At first I wasn't sure if having a history of cancer counted as a pre-existing condition that would put me in a high-risk category if I contracted the SARS-CoV-2 virus. Being NED means there is no evidence that I currently have cancer, and since my blood work already returned to normal after finishing chemo, I figured I'm not immunocompromised.
This article, "Cancer Patients in SARS-CoV-2 Infection: A Nationwide Analysis in China," describes a study that looked at coronavirus patients with cancer in China. Compared to patients without cancer, "patients with cancer were observed to have a higher risk of severe events." Okay, that makes sense. But what about patients who have a history of cancer?
The article goes on to say that "patients who underwent chemotherapy or surgery in the past month had a numerically higher risk (three [75%] of four patients) of clinically severe events than did those not receiving chemotherapy or surgery." Okay, that makes sense, too. It can take several weeks for your body to recover after chemo or surgery. For me, both surgery and chemo were completed well over a month ago, so does that mean I'm in the clear?
Well, apparently, "cancer history represented the highest risk for severe events." Great.
The article did not differentiate between different types of cancer, but I wonder if some cancers, like lung cancer, might have a greater risk for complications than other cancers.
Anyway, going with what is known, I've been isolating pretty strictly since my town closed schools on March 13. Most days I do go outside to do yard work, or to take a walk in a secluded area behind my neighborhood. The only other time I leave the house is for treatment. Ken does the grocery shopping, and we take all the recommended precautions when he returns.
Whenever I have an appointment, I feel anxious. I know I am increasing my chances of getting the virus every time I go out, but I don't want to miss any treatments, either. Delaying or missing treatments could increase my chances of recurrence. It's a trade-off between risks related to the coronavirus and risks related to cancer recurrence.
I'm thankful that I've already had my surgery and chemo. The timing of my diagnosis, and subsequent treatment, was pure luck. From what I'm seeing in Facebook support groups, some women are having their treatments delayed or discontinued, either because the risk of getting the coronavirus while on chemo was deemed too high, or because the treatment or procedure was deemed "elective", or at least "non-urgent". In this article, a man describes how the coronavirus is delaying his cancer surgery, a clear detriment to his prognosis.
Today I read this article, "Between Scylla and Charybdis — Oncologic Decision Making in the Time of Covid-19." I admit, I had to look up the reference. Wikipedia tells me that "between Scylla and Charybdis" means to choose between the lesser of two evils. (Scylla and Charybdis were monsters on either side of narrow waters travelled by Odysseus in Homer's Odyssey.) In the article, the oncologist writes, "To survive SARS-CoV-2 only to then succumb to an undertreated cancer would be a Pyrrhic victory. The acuteness of infection and the chronicity of malignancy are the Scylla and Charybdis between which oncologists and their patients must now chart a very cautious course indeed."
My next treatment is this Friday. I sort of hold my breath in between appointments, wondering if the Cancer Center will call to delay or cancel.
I know everyone is struggling with something during this pandemic. This is an unprecedented time with new and unfamiliar challenges for everyone. All the quiet time at home is finally giving me the space to process my cancer, the surgery, my mom's passing, and my dad's cancer. And that's on top of the pervasiveness of the fear and anxiety surrounding the coronavirus itself, the heartbreaking sadness and loneliness of people dying and mourning alone, the combined worry and gratitude for the front line workers, the feelings of distress for the many vulnerable groups who are most affected, and the unrelenting anger and frustration at the current administration for handling the pandemic response in the worst way possible.
So, it's one day at a time. We're going through a collective trauma, but each person is experiencing it and handling things in their own way. I think the best advice I've heard is for everyone to be more compassionate and more gentle, with themselves and with each other.
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