Cancer Care During the Pandemic: How to Access Treatment and Manage Diet and Exercise at Home?
Under the resurgence of the COVID-19 pandemic, many regions across the country are actively engaged in epidemic prevention and control. During this period, many cancer patients have been under home isolation, and their treatment progress has been affected. On April 15, Dr. Jiang Jingwei, Associate Director of the Department of Medical Oncology at Jiahui International Cancer Center in Shanghai, was invited to the “Together Through the Pandemic” Jiahui Health Live Broadcast. He conducted a video session titled “Fighting Cancer Without Interruption – What Should Cancer Patients Pay Attention to During Epidemic Prevention?”, offering detailed explanations on topics such as epidemic prevention methods for special populations, medication, treatment, diet, and exercise. The session was well-received by patients and their families alike.
For those who missed the live broadcast, don’t worry! The editor has summarized some key points and selected highlights from Dr. Jiang’s talk in this article, hoping it will be helpful to everyone.
Q1:
With the pandemic recurring, can cancer patients receive the COVID-19 vaccine or booster shots?
Dr. Jiang Jingwei:
This is a question many cancer patients are very concerned about. Based on the latest published literature and clinical research, cancer patients are not contraindicated for COVID-19 vaccination — in other words, cancer patients can receive the vaccine. However, there are a few important things to note:
First, it has been observed that the protective effect of the vaccine in some cancer patients is relatively low, meaning their ability to resist COVID-19 infection is weaker than that of healthy individuals.
Second, the vaccination effect in hematologic cancer patients is generally poorer than in solid tumor patients.
Although cancer patients can receive the vaccine, it is very important to arrange the appropriate timing for vaccination. In general:
• For chemotherapy: it is recommended to avoid vaccination within two weeks before or after chemotherapy.
• For immunotherapy: there is currently no evidence of conflict between immunotherapy and COVID-19 vaccines. Patients receiving immune checkpoint inhibitors such as PD-1 or PD-L1 can get vaccinated.
• For targeted therapy: it depends on the specific case. Generally, patients taking targeted drugs such as TKI agents for lung cancer or anti-angiogenic targeted drugs can receive the vaccine. However, for those receiving immune-targeted therapy with anti-CD20 monoclonal antibodies (e.g., rituximab), since the drug affects the function of B cells — and thus the vaccine’s efficacy — it is recommended to wait six months after discontinuation before vaccination.
• For endocrine therapy: there is no contraindication to COVID-19 vaccination.
• For radiotherapy: there is no effect on vaccination.
• For CAR-T immunotherapy and bone marrow transplantation: vaccination should be postponed and reconsidered three months after treatment.
Q2:
Should cancer treatment continue or be suspended during the pandemic?
Dr. Jiang Jingwei:
Cancer treatment is a continuous process. Under feasible conditions, we recommend that patients strive to avoid treatment interruption. However, in some cases, temporarily delaying treatment and observing disease progression does not affect efficacy. Balancing “epidemic prevention” and “cancer treatment” is not easy, so doctors will analyze and decide based on each patient’s condition and treatment stage.
For patients newly diagnosed with advanced cancer whose disease is progressing: active treatment is recommended. Especially for fast-developing cancers such as small-cell lung cancer, delaying treatment even for a month could lead to rapid disease progression and negatively impact prognosis.
For patients with severe or acute symptoms: complications such as intestinal obstruction, infection, or bleeding often require urgent treatment. If symptoms worsen progressively, seek medical attention immediately.
For patients whose disease is stable (for instance, those who have remained progression-free for more than 6–12 months after chemotherapy or immunotherapy): under the current epidemic situation, short-term (1–3 months) treatment suspension and observation may be acceptable. It is best to consult your oncologist or seek online medical advice to decide whether treatment can be delayed.
Q3:
To reduce going out, can intravenous medications be switched to oral drugs?
Dr. Jiang Jingwei:
Some intravenous drugs have oral equivalents, in which case it is acceptable to switch from IV to oral medication. For example, 5-FU (5-fluorouracil) can be replaced by oral capecitabine or S-1 (a compound preparation containing tegafur, gimeracil, and oteracil potassium).
If there are no oral alternatives and the patient cannot easily go out, doctors may consider adjusting the treatment plan. For instance, if the original plan was first-line chemotherapy followed by second-line targeted therapy, in special circumstances where the patient cannot receive IV treatment, doctors may temporarily use oral targeted therapy as first-line treatment. Each case should be carefully evaluated, and timely communication with the attending physician is essential.
Q4:
If follow-up examinations cannot be done on time due to home isolation, what should patients do?
