening the progression of the disease.
- Along with this, hospitals are over capacity with COVID-19 patients and most outpatient services are closed to control disease transmission, so it is even more difficult for cancer patients to seek appropriate medical care. A major dilemma of oncologists is whether to delay chemotherapeutic treatment or continue.
Given the unprecedented effects of COVID-19 on health systems worldwide, it is unfortunately inevitable that this pandemic will have a substantial impact on cancer outcomes.
Doctors treating cancer patients need to weigh up the risk and benefit of cancer treatment and surgeries against the risk of infection with COVID-19.
- Worldometer. COVID-19 Coronavirus Pandemic. Accessed on 1 July 2021. Available at: https://www.worldometers.info/coronavirus/.
- Onder G, Rezza G, Brussafero S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020;323(18):1775-1776. doi:10.1001/jama.2020.4683
- Liang W et al. Cancer patients in SARS-CoV-2 infections: a nationwide analysis in China. The Lancet Oncology. 2020;31(3):335-337.
- Richards M et al. The impact of the COVID-19 pandemic on cancer care. Nature Cancer. 2020;1:565-567.