The new respiratory illness commonly referred to as “coronavirus” and officially called COVID-19 has changed life as we know it for the foreseeable future.
一些乳腺癌治疗——包括chemotherapy, targeted therapies, immunotherapy, and radiation — can weaken the immune system and possibly cause lung problems. People who have weakened immune systems or lung problems have a much higher risk of complications if they become infected with this virus. For most people, the immune system recovers within a couple of months after completing these treatments, so those who have been treated for breast cancer in the past don't necessarily have a higher risk of severe illness.
The virus has now spread to most countries in the world and across all 50 states here in the United States, but the number of cases varies in different regions, so your immediate risk of coming into contact with the virus depends on where you live. The risk of infection will continue to change over the coming months as cases increase and decrease in different areas.
To protect yourself and help reduce the spread of the virus, it’s important to listen to health experts who recommend staying at home, limiting contact with others, and following other precautions.
如果你或loved one are receiving treatment for breast cancer during the COVID-19 pandemic, here’s what you need to know:
- Listen to the latest COVID-19 podcast episodes
- Watch our special COVID-19 video series
The first case was diagnosed in China in December 2019, and it has since spread to almost all countries throughout the world. Some coronaviruses spread from animals to people, and that appears to be the case with SARS-CoV-2, which is thought to have originated in bats and first infected people at a live animal market.
该病毒传染性很强的公司——大约3倍ntagious as the flu, CDC director Robert Redfield, M.D., said in an interview. People become contagious up to 2 days before developing symptoms, but it’s important to know that up to 25% of people who become infected don't develop noticeable symptoms, and you can still catch the virus from them. Data from China suggests that up to 80% of the people there who were infected with the virus that causes COVID-19 had no symptoms. Still, we don't know yet if this is happening in the U.S.
同样重要的是要知道，病毒可以通过粪便传播 - 换句话说，它可以住在你的船尾。
Respiratory droplets and fecal matter can end up on surfaces more often than you might think, and the virus can survive on these surfaces for hours or even days. When you touch these surfaces and then touch your face, you can be exposed to the virus. However, this doesn’t seem to be the main way the virus spreads — most often, it’s through close contact with others.
According to the CDC, a wide range of symptoms have been reported for COVID-19, ranging from mild to severe. Symptoms may appear from 2 to 14 days after you’re exposed to the virus.
- repeated shaking with chills
- loss of taste or sense of smell
Most people who get COVID-19 have mild respiratory symptoms and can recover at home in about 2 weeks. However, symptoms can become severe in certain people.
Severe symptoms that require immediate medical attention include:
- difficulty breathing or shortness of breath
- persistent chest pain or pressure
如果你或loved one experiences any of these emergency warning signs, call 911 immediately. People who are older than 60 and people who have existing serious health conditions such as heart disease, lung disease, and diabetes appear to have a higher risk of developing severe illness and complications from COVID-19. This includes people who are receiving cancer treatments that can weaken the immune system or cause lung problems and people who have cancer that has spread (metastasized) to the lungs.
The CDC says that most people have a low risk of becoming seriously ill from COVID-19. However, it's important to understand the difference between the risk of becoming seriously ill if you do get the virus vs. the risk of being exposed to the virus in the first place.
The virus has now spread to most countries in the world and in communities across all 50 U.S. states, and your individual risk of being exposed to the virus — whether or not it makes you seriously ill — depends on where you live and what precautions you're taking. The risk of being exposed to the virus will continue to change as COVID-19 cases increase and eventually decrease in different areas of the country.
People who currently have a higher risk of becoming infected include:
- healthcare workers who may be exposed to sick people
- people who require frequent hospital visits for medical care
- those who have had close contact with people who have been infected
- people who have recently traveled to places where the virus is known to have spread
While people who are being actively treated for breast cancer may be at higher risk for severe illness if they do become infected, it’s important to know that they do not necessarily have a higher risk of becoming infected compared to others who live in the same area, as long as they are limiting their contact with other people and aren't making frequent trips to the hospital.
“For most breast cancer survivors, the risk of becoming infected is going to be similar to that of the general population,” says Dr. Moore. “For people who are on active treatments that compromise the immune system, there will also be a similar risk for acquiring the infection, but they may have a higher risk of a more severe case should they become infected. So, similar to the precautions that they take regarding other illness, patients who are on treatments that affect the immune system should also be vigilant.”
The best way to avoid becoming sick from this coronavirus is to avoid being exposed to it. There are no treatments or vaccines yet, but scientists are working on them.
这是重要的采取预防措施，降低您生病的风险，特别是如果你有严重的健康问题，如乳腺癌。“Social distancing”or“physical distancing”做法正在推荐或在美国的大部分地区，在许多国家实行世界各地，以减少COVID-19的传播。
Social distancing means limiting close contact with other people — even if they appear to be healthy — to reduce your own risk of infection and prevent the virus from spreading. Staying at home and not seeing your loved ones can be difficult, but it’s important to do right now for your own safety and for the greater good.
