Myths & Facts about Cancer treatment during the current wave of COVID-19

We are facing another wave of COVID-19, a variant which is fastest spreading of all the variants. Memories of the harrowing time that our country experienced during the second wave has generated a lot of fear and apprehension sometimes leading to panic. Fortunately, almost everybody affected by the new variant is recovering within a few days of care at home. Nonetheless, we need to keep our guard up all the time taking due precautions because the current wave, though largely caused by omicron variant, is still having cases with delta variant which has a potential to cause more severe disease.

Cancer patients who have been diagnosed recently or are undergoing treatment feel themselves to be more vulnerable. Those treated for cancer in past and doing fine currently are also concerned. This anxiety of having/having had cancer combined with social media that is flooded with inaccurate information is adding to the confusion and anxiety. I would like to bust certain myths about cancer treatment during these times.

Myth: My doctor has expressed strong suspicion of cancer and advised further tests but I would prefer to wait till the current wave subsides completely and then get the tests done.
FACT: If the doctor has a strong suspicion of a cancer that is either not at a very early stage or is likely to be a fast growing tumor, it is not advisable to wait beyond 7-10 days. Please get the tests done with precautions.

Myth: Cancer treatment can wait; If I get COVID-19 I will die.
FACT: More than 90 percent of patients of COVID-19 infection in the current wave recover at home. Rest may require some treatment at hospital and only a few need critical care. Mortality rate with adequate treatment during delta wave was around 1.5-2.0 percent and is lower than that with omicron. However, if cancer treatment is delayed, it continues to increase / spread and chance of cure decreases.

Myth: I cannot undergo Surgery for Cancer and need to take other modalities only.
FACT: Although it is true that treatment modifications are needed for some patients, most patients can be subjected to the usually recommended treatment with adequate precautions.

Myth: If I get COVID-19 as a cancer patient, I wouldn’t survive.
FACT: It is true that the complications including mortality of COVID-19 are higher in cancer patients on treatment because of immunosuppressive effect of certain types of treatment. It is also true that cancer patients under treatment are more susceptible to get COVID-19 infection. However, the mortality due to COVID-19 infection for cancer patients is still less significantly less as compared to those with high BP, Diabetes or Cardiac disease. Any combination of these diseases would increase complications further

Myth: Cancer survivors (those who have been treated for cancer and are currently free of disease) have higher risk of getting COVID-19 infection.
FACT: Patients who have completed their treatment more than three months ago are NOT at an increased risk as compared to normal population.

Myth: COVID vaccines are unsafe for cancer patients.
FACT: There is no data to show any immediate safety risk of approved vaccines. Vaccines containing live virus that is capable of replication is not advisable. However, the one which contains live virus made incompetent to replicate can be taken.

Myth: COVID vaccines do not work in cancer patients.
FACT: Although larger trials done so far have excluded cancer patients, there is evidence from a study done in the USA that vaccines work in cancer patients as well and generates adequate antibodies after two doses of vaccine. Similar studies for other vaccines are not available yet but there is no evidence that they don’t work in cancer patients. The immune response of a cancer patient may be blunted as compared to general population thus they should continue to take general COVID precautions even after completing vaccination.

Myth: Patients on active cancer treatment should not take COVID vaccine.
FACT: There are no reports of increased risk of side-effects of vaccination in cancer patients as compared to general population, but published safety data are not currently available. Nonetheless, all major cancer guidelines have recommended vaccination of patients undergoing cancer treatment

In fact, those on active treatment are more vulnerable for COVID-19 infection and its complications and should be given a priority in vaccination. The vaccination date should be planned in between the treatment cycles such that the immune system is not compromised. Please consult your oncologist regarding the time of vaccination

Myth: Patients scheduled for cancer surgery should not be given COVID Vaccine.
FACT: They can be administered a vaccine either before or after surgery, preferably before giving an adequate gap pre or post-surgery (usually around 2 weeks but can be given even up to one week prior to surgery or after surgery in case of good recovery post-surgery)

Myth: Once vaccinated, I do not need to take any precautions as I have become immune to COVID-19 infection.
FACT: Maximum protection is achieved 2-3 weeks after the last dose but vaccine efficacy in the setting of weakened immune system of cancer patient is unknown.

Vaccine is shown to decrease the severity of disease and mortality but there is still a possibility of getting infected and transmit it further. Thus everyone should continue to take precautions, especially cancer patients and their caregivers.

Key Take-Home Messages

  • COVID-19 is going to stay – we should learn to live with it and NOT PANIC.
  • Maintain good physical and mental well-being, take healthy diet
  • Continue to take adequate precautions
  • Cancer treatment is safe during this time though it may need some modifications. DO NOT IGNORE your cancer for the fear of COVID-19.
  • Most people who are affected by COVID recover without much problem
  • Schedule online consultations and minimize hospital visits whenever possible.
  • Take the vaccine if you have not taken it so far.
  • Those who are vaccinated should take the booster dose eligible for it.