Care Considerations for Older Myeloma Patients During COVID-19
French blood cancer researchers provided some recommendations around older patient care during COVID-19 in The Lancet Oncology. The guideliines were intended to limiit hospiital admissions and exercise caution when starting or continuing treatment for a population that has greater risk because of cumulative factors such as age and potentially greater immunosuppression.
The Société Francophone d’Onco-Gériatrie (SoFOG) and the French cooperative group for clinical research in geriatric oncology DIALOG (GERICO-UCOG) endorsed the following suggestions:
- When considering cancer treatment during COVID-19, the treatment decisions should factor in: cancer type, disease extent, prognosis, treatment options and potential for viral infections
- Evaluation of life expectancy should be part of the treatment decision process
- Alternatives to standard therapy that have fewer side effects on the immune system (like targeted therapies vs. chemotherapies) are better than no treatment at all
- Personal protection (mask wearing, hand washing and confinement) and reduced clinic visits (like more spaced treatments or less frequent routine testing) can help
- Balancing COVID-19 exposure with undertreatment of the cancer is essential. Talk to your doctor!
- Age isn't always the most essential factor. Undertreatment based on age does patients a disservice.
According to the Center of Disease Control (CDC) in the United States, the following people are at greater risk for getting COVID-19:
- People 65 years and older (8 out of 10 deaths of COVID-19 were of people over the age of 65)
- People who live in a nursing home or long-term care facility
- People of all ages with underlying medical conditions, particularly if not well controlled, including those with:
- Chronic lung disease or moderate to severe asthma
- Serious heart conditions
- Immunocompromised conditions (caused by cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
- Severe obesity (body mass index [BMI] of 40 or higher)
- Chronic kidney disease undergoing dialysis
- Liver disease