- avoid public transportation and unnecessary travel
- avoid social gatherings
- work from home
- stay at least 6 feet away from people when out in public
- avoid physical contact such as handshakes, hugs, and kisses in social situations
In addition to limiting contact with other people, here are some steps you can take to help protect yourself and others against this virus or any harmful germs:
- Use alcohol-based hand sanitizer具有至少60％的醇时肥皂和水不可用。
- 不要触摸你的脸当你的手不干净,让它成为一个习惯to not touch your face when you're outside your home.
- Clean and disinfect surfacesyou touch daily, including things you might not think of such as doorknobs, light switches, faucet handles, and phones. Make sure you usea cleaning agent that the Environmental Protection Agency says is effective for killing this virus。
- Practice healthy habits:吃得好，运动，避免或限制饮酒，不吸烟或VAPE，并获得足够的睡眠。
- 切换到眼镜如果你戴隐形眼镜to avoid touching your eyes more than necessary, or at least followproper contact lens hygiene。
If you are receiving treatment for breast cancer that can weaken your immune system or cause lung problems, or if you are living with breast cancer that has metastasized to the lungs, the following extra precautions may help you protect yourself:
- 避免密切接触with friends and family and take precautions if you depend on them for medical care
- make a plan with your doctor监视症状
- 做一个计划，你的照顾者or other loved ones in case you or they get sick
- stock upon medications
- ask a friend or family memberto shop for groceries or pick up medications for you
“由于这是这样一个不断变化的环境，这是供人参观重要CDC.govor their state health department website for updated information,” says Dr. Moore. “Some hospitals and state health departments are also setting up hotlines to help keep people informed or answer questions.”
You may have heard conflicting information about whether you should wear face masks to protect yourself and others from COVID-19. At the beginning of the pandemic, the World Health Organization (WHO) and the CDC said that only sick people needed to wear a mask to avoid spreading the virus to other people. But on Friday, April 3, the CDC started recommending that everyone wear a cloth face mask when out in public places. Many states, including New York and New Jersey, made wearing a cloth face mask in public a requirement.
The recommendations on cloth masks for everyone changed for several reasons. First, the CDC initially didn’t recommend everyone wear a mask because the organization didn’t want people hoarding masks, especially N95 respirator masks and surgical masks. Healthcare workers depend on N95 masks to keep them safe when they’re caring for COVID-19 patients.
Research also has shown that the coronavirus that causes COVID-19 travels in droplets that range in size from larger blobs (think of a drop that you can see when someone sneezes) to very tiny aerosol microdroplets. Cloth masks can help keep the larger droplets from getting into your mouth from your surroundings and also help keep any large droplets from leaving your mouth and getting into the air.
While no large controlled studies have been done on cloth masks, smaller studies show that wearing a cloth mask is better than wearing nothing.
The CDC recommends that you use a mask with two layers of 100% cotton fabric that is tightly woven. Fabric with a thread count of 180 or higher is a good option. To check on how tightly woven the fabric you plan to use for your mask is, hold the material up to the light. If you see a lot of light coming through or even see the fibers of the fabric, it’s a good idea to choose a different material.
If you only have bandanas, use two. If you only have a scarf, wrap it around your face twice. If you’re using a t-shirt, use two layers.
It’s also very important to make sure that you put on, wear, and take off your mask properly:
- When you’re taking off the mask, never allow the outside of the mask to touch your face and never touch the outside of the mask with your hands. Take the mask off by the ear loops or ties and very carefully move it away from your face. When you’re out in public, don’t pull the mask down below your mouth to talk and then put it back on again. Keep your mask tightly fitted to your face the entire time you’re out. It’s a good idea to wash your mask with warm water and soap as soon as you’re done wearing it and then let it dry thoroughly before you use it again. A mask is not as effective when it’s wet.
TheCDC布面覆盖准则have instructions on how to make both sewn and no-sew cloth face masks. Some people are even adding squares of HEPA vacuum cleaner bags in between the two layers of cotton fabric.
Still, it’s hugely important to know that wearing a face mask is not a substitute for social distancing practices. Just because you and your friends are wearing masks doesn’t mean that you can be close to each other. You still need to avoid contact with others, stay 6 feet away from people when out in public, and stay home if you are sick.
It's especially wise to wear a face mask when visiting a healthcare facility for medical care. Ask your healthcare provider in advance if they will be able to provide one at your appointment or if you should wear your own.
If you experience fever, cough, or shortness of breath, you should call your doctor. If you or a loved one experiences severe symptoms that can signal an emergency, such as difficulty breathing, persistent chest pain or pressure, confusion or inability to awaken, or blueish color in the lips or face, immediate medical attention is needed and you should call 911. Make sure to tell the 911 operator that you suspect COVID-19 so the responders can take the necessary precautions to protect themselves.
People who experience mild symptoms can usually stay home while the illness runs its course and recover in about 2 weeks. But if you are receiving treatment for breast cancer, you should definitely let your doctor know.
