Cancer doctors are used to managing in tough times. We live in a world where the news is not always good. We knew that when we chose this profession. But the COVID-19 pandemic has made treating cancer — and being treated for cancer — exponentially more difficult.
While healthy people can do their part to protect public health by heeding Gov. Jay Inslee’s stay-at-home order, people with cancer can’t always hunker down at home and forgo treatment. Although the health-care spotlight is rightfully on preparing for and responding to COVID-19, those of us who care for people with chronic diseases such as cancer are working on two fronts. We are engaged in complicated choreography as we work to protect our immune-compromised patients, who are more vulnerable to COVID-19, while we remain dedicated to actively treating their cancer.
For people with cancer, dealing with their personal health crisis is much more difficult when the entire world is dealing with a global health crisis. That’s why it is so incredibly important for healthy people to stay at home so as not to endanger the health of people who are older and/or have underlying diseases that increase their risk of suffering complications from COVID-19. But it’s not just important to stay home for people who have cancer. It’s also important to help protect the health of health-care providers, including thousands of doctors, nurses and medical staff members, who are continuing to come to work at our clinics every day to make sure that people with cancer get the care and support they need during this tumultuous time.
Our staff members at Seattle Cancer Care Alliance — together with our partners at University of Washington Medicine, Fred Hutchinson Cancer Research Center and Seattle Children’s — have had to develop procedures and protocols that we couldn’t have imagined at the beginning of this year. We’ve had to figure out how to continue care for patients on clinical trials so that research to improve the lives of people with cancer can proceed, even in these difficult times. We’ve had to embrace telehealth as we transition many critical medical appointments to virtual ones to avoid having patients leave their homes unnecessarily.
And we’ve had to have conversations with patients whose surgeries can be delayed without adversely impacting their outcomes, such as early-stage breast cancer patients. Every cancer treatment plan is personalized for each patient, whether we’re battling a pandemic or not. In these unusual times, this might mean that some patients continue their treatment as previously scheduled; for others, it might mean exploring other treatment routes under their physicians’ thoughtful guidance. As a breast medical oncologist, I conferred with my surgical and radiation oncology colleagues and recently advised a few of my patients to reverse the typical order of treatment, starting oral hormone-blocking therapy first, followed by surgery when the pandemic begins to slow down. These patients were relieved to not have to undergo surgery at a time when hospitals are ramping up to care for critically ill COVID-19 patients.
Patients are stepping up too. Another patient proactively contacted us to ask if it was safe for her to temporarily postpone her scheduled breast cancer surgery in order to give her place to someone with more pressing needs. When we reassured her that her plan was a good one for her, she immediately volunteered to give up her spot in the surgical schedule. Her generosity is proof that everyone plays a role in helping protect our community’s health.
It’s that kind of selflessness that all of us need to exhibit as we make our way through this unprecedented challenge. We are resilient and we will prevail, but it will take the continued efforts of the community to protect the most vulnerable among us and the dedicated health-care workers who are risking their own lives to care for them.