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Explained: Why are cancer patients more vulnerable to coronavirus?

For some cancer patients receiving treatment, the global pandemic poses a different set of challenges, even if they do not have COVID-19. Here's a look at some of these challenges.

By: Explained Desk | New Delhi |
Updated: April 7, 2020 9:44:10 pm
cancer and coronavirus, cancer treatment covid 19, coronavirus cancer treatment, indian express, explained indian express What are the risks if those suffering from cancer contract coronavirus? Image source: Pixabay

The number of people infected with COVID-19 across the world has now reached a million. It is well known now that while people of all age groups are vulnerable to infection from the disease caused by the SARS-CoV-2 virus, the people likely to develop severe COVID-19 are those above the age of 60 years.

Especially vulnerable are those people who have comorbidities such as heart disease, hypertension, diabetes, chronic respiratory disease and cancer.

For some cancer patients receiving treatment, the global pandemic poses a different set of challenges, even if they do not have COVID-19. Here’s a look at some of those challenges and how doctors and cancer specialists have been advised to alter treatments during this time.

Are cancer patients at higher risk of developing serious illness due to COVID-19?

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Yes, a subset of cancer patients are more vulnerable to developing serious illness due to COVID-19. This subset includes people with cancer who are undergoing active chemotherapy, those undergoing radical radiotherapy for lung cancer, people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma (at any stage of treatment), those getting immunotherapy or antibody treatments for cancer, those having other types of targetted cancer treatments which may affect the immune system and cancer patients who have undergone bone marrow or stem cell transplants in the last six months or who are still taking immunosuppressive drugs.

Further, a cancer patient who is over the age of 60 and has comorbodities such as cardiovascular or respiratory issues will also be especially vulnerable to illness due to COVID-19. As per a recent analysis of patients in Italy, 20 percent of those who died in the country had active cancer.

Also in Explained: The cancer crisis in India

Why are cancer patients more vulnerable to Covid-19?

Some cancer patients are more vulnerable because of their weakened immune systems. The immune system has an important role to play to fight off infection or repair an injured tissue. With COVID-19 as well, the role of the immune system is to try and fight off the virus. For this to happen, the immune system should not be overstimulated so as to cause hyper inflammation caused when more than necessary number of white blood cells are deployed by the immune system, which can lead to sepsis or even death. The immune system should also not be weak that it is unable to fight off the infection.

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Some cancer treatments such as chemotherapy and radiotherapy might weaken the immune system of the patient, since such treatments can stop the bone marrow from making enough white blood cells. Due to this, the immune system is weakened, reducing the person’s ability to fight off infection.c

What about cancer patients who do not have COVID-19?

The UK’s National Health Service (NHS) has placed guidelines for treatment of cancer patients who do not have COVID-19. These guidelines state that cancer patients may need to consider if the risks of beginning or continuing their cancer treatment could outweigh the benefits, since patients receiving therapies are more at risk from becoming seriously ill if they were to contract COVID-19. When deciding on whether a particular cancer treatment should be undertaken, doctors may also take into account the exposure of the patient to the virus during hospital visits.

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Further doctors dealing with cancer patients will also have to consider the overall impact of the coronavirus on health services, Cancer Research UK points out. “For example, it’s likely that there will be staff and bed shortages. This means they might need to delay or rearrange treatments. Because of this, they might need to prioritise some treatments over others,” it says.

Here’s a quick Coronavirus guide from Express Explained to keep you updated: What can cause a COVID-19 patient to relapse after recovery? | COVID-19 lockdown has cleaned up the air, but this may not be good news. Here’s why | Can alternative medicine work against the coronavirus? | A five-minute test for COVID-19 has been readied, India may get it too | How India is building up defence during lockdown | Why only a fraction of those with coronavirus suffer acutely | How do healthcare workers protect themselves from getting infected? | What does it take to set up isolation wards?

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