Cancer patients who developed COVID-19 died much more often within one month than people without cancer who got it, according to two studies.
These are the largest reports of people with both diseases in the United States, the United Kingdom, Spain and Canada.
In one study, half of 928 current and former cancer patients with COVID-19 were hospitalized and 13% died. This is far more than the various rates that have been reported in the general population.
The results were published in Lancet magazine on Thursday and will be discussed this weekend at an American Society of Clinical Oncology conference taking place online due to the pandemic.
A second study in Lancet by researchers in England involving 800 patients with various types of cancer and COVID-19 showed an even higher mortality rate – 28 percent. The risk increased with age and other health problems such as high blood pressure.
The studies are having a big impact: More than 1.6 million new cancers are diagnosed in the US each year, several million Americans are currently under treatment, and about 20 million are cancer survivors.
Dr. Jeremy Warner, a data scientist at Vanderbilt University who led the larger study, said the results show the wisdom of the measures many hospitals have taken to delay or change the care of many cancer patients and the need for that in the past Treated people should be treated with caution now.
“If you don’t have a COVID-19, you want to do everything you can to get it,” he said.
For Luciano Orsini, this meant postponing the operation at the Fox Chase Cancer Center in Philadelphia by about a month to avoid it from happening when virus cases occur.
Orsini lost one kidney to cancer last year and has attempted to use this surgery to remove tumors from its only remaining one. He has been tested for the virus several times, including the night before his surgery on April 29.
“It was a little daunting,” he said. “I checked my watch all the time.”
He is now recovering at home in Sicklerville, New Jersey, and was tested negative for the virus just last week.
“The pandemic places incredible demands on the cancer treatment system,” and the new studies are worrying, said Dr. Howard Burris. He is President of the Cancer Society and heads the Sarah Cannon Research Institute in Nashville, Tennessee.
“We try to keep trips to the clinic as short as possible,” and tell older cancer patients and patients with lung problems, “be extra vigilant, extra isolated, stay home, and be careful with family members,” said Dr. Burris.
Almost half of the patients in Warner’s study received cancer treatment when COVID-19 was diagnosed. The others either stopped treatment, had not started, were under observation, or had cancer in the past.
The researchers included all of these groups, as some cancer treatments can affect the lungs or immune system years later, and can affect the chances of the coronavirus surviving, he said.
Men seemed to be worse off – 17 percent of them died compared to nine percent of women.
This could be because breast cancer was the most common type of tumor in this group, and women with this tendency tend to be younger and have fewer health problems than many cancers that occur in men who are typically diagnosed at a later age. Smoking is also more common in men.
The risk of death also appeared to be higher in patients taking the hydroxychloroquine malaria drug plus the antibiotic azithromycin. However, this could be due to the fact that sick patients received these drugs.
Of the 928 study participants, 89 took hydroxychloroquine and 181 took the combination.
The mortality rate in patients who received both drugs was 25 percent, about double the 13 percent for the entire group, Warner said.
“We don’t know if this is cause and effect,” and studies like this cannot prove such a connection, he emphasized.
Use of hydroxychloroquine alone was not associated with a significantly higher risk of death, but there were fewer patients taking it in this way. The study now includes more than 2,000 patients, and the next analysis will determine whether the trends remain the same, Warner said.
Only two of the 270 took the medication as part of a clinical trial that “really struck me because of the potential side effects,” Warner said. Unless cancer patients are not participating in any of the carefully designed studies that are currently testing hydroxychloroquine, you shouldn’t take this medication yourself, he advised.
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