Many people are concerned about the new respiratory illness commonly referred to as “coronavirus” and officially called COVID-19. While it can be alarming to hear news reports about the coronavirus spreading, schools closing, and events being canceled, it’s important to know that the current risk of becoming ill from this particular virus is still low for most people.
Still, it’s also important to know that some breast cancer treatments — such as chemotherapy, targeted therapies, immunotherapy, and radiation — can weaken the immune system, and people who have weakened immune systems have a much higher risk of complications if they do become infected with this virus.
If you or a loved one is receiving treatment for breast cancer that can affect the immune system, here’s what you need to know.
What is coronavirus?
Coronaviruses are a large group of viruses that can cause respiratory illness in humans and animals. The new coronavirus you’ve heard about in the news is called SARS-CoV-2 and the illness it causes is called coronavirus disease 2019, which is why it’s abbreviated as COVID-19.
The first case was diagnosed in China in December 2019 and it has since spread to many countries throughout the world. Some coronaviruses spread from animals to people, and that appears to be the case with SARS-CoV-2, which is thought to have originated in bats.
How does COVID-19 spread between people?
This virus appears to spread through close contact (within about 6 feet) through droplets of bodily fluids produced when a person coughs or sneezes. These droplets can travel through the air and either be inhaled or otherwise get into the noses, mouths, or eyes of people nearby. People seem to be most contagious when they have symptoms, but you can also catch the virus from infected people who have no symptoms.
These droplets can also land on surfaces and the virus may survive on them for hours or even days. When you touch these surfaces and then touch your face, you can be exposed to the virus, but this doesn’t seem to be the main way the virus spreads.
What are the symptoms of COVID-19?
Common symptoms of this coronavirus include:
- shortness of breath
These symptoms can start between 2-14 days after coming into contact with the virus.
“Often [COVID-19] can start out with symptoms similar to a common cold,” Halle Moore, M.D., director of breast oncology at the Cleveland Clinic, told Breastcancer.org. “Patients may experience fatigue, a sore throat, and a cough, and often a fever, as well. The illness can also progress to shortness of breath and respiratory difficulties.”
Most people who are infected with this coronavirus have mild respiratory symptoms, and some people show no symptoms at all. However, symptoms can become severe in certain people, and some have died from the illness.
People who are older, and people with severe underlying health conditions, such as heart disease, lung disease, and diabetes, appear to have a higher risk of developing severe illness from this coronavirus. This includes people who may have weakened immune systems from certain cancer treatments. Also, some cancer treatments can cause lung side effects, which the virus may worsen.
Emergency warning signs for COVID-19 that require immediate medical attention include:
- difficulty breathing or shortness of breath
- persistent chest pain or pressure
- confusion or inability to awaken
- blueish color in the lips or face
Who is at risk of getting COVID-19?
Most people have a low risk of becoming infected with this virus. People who have a higher risk of becoming infected include:
- those who live in places where the virus is spreading in a local community
- healthcare workers who may be exposed to sick people
- those who have been in contact with people who are known to have been infected
- people who have recently traveled to places where the virus is known to have spread
While people who are being actively treated for breast cancer may be at higher risk for complications from the illness if they do become infected, it’s important to know that they do not necessarily have a higher risk of becoming infected in the first place.
“For most breast cancer survivors, the risk of becoming infected is going to be similar to that of the general population,” says Dr. Moore. “For people who are on active treatments that compromise the immune system, there will also be a similar risk for acquiring the infection, but they may have a higher risk of a more severe case should they become infected. So, similar to the precautions that they take regarding other illness, patients who are on treatments that affect the immune system should take precautions against exposure to COVID-19.”
How can I protect myself?
The best way to avoid becoming sick from this coronavirus is to avoid being exposed to it. There is not yet a vaccine to prevent COVID-19, but scientists are working to develop one.
