Hello, I'm Dr. Sonali Smith.
And I'm currently the interim section chief
of Hematology and Oncology at the University of Chicago.
Part of our mission is to take outstanding care
of our patients with cancer.
And during this current coronavirus pandemic,
there are many questions and concerns you have specifically
related to your diagnosis and the treatment
for your diagnosis of Cancer
One of the first questions is, what is coronavirus?
What is COVID-19?
And how does that apply to me?
So although you may have read quite a bit
about this, just as a background,
this new coronavirus, more properly
called SARS-CoV-2 is a new coronavirus that
is extremely contagious and can cause a very severe disease
called COVID-19.
My name is Dr. Nita Lee, and I'm a GYN oncologist
at University of Chicago.
I'm here to help today to answer some questions about how
the coronavirus pandemic can affect cancer
patients that we're caring for.
What we do know from other countries
is that patients who have cancer,
especially those under recent treatment,
may have a higher risk of getting sicker with COVID-19.
We're not sure if they're all at higher risk for getting it.
But it's very important to think about in terms
of any immunocompromised and how your immunity is.
There are some patients with cancer,
specifically with blood cancers who
have a higher risk because their immune systems have been
weakened, patients who have been through stem cell transplant,
CAR T therapy, or other treatments that
are designed to knock down the immune system do
have an increased risk of complications related
to the disease.
However, in general, we caution all patients
to follow the guidelines in terms of frequent and prolonged
handwashing and avoiding sick contacts
as we don't feel the actual risk of getting the disease is
higher, just the severity of the disease if it should happen.
Right now, this is a very personalized plan.
Each of the providers and all of the oncology, GYN oncology,
radiation oncology, and surgery are, really,
making decisions on a case by case basis.
We are continuing with chemotherapy.
We are looking at all of the patients
to see what's going to be the most appropriate course.
And most of all of our patients are getting personal calls
from our nursing teams or the physicians
themselves to help us make those decisions.
We want to do what's safest and best.
At this time, the situation with clinical trials
is changing nearly on a daily or weekly basis.
For right now, the majority of our trials
are still open for patients who have already been enrolled.
However, we are cutting back on trials
that do not have a clear treatment component.
So for example, if there are registry studies
or clinical trials, where there is extra tissue required
or extra visits to the campus, those particular trials
are being slowed down and, hopefully, will be available
again down the road.
However, if you are already consented to a clinical trial
or part of a clinical trial, it's really important for you
to communicate with your health care team
to know when you should or should not
come to the medical center.
Many, potentially, optional parts of the trial
are being put on hold for the safety of you
and others around you.
I think you can expect that we're here
just to sort of take care of you and to make sure
that you're going to continue to do well.
For patients who are doing well and are not on active treatment
right now, we still care about how you're doing.
But we want to also do what's safest
and makes the most sense.
This may mean, if you're feeling well
and without any specific new symptoms,
we will likely postpone your visit
and reschedule you or do a telemedicine visit
and talk to you about all of these things.
If you don't have any new symptoms,
we really do feel that it's the safest thing for us
to postpone visits and make sure that we touch base
with you in a different way.
This may help us reorganize when you lab work, imaging,
or exams as well.
While patients who are on chemotherapy
will, obviously, sometimes be in the process of getting
their white blood cell counts tested
to see if they're particularly immunocompromised such as
neutropenia, but there's not another specific test
that we would do unless it was part of your treatment plan.
Patients who are not on current treatment
and are cancer survivors don't have any other specific testing
that we would warrant them taking.
While we always think that cancer screening
for the cancers that we can screen for,
colorectal, breast, and cervical, are really important,
this is actually a public health time
where we do not recommend that usual screening gets done.
So that means, if you are not having
any symptoms in those organs and you are just
going for a screening mammogram, colonoscopy, or pap smear test,
those are not recommended to be done at this time.
And those, you can reach--
talk to your provider about when those would eventually
be rescheduled.
I think, right now, if you have an appointment
and you're due for a cancer screening, especially
University of Chicago, you're going
to be called by the provider group
or the care team to, really, reschedule your appointment.
And we are keeping track of all of our patients
that we are rescheduling and making
sure they're aware of their care plan
as well going forward as, especially, as all
of this changes so quickly.
So even though cancer patients may be at slightly higher risk,
we do not think that there is any recommendation for COVID-19
testing in that circumstance unless patients have symptoms
of the disease, which include fever, flu-like illness, cough,
some GI symptoms, some cluster that makes it indicated.
If you're not having any symptoms,
there is no reason to leave your house
or leave your-- you know, where you are and come to get tested.
It wouldn't be appropriate.
If you are having symptoms, we recommend
that you call your provider.
Let them know so they can best help
you decide whether testing is appropriate
and how to handle that situation.
If you develop any symptoms of a respiratory infection--
and this includes fever, headache, body aches, cough,
or chills--
It's important for you to contact your health care
provider and talk through these symptoms with them.
If they are very severe, you should call 911.
But in most cases, it's important to talk
to your provider first who can direct you whether or not you
need to be tested for COVID-19.
If you need to be tested, you will
be provided with a phone number along with the specific details
on how to get tested.
I think the main thing that we're asking our patients
to do is what we're asking everyone to do, which all of us
should be doing, which is social distancing,
so making sure that you're avoiding sort
of public spaces, group meetings, or forums,
even if that means things that you normally
attend such as church.
There is a lot of different ways that you can stay not socially
isolated but, really, making sure
that you're not close to people in your own home,
also just doing good handwashing if you
have to go outside, frequent hand washing,
hygiene using alcohol based hand sanitizer, as well.
Those are really all important elements.
I think that, for patients with cancer,
you may want to also make sure that you're
up-to-date with having enough medications at home
and talking to your provider and your pharmacist
about making sure you have everything that you need.
We are always going to be here and available
and, you know, for our patients in terms
of questions and concerns.
But just making sure you have enough supplies
in terms of those kinds of things would be important.
And then just following along with any guidelines
that come out from any of our public health officials.