Dr. Jiang Jingwei:
After completing a treatment plan, doctors usually instruct patients to return for regular follow-ups, which are very important for monitoring disease status. For example, patients who finished chemotherapy less than three months ago should follow up on schedule to assess tumor progression, treatment response, and side effect management. However, for patients whose condition is stable and who usually return every three months, it may be acceptable to postpone follow-up slightly during special periods — but this should be determined by the attending physician. Generally, short delays have little impact.
Q5:
If cancer patients develop a fever while staying at home, what should they do?
Dr. Jiang Jingwei:
Fever is common among cancer patients, both from the disease itself and from treatment. The causes vary and must be analyzed comprehensively:
1. Tumor-related fever: usually mild to moderate and not accompanied by severe symptoms; can be managed with oral antipyretics.
2. Drug-related fever: may occur after anti-tumor treatments; generally requires only symptomatic care.
3. Infection-related fever: cancer can lead to secondary infections (e.g., biliary or respiratory), which require anti-infective treatment.
4. COVID-19 infection: can also cause fever. For cancer patients, it’s essential to rule out COVID-19 as the cause. If infection is confirmed, patients should immediately report to local authorities and seek treatment.
Most fevers in cancer patients are not related to COVID-19. Once COVID-19 infection is excluded, patients should assess their condition: If fever is mild and doesn’t affect daily life, take antipyretics under medical guidance. If fever is high or accompanied by chills, visit a fever clinic immediately.
Q6:
What are the dietary recommendations for cancer patients during epidemic control?
Dr. Jiang Jingwei:
A balanced diet is crucial for cancer patients. Adequate nutrition and maintaining a healthy body weight (neither overweight nor underweight) help strengthen the immune system against cancer.
Given the current challenges in food supply, we recommend prioritizing protein-rich foods (eggs, milk, fish, shrimp, soy products) and vitamin C-rich and storable fruits and vegetables (broccoli, carrots, green peppers, cabbage, Chinese cabbage, and kiwifruit). Avoid frying and deep-frying to prevent nutrient loss.
Some patients ask whether vitamin C tablets or effervescent tablets can replace fresh fruits and vegetables. If fresh produce is available, natural sources are best. Otherwise, moderate supplementation with vitamin C tablets is acceptable — just avoid excessive intake.
Q7:
What kinds of exercise are suitable for cancer patients at home?
Dr. Jiang Jingwei:
We always encourage cancer patients to maintain appropriate physical activity according to their condition. This helps prevent muscle atrophy and deep vein thrombosis. For patients with good physical strength: Tai chi, yoga, squats, and push-ups are suitable. For patients with weaker strength: gentle exercises such as slow walking, stretching, and light leg movements are recommended. For bedridden patients: family members can assist with passive stretching exercises.
Also, maintaining regular daily routines is essential. Cancer patients should aim for 7–8 hours of sleep each night.
Q8:
How can cancer patients maintain psychological resilience during the pandemic?
Dr. Jiang Jingwei:
Being diagnosed with cancer is already a major psychological blow. During epidemic control, concerns about COVID-19 and treatment delays add extra stress. Patients and their families may experience anxiety, irritability, or depression. These negative emotions can disrupt the endocrine and immune systems, which is harmful for both virus resistance and cancer control. Staying optimistic and emotionally stable is therefore critical.
Although neither cancer nor COVID-19 can be changed by individuals, what patients can do is face challenges positively. Engage in activities that bring joy — listening to music, watching TV, painting, or calligraphy; avoid excessive negative news; and maintain a balanced diet, moderate exercise, and regular routines to strengthen mental resilience and immune function.
Q9:
How can cancer patients reduce infection risk, especially those receiving regular chemotherapy or radiotherapy at hospitals?
Dr. Jiang Jingwei:
Staying home as much as possible is one of the most effective ways to avoid infection. If patients must go out for medical appointments, proper precautions are necessary:
• Avoid crowded places and make appointments in advance to understand hospital policies.
• Avoid public transportation; use private vehicles or community-arranged transport when possible.
• Wear masks throughout the visit and keep distance from others.
• Upon returning home, wash hands immediately and disinfect clothing and belongings.
• Disinfect the outer packaging of delivered goods, groceries, and takeout.
At this critical time of epidemic prevention, life is indeed challenging for cancer patients. Up to now, Jiahui International Cancer Center has continued to implement strict prevention and control measures, ensuring proper care for all inpatients and smooth consultations and follow-ups for outpatients.
We hope all cancer patients will cooperate with public health policies, protect themselves and those around them, and maintain healthy lifestyles — eat well, exercise moderately, sleep adequately, and stay optimistic. Keep your body in its best state to fight both the pandemic and cancer together!
Feel free to share this article with patients who may need it.
