Fighting cancer, awaiting vaccine
Cancer patients facing viral, treatment threats
Tori Geib has tried to stay home during the coronavirus pandemic, but stage 4 metastatic breast cancer forces her to frequently leave the house.
She was recently accepted into a clinical trial three hours away from her Ohio home, where she spends five days in the hospital every three weeks. In between clinical trial sessions, she ventures out three times a week for doctors’ appointments and physical therapy after two cancer-related surgeries.
“Staying out of the hospital or treatment center isn’t possible for someone like me,” Geib said. “You’re always in treatment for the rest of your life.”
She’s looking forward to the day she can get the COVID-19 vaccine and relieve some anxiety about leaving the house. Unfortunately, there’s no clear answer on when it will be her turn, as her state mostly vaccinates by age and occupation. The 34-year-old Geib doesn’t expect to make the cut any time soon.
Ohio isn’t the only state making cancer patients wait. Although guidelines from the Centers for Disease Control and Prevention recommend states prioritize patients 16 to 64 with underlying medical conditions, such as cancer, many aren’t vaccinating them yet.
Geib grows more impatient each day as she sees fellow cancer patients in Pennsylvania and other neighboring states get their shots.
“It’s more frustrating than anything,” she said. “I’ve seen friends that are getting vaccinated and it’s just this waiting game of ‘OK, when are we going to be able to access this?’ ”
Doctors recommended Geib wait for the Johnson & Johnson COVID-19
vaccine, which is expected to be authorized by the Food and Drug Administration in the coming days, instead of the two mRNA-technology vaccines now allowed for use because of her history of anaphylactic reactions. But even if the J&J vaccine were to be delivered next week, she still wouldn’t be eligible to get a shot.
The American Association for Cancer Research released a letter Wednesday signed by 130 organizations, cancer centers and institutions to the Biden administration and state leaders to raise awareness about the importance of cancer patients and survivors receiving the COVID-19 vaccine.
A December study published in JAMA Oncology found cancer patients diagnosed with COVID-19 were more likely to require hospitalization than people without cancer. More than 47% of cancer patients with COVID-19 were hospitalized versus 24% of COVID-19 patients without cancer. The study also showed about 15% of patients with cancer died from COVID-19 compared to 5% of non-cancer patients.
“Cancer patients because of their cancer have relative weakened immune systems and weakened immune systems lead to a higher chance of infection,” said Dr. David Cohn, chief medical officer at The Ohio State University Comprehensive Cancer Center. “Cancer treatment (such as chemotherapy) does the same thing.”
There are 17 million cancer survivors at higher risk of COVID-19 infection or severe disease. Cancer kills more than 600,000 Americans each year, making it the second leading cause of death in the U.S., according to the American Association for Cancer Research.
Cancer patients not only are more likely to die from COVID-19, they’re more likely to die from cancer if they were to pause treatment to recover from infection, said Dr. Antoni Ribas, the association’s president. “Patients with cancer have life-saving therapies. If there’s a delay or a break in their treatment, their outcomes are worse,” he said.
In states where cancer patients are eligible to receive the COVID-19 vaccine, limited supply keeps them waiting as health care workers, front-line essential workers, nursing home residents and staff, and other Americans with underlying health conditions fill up available appointments.
Even cancer centers that have already begun vaccinations are forced to decide who should go first because they don’t have enough doses for all their eligible patients.
“For us, it’s not whether to immunize patients with cancer ... for us is the challenge to prioritize which patients,” said Dr. Brahm Segal, chair of internal medicine and chief of infectious diseases at Roswell Park Comprehensive Cancer in Buffalo, New York.
Data has shown patients with blood or lung cancers have a higher risk of COVID-19 complications, Ribas said, and delaying their treatments due to infection can be just as detrimental to their health.
Geib’s cancer already has metastasized to her lungs, which further amplifies her fears, especially after she’s seen friends and family with cancer struggle in the hospital when they caught COVID-19.
“It’s terrifying even getting bronchitis but to think about getting COVID or COVID pneumonia when my lungs are already shot from the cancer, it’s a scary thing to think about,” she said.
But she also knows treatment can save her life, so she takes extra precautions to protect herself from the virus. Dedication to simple public health measures – masking, social distancing and hand-washing – is the only thing protecting cancer patients as they wait for the vaccine, experts say.
Researchers at New York-Presbyterian Hospital and Columbia University Irving Medical Center in New York City found that patients with cancer were less likely to get infected with COVID-19 than patients without, according to data presented at the American Association for Cancer Research Virtual Meeting: COVID-19 and Cancer held in early February.
“They know they have a serious disease and that makes them more aware to be careful and follow the guidelines to limit exposure,” Ribas said. But if they get COVID-19, their outcomes are much worse than patients without cancer.
Geib is doing everything necessary to protect herself, but she knows there’s a higher risk of infection without the vaccine: “It’s a scary time.”