How Patients With Cancer Should Approach Questions Surrounding the Final Outcome of COVID-19, Their Diagnosis

May 20, 2020

“For the patients that are nervous about how this is going to end, or what's going to happen, I would say that that's true for them outside of the COVID crisis because that's the same question they have about their cancer,” Dr. Scott A. Irwin said.

As COVID-19 has spread throughout the world, many people have likely had questions as to when the pandemic will end and what will eventually happen. Patients with cancer, according to one expert, are more familiar with those questions as they likely came up during their diagnosis.

“For the patients that are nervous about how this is going to end, or what's going to happen, I would say that that's true for them outside of the COVID crisis because that's the same question they have about their cancer,” Dr. Scott A. Irwin, director of the patient and family support program at Cedars-Sinai Medical Center, said in an interview with CURE®. “How is this going to end, when is it going to end, what am I going to have to go through?”

Irwin discussed what patients should consider when wondering when the pandemic will end, as well as how patients with cancer should go about speaking to their oncologist after they receive a diagnosis.

Transcript:

For the patients that are nervous about how this is going to end, or what's going to happen, I would say that that's true for them outside of the COVID crisis because that's the same question they have about their cancer. How is this going to end, when is it going to end, what am I going to have to go through? Now, I'm not a virologist or immunologist but my understanding with the COVID crisis is we have examples from the past with SARS, with MERS, with Ebola, with the Spanish Flu and other flu epidemics, and these are natural cycles that come and go, I think we have done a great job mitigating those in this country, we may have started a little bit too late, but it still was effective and we have efforts going forward to help in the future.

So, this morning they were talking about antibody tests so that you know that if you have had it and are immune to it, they are talking about deploying many people from the CDC to do surveillance and tracking if a hot spot were to reoccur just like we did with Ebola in Africa. A vaccine may be around in the future, so, this may be part of our lives like the normal flu cycle, or this may go away largely like SARs and MERs and we'll just have to see, but there will be a time, just like with all the other epidemics that we will get back to a normal life.

However, I think as we discussed earlier, I think they may be some changes in our lives. How we do medicine and patient care, for the convenience for the patient especially in a place like Los Angeles to have to come in for not only your cancer treatments but then to see me as a psychiatrist, if we can't align those, that's a lot of effort. I'm hearing there's going to be a change in landscape in the retail space and the number of physical stores.

So, I think we will see life changed after this, but we will get back to a time where we feel like this is normal and it's not front and center. I think a good example is the election, which was all we could hear about on the news every day until this occurred and now, we barely hear a peep about the election and all we hear about is this. And I think that will come to an end too.

For patients that aren't sure about their futures and what's going to happen, I encourage them to talk to their oncologist. First and foremost, I encourage them to decide what they want to know and what they already understand. So, usually that's one of my first questions, what do you understand about your cancer, and what do you want to know and I have people at opposite ends of the spectrum, so some people will say 'I don't want to know anything, I'm going to live everyday like it's my last day and one day it will be' I have other patients that will say, that are very technical and scientific and they want every number and every detail and every statistic as well and most people are in between.

When patients don't feel like they are getting the information that they want or need, I often encourage them to ask the following questions, number one, what's the best case scenario for me, number two, what's the worst case scenario for me, number three, what does the literature say about people like me, and fourth ask your oncologist, 'OK, you've seen 1,000 patients like me, where do you think I fall in all of this?'

Realizing that none of us have crystal balls, that life is uncertain on any day for any of us, but in general what is your best guess. And what I want patients to avoid is getting into a situation where they didn't plan for a worse outcome than they expected and then once that happens it's hard for them to do all the things that they had wanted to do. I would rather that patients plan as if that worst-case scenario may happen and then never need those plans, than not make the plans and suddenly need them unexpectedly.


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