Should I postpone chemo to avoid COVID-19?

05 March 2020

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Question

I'm just about to start FEC-T chemo - a combination of drugs for breast cancer - and I'm very concerned about losing my immune system with the spread of the coronavirus. Should I postpone? I'm 74 and otherwise fit and healthy.

Answer

We had this important question come in from listener Lorna, for virologist Chris Smith...

Chris S - The answer to this is at the moment, the risk of coronavirus in the population is low, so the chances of you encountering it is low. But you're right to be concerned, because people who are at greater risk are those whose immune system doesn't work as well as someone who's got a fully functioning immune system, and the way chemotherapy drugs work, not exclusively, but some of them, is to switch off the way cells divide, and that includes your immune system. So it can cause the immune system to stop working quite as well. Now the risk placed on your health from breast cancer, is almost certainly, at the moment, going to be higher than the risk posed by coronavirus infection.

Now, what you could do if you are concerned about this is to do two things. If you need to go to clinic appointments, then everyone who's going to a clinic appointment should, if they have any symptoms whatsoever of any kind of infection, as a courtesy, should phone the clinic and warn them, because that means the clinic could see that person at the end of the list, and they don't then sit in a waiting room full of people who don't have the infection and give it to them. So if we all do that, and we can all rely on people to do that, then it means that you're not at risk going to say, clinic appointments. And the same goes for your general practice.

At the same time you may think, well I don't feel comfortable going out into mass gatherings and things while I'm at higher risk. And the same would apply for any kind of viral infection, whether it's flu or just the common cold, because all of these things will provoke a more intense infection in a person who's taking drugs like these ones, which will suppress the immune system for a while. Under those circumstances you might say, well, I'm going to just use a common sense approach, and I'm going to keep myself away from people who obviously have symptoms. I'm going to warn my friends and family, look, if you've got some kind of symptoms or you're not feeling very well, don't come over while you've got them. Don't come and see me. Wait until you're feeling better, and at the same time don't go out to various places where there will be lots of people who you can't warn in advance, and then once you're over your course of chemotherapy and hopefully you're all better, everything should come back to normal and the risks will pass and you'll be fine again.

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