Coping with COVID-19 pandemic as head and neck cancer patient

Navigating the COVID-19 crisis: Resources for Patients, Survivors and Caregivers

By The Head and Neck Cancer Alliance (modified)

The global COVID-19 pandemic is particularly stressful for those undergoing treatment for head and neck cancer, their caretakers, and cancer survivors. Because of the increasing numbers of patients with COVID-19 infections, many health systems adopted strategies to provide sound care for non COVID-19 patients while reducing the risk of infection transmission to patients and medical personal. Additional considerations include the limited availability of operating rooms and inpatient beds, and the scarcity of personal protective equipment needed to provide safe and hygienic conditions.

Below is a brief outline of some of the changes in near future.

People undergoing active treatment (especially chemotherapy) are at increased risk of getting an infection. it is very important that they and those in close contact withe them,  follow the CDC and local government instruction:

• Washing hands with soap and water frequently, for 20 seconds, including wrists.
• If unable to wash hands, using hand sanitizer and rubbing them for 20 seconds.
• Disinfecting commonly used surfaces such as tabletops, doorknobs, and phones.
• Avoiding direct contact with others such as hugging or shaking hands, and staying at least 6 feet away from other people.
• Avoiding being in large groups of 6 or more people, especially when in an enclosed space.
• Avoiding sharing cups or utensils with others.
• Covering the mouth or stoma during a cough or sneeze.
• Wearing a face mask and protective glasses when at risk of exposure to the virus
• Avoiding contact with anyone with a known COVID-19 infection or individuals with a cough and/or fever.
• Avoiding air travel or other public transportation.
• Notifying their doctor immediately when feeling sick (develop a cough, fever, muscle aches, or other symptoms) or if after having contact with anyone with a known or suspected COVID-19 infection. It may be necessary to be evaluated and potentially tested for the virus.

Patients who have finished therapy are seen regularly to monitor for cancer recurrence and also to address any of their treatments side effects. In the current crisis, these visits are typically not urgent and may increase the risk of exposure to COVID-19 to both survivors and physicians. As a result, many hospitals are postponing non-urgent surgeries, routine follow-up visits and imaging tests (such as CT and PET/CT scans) to minimize the risk of transmission and to conserve health care resources that may be in limited supply. However, if a patient experiences concerning new signs or symptoms for cancer ( e.g., worsening mouth or throat pain, changes in one’s voice or swallowing, a spot in the mouth that has not healed in 2 weeks, unexplained ear pain, new lump in your neck) he/she should inform their doctor as they may still need to be seen.

While social distancing, isolation, and quarantine at home are effective in reducing the incidence of COVID-19, they do increase health risks from other causes. Social isolation among older adults is associated with heightened risk of cardiovascular, autoimmune, neurocognitive, and mental health problems. It is therefore important that individuals do not neglect their medical problems during the pandemic.

Some institutions are offering virtual clinic visits (Telemedicine) interactions with medical providers by way of a video conference call) in an effort to reduce exposure of both patients and health care staff. While virtual visits and telemedicine will never completely replace in-person interactions, in times of crisis, they can provide an effective means to maintain a patient-doctor relationship, allowing them to engage in a directed conversation about disease-specific symptoms and concerns, and to discuss future plans of care. Virtual visits can be very important for head and neck cancer survivors, as they reduce individual patient exposure in clinics and hospitals, and minimize the risk to other cancer patients with compromised immune systems, as well as health care providers and staff. Survivors and caregivers should be reassured that these encounters are a sound approach to cancer surveillance and can allow providers to identify patients who may require an in-person visit.

Other general considerations:

• Maintaining close communication with family/loved ones and health care team
• Having a sufficient supply (at least a 2-week supply) of easy to preserve food items, prescriptions and cleaning supplies and other essentials. 
• Contacting one’s physician to ensure one has adequate access to prescription medications, and necessary supplies (e.g., tube feedings, tracheostomy supplies and personal protective equipment)

Neck breathers ( Laryngectomees and those with tracheostomy) are likely at higher risk of becoming infected with COVID-19 due to the increased exposure of their airway. These individuals should observe special precautions (Click for precautions).