The COVID-19 pandemic has affected the lives of everyone. But it’s posed a particular challenge for people with serious illnesses such as metastatic breast cancer (MBC).

It’s affected everything from doctors’ appointments, to screenings, laboratory tests, treatments, and follow-up care.

People with MBC have had to face many difficult decisions during this time. They may have had to postpone treatments and speak with their doctors only virtually. Many hospitals were also forced to stop performing breast reconstruction procedures, as these were considered “elective” surgeries.

During these difficult times, coping with MBC can pose more challenges than ever before. It’s important to find ways to adapt in order to stay safe, reduce your chances of infection with COVID-19, and mitigate stress while ensuring you get the care you need for MBC.

At the start of the pandemic, many government organizations, including the Centers for Disease Control and Prevention (CDC), recommended that healthcare systems delay non-urgent surgeries, screenings, and certain treatments to protect people from exposure to COVID-19.

Hospitals also needed to do this to preserve resources such as hospital beds, personal protective equipment (PPE), blood supplies, and staff to care for people with COVID-19.

People with MBC may have experienced any of the following impacts to their care:

  • physical distancing at appointments
  • limited visitors
  • COVID-19 testing before procedures
  • telehealth appointments instead of in-person appointments
  • shorter hospital stays
  • having follow-up care at home instead of at the hospital
  • changes in locations for procedures and treatment
  • universal masking
  • treatment delays
  • private infusion rooms
  • curbside clinics for routine blood draws and lab tests
  • an increase in the use of neoadjuvant therapy, or treatment before surgery, which usually consists of hormonal therapy, chemotherapy, or targeted therapies to help slow or stop the growth of the tumor before surgery is performed to remove it
  • inability to enroll in clinical trials

In a survey conducted the American Cancer Society (ACS) conducted, 1 in 5 people said they were worried about their cancer growing or coming back due to interruptions in their care. Many people also reported concerns about losing their health insurance.

In a Breastcancer.org survey, roughly 80 percent of responders reported feeling some level of anxiety about COVID-19 affecting their care.

A breast cancer diagnosis doesn’t automatically increase your chance for having serious complications if you develop COVID-19.

However, certain MBC treatments may put you at a higher risk for serious complications.

Some medications may weaken your immune system or lead to side effects involving your lungs.

The following treatments can weaken your immune system:

  • standard chemotherapy drugs, such paclitaxel (Taxol), carboplatin (Paraplatin), and docetaxel (Taxotere)
  • targeted therapies, including palbociclib (Ibrance), ribociclib (Kisqali), abemaciclib (Verzenio), and alpelisib (Piqray)

Your immune system typically recovers within a couple of months after you stop receiving chemotherapy or targeted therapy, but this varies from person to person. If you’re receiving ongoing treatment with any of the above medications, it’s likely that your immune system has been weakened.

Rare but severe lung inflammation has been linked to palbociclib (Ibrance), ribociclib (Kisqali), abemaciclib (Verzenio), and the immunotherapy drug atezolizumab (Tecentriq).

Other risk factors for developing serious complications from COVID-19 include:

  • being older than 65 years
  • chronic obstructive pulmonary disease (COPD)
  • serious heart conditions
  • type 2 diabetes
  • chronic kidney disease
  • sickle cell disease
  • obesity

Researchers at Vanderbilt University found that people with cancer were at a higher risk for dying from COVID-19. But the specific type of cancer and treatment method didn’t appear to affect the risk of dying from COVID-19.

Other small studies have shown that most people with breast cancer who developed COVID-19 recovered.

The new coronavirus is thought to be transmitted from one person to another by respiratory droplets produced when a person with the virus talks, coughs, or sneezes.

To reduce your chance for infection, stay alert and follow these guidelines:

  • wash your hands often and if you don’t have access to soap and water, use an alcohol-based hand sanitizer
  • keep your distance from others in public
  • avoid crowds
  • wear a mask
  • avoid touching your face
  • disinfect commonly touched surfaces each day, such as doorknobs, countertops, light switches, keyboards, phones, faucets, and handles

If you’re receiving chemotherapy, your doctor may prescribe a medication such as pegfilgrastim (Neulasta) to increase your white blood cell count and make you less vulnerable to serious infections.

Oftentimes, your treatment schedules can be a bit flexible. Keep in mind that your healthcare team is working hard to reschedule treatments in the safest way possible. This may include:

  • receiving your care at a different facility that’s separate from where people with COVID-19 are being treated
  • having support from family and friends virtually rather than in person
  • delaying surgery and taking systemic therapy (neoadjuvant therapy) in the meantime
  • changing appointments to video consults whenever possible

If your MBC treatment is urgent, or you’re experiencing alarming symptoms, you’ll be prioritized. However, reconstructive surgery procedures may still be delayed until the pandemic is over.

You shouldn’t have to go through this alone. With your doctor’s permission, have a friend or family member join you virtually at your appointments or treatment centers.

With today’s technology, they can easily join you via phone or video chat. You may want to invest in a tablet device to make this process even easier.

If you’re feeling anxious, depressed, or stressed, consider meeting with a mental health professional. Many are offering virtual appointments.

Additionally, many support groups for people with breast cancer that used to meet in person are now meeting online.

Memorial Sloan Kettering’s Virtual Programs, for example, offer free education, support, and resources for both patients and caregivers.

The uncertainty and changes to your treatment plans that the COVID-19 pandemic caused may have you feeling frustrated.

However, it’s important that you work with your medical team to still get the care you need. Researchers have worked hard to develop new policies for ensuring the safety of people with cancer during the pandemic.

Though it’s been several months since the pandemic started, it’s important that you stay vigilant.

Continue to wash your hands, practice social distancing, and wear a mask. If you have any concerns, don’t hesitate to reach out to your medical team.