Here are some common sense steps you can take to help avoid being exposed to this or any harmful virus:
- wash your hands frequently using soap and water for at least 20 seconds, especially after being out in public
- use alcohol-based hand sanitizer when soap and water aren’t available
- avoid touching your face when your hands aren’t clean
- avoid contact with people who are or may be sick, especially if COVID-19 is spreading where you live
- avoid travel to places where COVID-19 is known to be spreading
- clean and disinfect surfaces you touch daily, including things you might not think of such as doorknobs, light switches, and phones; make sure you use a cleaning agent that is effective for killing viruses
If you are receiving treatment for breast cancer that can weaken your immune system, you may want to take some of the following extra precautions to protect yourself:
- avoid close contact with people outside your home
- avoid large crowds
- stay home if COVID-19 is spreading in your community
- avoid unnecessary use of public transportation, air travel, and especially cruises
- be extra vigilant about hand hygiene
- make a plan with your doctor to monitor for symptoms
- remind friends and family to stay away from you if they’re sick
- make a plan with your caregiver or other loved ones in case you get sick
- make a plan with your employer to work from home
- stock up on groceries and extra medications
“The main thing you should do if you know your immune system is suppressed is try to avoid putting yourself in a position where there may be exposures, especially in areas where there may be a high prevalence of the disease,” says Dr. Moore.
However, if you’re receiving treatment for breast cancer, you may need to travel to a doctor’s office or the hospital for your medical care. If you do, just make sure you are diligent about washing your hands and not touching your face to minimize your risk of infection. It’s also OK to ask healthcare providers and caregivers to wash their hands before touching you.
“Hospitals throughout the country and state health departments are putting procedures in place to try to reduce exposure, so most hospitals have some sort of screening in place to try to quickly identify people who are at risk and provide those individuals with masks and isolation and appropriate testing,” says Dr. Moore.
The Centers for Disease Control and Prevention (CDC) says that cases of COVID-19 will probably increase over time, and it could become a widespread problem. Because this is a rapidly changing situation, it’s wise to pay attention to the CDC’s updates to continue assessing the risks.
“We expect more cases to emerge throughout the country over time, so it’s important to pay attention to what’s going on in terms of how much of the virus spread is in your area,” says Dr. Moore. “Since this is such a changing landscape, it’s important for people to visit CDC.gov or their state health department website for updated information. Some hospitals and state health departments are also setting up hotlines to help keep people informed or answer questions.”
What should I do if I develop symptoms?
If you experience fever, cough, or shortness of breath, you should call your doctor. People who experience mild symptoms can usually stay home while the illness runs its course. But, if you are receiving treatment for breast cancer that may weaken your immune system, you should definitely let your doctor know.
“Anybody who’s on any treatment that can suppress the immune system should always call their doctor if they notice a fever or if they have severe cold or flu-like symptoms,” says Dr. Moore. “For someone who’s receiving chemotherapy for breast cancer, a fever is a medical emergency anyway, so that’s something for which they need to contact their medical team.”
If you do need to seek medical care for symptoms of COVID-19, Dr. Moore says it’s very important to let your healthcare provider know about your symptoms ahead of time.
“It’s important to call ahead and not just show up to a doctor’s office with symptoms,” she says. “That way the medical team can get a better sense of the severity of the symptoms, determine whether this is something that can be managed at home, something that can be seen in the clinic, or something that needs to be treated in the emergency department. In addition, calling ahead will help the healthcare team take precautions to help prevent exposure to others.”
If you do become sick, you can take the following steps to protect others:
- Stay home, unless you need medical care.
- Cover your mouth and nose when you cough or sneeze, properly dispose of tissues, and wash your hands.
- Monitor your symptoms and temperature.
- Wear a facemask only if you are sick or are caring for someone who is sick. You do not need to wear a facemask if you are not sick, because they are in short supply and are not proven to be effective for preventing infection when worn by healthy individuals.
We’re all in this together
While the developing news about COVID-19 can be distressing, Breastcancer.org Founder and Chief Medical Officer Marisa Weiss, M.D., would like to remind you that we’re all in this together, and that there are common sense precautions we can all take to protect ourselves and our families.
“The COVID-19 pandemic reminds us that it’s a small world out there,” she says. “We are all interconnected in good and sometimes dangerous ways. For now, it’s wise to lay low and stay home whenever possible, especially if you’re at high risk of having complications from getting this virus.”
Written by: Adam Leitenberger, editorial director
Halle Moore, M.D., director of breast oncology, Cleveland Clinic
Marisa Weiss, M.D., chief medical officer