New research released Thursday showed how dangerous the new coronavirus is for cancer patients in treatment and in remission. Those who developed COVID-19 disease were much more likely to die within a month than people without cancer who contracted the new coronavirus, according to two studies.
They are the largest studies of people with both diseases in the United States, Great Britain, Spain and Canada. In one of the studies, half of the 928 cancer patients in treatment and in remission infected with COVID-19 were hospitalized and 13% died. It is a much higher amount than the rates that have been reported in the general population.
The results were published in The Lancet magazine and will be discussed this weekend at a conference of the American Society for Clinical Oncology to be held because of the pandemic.
A second study published in The Lancet and carried out by researchers in England, with 800 patients with COVID-19 and various types of cancer, found a higher mortality rate: 28%. The risk increased with age and other health problems, such as hypertension.
The studies have big implications: More than 1.6 million people are diagnosed with cancer in the United States each year, several million Americans are on treatment, and about 20 million are survivors.
Physician Jeremy Warner, a data scientist at Vanderbilt University who was in charge of the larger study, said the results show the prudence of the measures that many hospitals have implemented to delay or modify care for many cancer patients, and the need for people previously treated to be more careful now.
“If they don’t have COVID-19, they had better do everything they can to avoid getting it,” he said.
For Luciano Orsini, that meant postponing his surgery at the Philadelphia Fox Chase Cancer Center for about a month to avoid undergoing it as coronavirus cases increased there. Orsini lost a kidney to cancer last year and was eager for this operation to remove the tumors he has left. They tested him for COVID-19 several times, including the night before his operation on April 29.
“It was a little daunting” to have to wait, he said. “I was constantly checking the clock,” he said.
He is currently recovering at his home in Sicklerville, New Jersey, and tested negative for the coronavirus last week.
“The pandemic places enormous demands on the cancer care system,” and “new studies show good reason to be concerned,” said Dr. Howard Burris, who is president of the Cancer Society and runs the Sarah Cannon Research Institute in Nashville, Tennessee.
“We try to minimize clinic visits” and ask elderly cancer patients and those with lung problems “to be more vigilant, isolated, stay home and be careful with their families,” said Burris. .
Almost half of the patients who participated in the Warner study were receiving cancer treatment when they were diagnosed with COVID-19. The others had already completed their treatment, had not started it, had been under observation, or had cancer. The researchers included all of these groups because some cancer treatments can affect the lungs or immune system years later and impact the likelihood of surviving the coronavirus, he explained.
Men had worse results: 17% of them died for 9% of women. That could be because breast cancer was the most common type of tumor in this group, and women with it tend to be younger and have fewer health problems compared to various types of cancer seen in men and women. They are generally diagnosed at older ages. Smoking is also more common among men.
The risk of death also appeared to be higher in patients taking the antimalarial drug hydroxychloroquine plus the antibiotic azithromycin, but this may have been due to sicker patients receiving the drugs. Of the 928 participants, 89 took hydroxychloroquine and 181 the combination.
The death rate in patients who received both drugs was 25%, about twice 13% for the group as a whole, Warner said.
“We don’t know if this is cause and effect,” and studies like this cannot prove that link, he said. The use of hydroxychloroquine alone was not associated with a significantly increased risk of death, but fewer patients took it this way. The study currently has more than 2,000 patients enrolled and the next analysis will check to see if the trends remain the same, Warner said.
Only two of the 270 took the drugs as part of a clinical trial, something that “caught my eye” due to possible side effects, Warner said. Unless cancer patients are in one of the carefully designed studies testing hydroxychloroquine, “don’t take that drug” on your own, he advised.