COMMENTARY

Confronting Isolation Among Cancer Patients During COVID-19

Mark G. Kris, MD

Disclosures

August 28, 2020

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This transcript has been edited for clarity.

Hello. I'm Mark Kris from Memorial Sloan Kettering Cancer Center, speaking today about the COVID-19 pandemic and how it has affected our patients fighting lung cancers and their families.

It's almost 5 months to the day when I was first faced with COVID-19 in one of my patients. It's been an interesting and wild time. I'm happy to say that people are surviving this virus, and it's our job to try to help them through this time.

In my practice, I'm far more impressed by the number of survivors of COVID-19 than by those who succumb to it. That's an important fact to share with patients too. Even if you have lung cancer — and yes, any kind of chronic disease like lung cancer could increase your risk of dying from COVID-19 should you get it — it is still possible to survive with good care and attention.

It's vitally important to remember, though, what the real risk is to our patients, and that is cancer. We cannot lose sight of the seriousness of a cancer illness. Almost my complete population of patients has advanced lung cancer. They need ongoing care; those who could potentially have a cure need concentrated, focused care. You can't miss a beat in the care of these patients because you cannot jeopardize their chance for cure. I don't have any quick answers on how to do this, other than to pay attention and to make whatever compromises you can to give them the care they need on time.

The other important issue to acknowledge is what a horrible burden this has been to our patients and their families, and the isolation that it's fostered.

From day one, we've always encouraged our patients to put together their team — that is, to find those people who are going to help them get through this illness, to be an extra set of ears, to be those rocks in their lives whom they can stand on at a time when they're being pushed by so many forces. We tell that to our patients, and it suddenly got taken away.

Here in the state of New York, at least, things have gotten better. Caregivers can come now, but we need to acknowledge that we pulled the rug out from under our patients by taking away that team that they relied on for help.

There is the physical isolation that our patients have suffered, and even more important, the psychological isolation that they've had. What can we do about it? Number one, it's important to acknowledge it. During every visit with every patient, I make a point now of seeing how COVID-19 is affecting them and talking about what they're doing to cope with it.

I have been clear about the risk, but I've also been clear about the risk being regional. I urge everyone to look at what the risk for COVID-19 is in their region of the country and to follow the rules of the government and health officials for their area. Where those rules permit, allow patients to get out and spend more time with those people who mean a lot to them. Tell them it is okay to do that. Obviously, they should follow the rules that we know can make a difference: handwashing, masks, and social distancing. But they need to have a life; it's important. They need to try to overcome the physical and psychological isolation that they've suffered.

Our patients' quality of life has been affected, and we need to help them confront the isolation they have had and help them deal with it. Bring it up, talk it through, and do what's best and prudent for each patient while obeying the rules.

Mark G. Kris, MD, is chief of the thoracic oncology service and the William and Joy Ruane Chair in Thoracic Oncology at Memorial Sloan Kettering Cancer Center in New York City. His research interests include targeted therapies for lung cancer, multimodality therapy, the development of new anticancer drugs, and symptom management with a focus on preventing emesis.

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