Cancer treatment delays due to COVID-19: How to cope
Focus on keeping your body healthy and finding ways to relieve stress while you wait for your cancer treatment to begin.
If your cancer treatment is delayed because of the pandemic, you might be worried about what that may mean for your prognosis. Being diagnosed with cancer is stressful, but you may feel additional distress and anxiety if the risk of coronavirus disease 2019 (COVID-19) impacts your treatment.
Many people with cancer are finding that their treatments are being temporarily delayed. Here's a look at why doctors are delaying cancer treatment and how you can cope while you wait for treatment to begin.
Why are cancer treatment delays happening?
Considering whether to begin cancer treatment right away during a pandemic requires a careful balance of the risk of contracting the virus that causes COVID-19 and the risk that cancer may progress if treatment is delayed.
Reasons your doctor might recommend delaying your treatment include:
- There's a high level of virus activity in your area. If infections and hospitalizations due to the virus that causes COVID-19 are reaching critical levels in your area, your doctor may recommend delaying your treatment. Your doctor may determine that the risk of infection and the lack of resources, such as hospital beds and protective equipment, may pose a greater risk to your health than the cancer.
You have a slow-growing cancer. If your cancer isn't aggressive and is slow growing, your doctor may be more likely to recommend delaying your cancer treatment. To determine if a cancer is aggressive, doctors analyze the cancer cells in a lab and use information from imaging tests.
Slow-growing cancers are unlikely to spread in the weeks or months that cancer treatment is delayed. Conversely, if your cancer is aggressive and has a higher risk of spreading, your doctor may decide that immediate treatment is necessary despite the risks related to the virus that causes COVID-19.
- A less invasive treatment available. Most people with cancer undergo surgery as part of their treatment. But if surgery is more risky because of concerns about the virus that causes COVID-19, your doctor may recommend delaying your surgery and using chemotherapy, hormone therapy or radiation therapy instead. This treatment strategy (sometimes called neoadjuvant therapy) helps control the cancer until surgery is safer.
- You currently have COVID-19. Generally, doctors advise delaying or pausing treatment if you're found to have the virus that causes COVID-19. How your treatment plan is adjusted will depend on your particular situation.
Are cancer treatment delays safe?
Knowing you can't start your cancer treatment right away may make you wonder if your cancer may be more likely to spread or if future treatment will be more difficult. Discuss your concerns with your doctor and ask for details about your particular situation. As you learn more about your cancer, you may feel more comfortable with your doctor's decision about your care.
For many types of cancer, doctors have a good understanding of which cancers may need immediate treatment despite the virus risks and which cancers can wait weeks or months. For example, for most prostate cancers that haven't spread beyond the prostate and some breast cancers that are very small, delaying treatment for six months or longer might not be harmful, especially when neoadjuvant therapy is used.
Your doctor carefully considers your cancer, your overall health and the availability of health care resources, such as hospital beds, when deciding whether to delay your treatment.
How can you cope with cancer treatment delays?
As you wait for your cancer treatment to begin, follow your doctor's advice on preparing for treatment. It might help to:
July 19, 2020
- Take precautions to avoid the virus that causes COVID-19. Being infected with the virus that causes COVID-19 could make you sick and further delay your cancer treatment. Follow the precautions recommended by your doctor and local health officials, such as staying at home as much as possible, practicing social distancing around other people, wearing a cloth face covering in public settings and frequently washing your hands.
- Keep yourself healthy so you're ready to start cancer treatment. Start healthy habits now so that you feel strong at the start of cancer treatment. Get enough sleep so that you wake each day feeling rested. Choose a healthy diet full of fruits and vegetables. Try to exercise most days of the week. Find activities to help you reduce stress, such as deep breathing and relaxation exercises.
- Talk about your feelings with someone you trust. Turn to a friend or loved one to talk about your emotions as you wait for cancer treatment to begin. Connect with other people with cancer through online groups. If you're feeling overwhelmed, talk with your doctor or someone else from your health care team about getting a referral to a mental health professional, such as a certified social worker, psychologist or psychiatrist.
- Seek a second opinion. If you're uncomfortable with your doctor's treatment plan, you might find some peace of mind if you seek a second opinion. It may be possible to do this through a virtual or telemedicine visit rather than by seeing another doctor in person. Check with your insurance provider to make sure this type of appointment will be covered.
See more In-depth
- Printz C. When a global pandemic complicates cancer care. Cancer. 2020; doi:10.1002/cncr.33043.
- Cancer treatment and supportive care. American Society of Clinical Oncology. https://www.asco.org/asco-coronavirus-resources/care-individuals-cancer-during-covid-19/cancer-treatment-supportive-care. Accessed June 24, 2020.
- ASCO special report: A guide to cancer care delivery during the COVID-19 pandemic. American Society of Clinical Oncology. https://www.asco.org/sites/new-www.asco.org/files/content-files/2020-ASCO-Guide-Cancer-COVID19.pdf. Accessed June 24, 2020.
- Dietz JR, et al. Recommendations for prioritization, treatment and triage of breast cancer patients during the COVID-19 pandemic. National Comprehensive Cancer Network. https://www.nccn.org/covid-19/pdf/The_COVID-19_Pandemic_Breast_Cancer_Consortium_Recommendations.pdf. Accessed June 24, 2020.
- Management of prostate cancer during the COVID-19 pandemic. National Comprehensive Cancer Network. https://www.nccn.org/covid-19/pdf/NCCN_PCa_COVID_guidelines.pdf. Accessed June 24, 2020.
- AskMayoExpert. COVID-19: Anxiety management. Mayo Clinic; 2020.
- Self-care and distress management during the COVID-19 pandemic. National Comprehensive Cancer Network. https://www.nccn.org/covid-19/pdf/NCCN_Patient_Self_Care_COVID-19.pdf. Accessed June 24, 2020.
- Schilsky RL. Common questions about COVID-19 and cancer: Answers for patients and survivors. Cancer.Net. https://www.cancer.net/blog/2020-06/common-questions-about-covid-19-and-cancer-answers-patients-and-survivors. Accessed June 26, 2020.