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Cancer in the Age of Covid-19: Focus on Host Immune Resiliency

Not long ago, I presented a compendium of articles under the theme of How to Be a Horrible Host to Cancer. In this reading guide I cherry-picked articles that represent my most impactful writings on the host-tumor relationship.

If you are hosting an underlying malignancy—and especially if you’re actively undergoing treatment—you are immunocompromised. This puts you in a high-risk category for contracting, and potentially succumbing to, COVID-19. It places you in a similar category as those hosting chronic underlying conditions such as, diabetes, kidney failure, and lung or heart disease.

In 1991, shortly after I was diagnosed with chronic lymphocytic leukemia (CLL), my spleen was removed as it was full of cancer cells. Afterwards, as a matter of course, I was given various vaccines and, over the decades that followed, a few booster shots.

Though the underlying leukemia was never conventionally treated, and today there is no evidence of disease, I am still, by definition—because of having no spleen—immunocompromised.

The spleen is part of the immune system. It acts as a blood filter. Old red blood cells are recycled there, and platelets and white blood cells are stored there. The spleen also helps fight certain kinds of bacteria that cause pneumonia and meningitis.

Though by no means a categorical anti-vaxxer, I am 15 or more years behind on ALL vaccines that are recommended for my specific situation. The reasons why I have chosen to skip pneumonia, shingles, and even annual flu vaccines, can be covered in another post. My personal circumstances are unique and complex; I rarely encourage the approach I’ve taken to individuals I coach.  The point is, on paper, I have a compromised immune function.

Limited Pharma-Based Options Against COVID-19

As of this writing there is no vaccine for COVID-19—over one hundred are being investigated. When one or more are approved, they will likely have a similar effectiveness to those such as the seasonal flu vaccine: 30-50% of those inoculated will be protected.

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Currently, myriad existing drugs are being tested for off-label use against COVID-19. At this time, Gilead’s Remdesivir is the only approved therapeutic to treat COVID-19. It may shorten the length of illness by 30%. This drug is not a cure; newly published data reveals it had limited benefit for patients who were severely ill.

As previously mentioned, those with compromised immune systems are most at risk for COVID-19. With no vaccine and the limited effectiveness of Remdesivir, we do not have much in the way of drug-based protection from this virulent virus.

Here is an excerpt of what HHS Secretary Alex Azar recently said to CNN’s Jake Tapper about causes of susceptibility to COVID-19 infection and death specific to America:

“Unfortunately the American population is a very diverse…  a population with significant unhealthy comorbidities…  many individuals in our communities, in particular African American, minority communities… … at risk here because of significant underlying disease health disparities and disease comorbidities—and that is an unfortunate legacy in our health care system that we certainly do need to address.” ~Alex Azar, U.S. Secretary of Health and Human Services

Added Complexity of Cancer Care in the Age of COVID-19

My oncologist friends and colleagues have expressed how challenging and stressful it has been to be on the frontlines of cancer care in the age of COVID-19. Certainly, cancer management and treatment is even more complex due to the virus. ASCO, the leading society for oncology leaders and practitioners, has recently come out with new guidelines and best practices for clinical care.

The Cancer Host Environment in the Age of COVID-19: Your Action Plan

What can you do to help prevent or reduce the severity of symptoms associated with COVID-19?

You can actively work on your immunity and resiliency to create an anticancer environment and, by default, create an internal milieu fortified to help protect against COVID-19 and every chronic disease prevalent in today’s society.

  • Be connected. Absolutely, practice physical distancing, and embrace personal protective equipment, but do not confuse physical distancing with the awful term ‘social distancing’—currently we need social connectedness more than ever.
  • Consult my reading guide on How to Be a Horrible Host to Cancer—because every article in this collection squarely focuses on strengthening immune function and resiliency.

While we await effective vaccines and drugs… and antibody testing… and contact tracing… and containment for COVID-19… there is plenty you can do in the here and now to help protect yourself over the long run. Start here.

Image Credit: Molecular model of antibody taking part in immune defense by BigStock.com/Tyrannosaurus