“任何人在任何治疗可以抑制the immune system should always call their doctor if they notice a fever or if they have severe cold or flu-like symptoms,” says Dr. Moore. “For someone who’s receiving chemotherapy for breast cancer, a fever is a medical emergency anyway, so that’s something that they need to contact their medical team for.” If you do need to seek medical care for symptoms of COVID-19, Dr. Moore says it’s very important to let your healthcare provider know about your symptoms ahead of time.
If you do become sick, you can take the following steps to protect others:
- separate yourself from othersin your home
- cover your mouth and nose当你咳嗽或打喷嚏时，妥善处置的组织，并洗手
- 周围的人时戴上口罩; you should also wear a face mask if you are caring for someone who is sick
You should follow these steps until:
许多医院和其他医疗设施，延迟或取消选举程序，这意味着放映，手术，并且不被认为是紧急的其他治疗，紧急情况或危及生命的条件另有说明。这可以令人痛心的，如果它发生在你或心爱的人 - 如果你计划进行癌症筛查，手术或其他治疗，你可能觉得这是当务之急。但是，这些艰难的决定，正在以帮助保护人民作出从被感染导致COVID-19在医疗机构，并确保医疗服务提供者有足够的资源，他们需要把谁感染了COVID做弱势群体的病毒的风险增加-19。
Treatment cancellations and delays are often being made on a case-by-case basis, and the policies are different and rapidly changing among healthcare facilities. If this is happening to you, know that you are not alone — many people diagnosed with cancer are having their treatments rescheduled right now.
“There is one general rule right now,” said Breastcancer.org medical adviser Brian Wojciechowski, M.D., a medical oncologist. “Any appointment should be delayed or cancelled if, in the doctor’s judgment, it does not risk harm to the patient.”
The American Cancer Society and other medical authorities recommend that all routine cancer screenings for people without cancer symptoms should be delayed for now, but rescheduled as soon as it’s safe again. Many healthcare facilities are already canceling routine cancer screenings. Routine screenings are different than tests performed on people with cancer symptoms — if you have symptoms, you should tell your doctor and follow their recommendations for next steps.
The American College of Surgeons has recommended that all elective surgeries should be postponed. Surgeries are still being performed if your surgeon determines that the risk of delaying the procedure outweighs the risk of exposure to the virus that causes COVID-19. As long as your hospital doesn’t have high numbers of COVID-19 patients to treat, the American College of Surgeons recommends that certain breast cancer surgeries should still be performed for certain people, including:
- those who are completing treatment before surgery (doctors call this neoadjuvant treatment)
- people who had a breast lump checked with a mammogram and a biopsy and the results of the two tests don’t match; for example, the mammogram may show the lump isn’t cancer, while the biopsy shows the lump is cancer
Talk to your doctor about the best way to proceed to make sure you can get the best care possible in this challenging situation. You may be able to see healthcare providers virtually for certain appointments through telemedicine (by phone or internet video).
At Breastcancer.org, we’re doing our best to learn about how the COVID-19 pandemic is impacting the treatment plans of people diagnosed with breast cancer so that we can better inform others about the situation.Take our survey。
Limiting your contact with others is critically important for protecting yourself and lowering your risk of getting COVID-19. But long-term social distancing is not easy and can lead to feelings of anxiety, depression, and loneliness. If you’re experiencing these feelings while isolating at home, you are not alone — so many of us are going through it with you.
Fortunately, there are plenty of things we can do to manage these feelings and stay connected with our loved ones. Here are some tips from licensed clinical social worker Kelly Grosklags on how to manage the loneliness or anxiety you might be feeling during this time of social distancing because of COVID-19:
- Use social media and electronic tools such as FaceTime, Zoom, Google Hangouts, messaging apps, and texts to stay in touch with loved ones.
- Start a virtual book club with your friends.
- Consider writing letters to people with dementia who are in care facilities and may not be able to work a phone.
- Above all, remember to breathe and live in the now. Living in the past can make you depressed. Living in the future can make you fearful. Live in the now and practice gratitude for the good things in your life.
Hear from experts about delayed surgery, insurance, staying active, treatment plans, and more:
COVID-19和转移性乳腺癌, with Shirley Mertz, chair, Metastatic Breast Cancer Alliance
更新：乳腺外科与重建COVID-19, with Julie Sprunt, M.D., FACS, and Elisabeth Potter, M.D.
COVID-19 Insurance and Financial Issues for People With Breast Cancer与乔安娜·莫拉莱斯，彼岸，CEO，分流癌症
保持活跃在检疫：提示患有乳腺癌, with Sami Mansfield, cancer exercise specialist
Breast Surgery and Reconstruction During COVID-19, with Julie Sprunt, M.D., FACS, and Elisabeth Potter, M.D.
COVID-19和乳腺癌治疗, with Brian Wojciechowski, M.D.
Managing Loneliness and Anxiety During This Time of Social Distancing, with Kelly Grosklags, LICSW, BCD, FAAGC
Watch all of the COVID-19 videos on ourYouTube channel更多的专家意见和信息。
“The COVID-19 pandemic reminds us that it’s a small world out there,” she says. “We are all interconnected in good and sometimes dangerous ways. For now, it’s wise to lay low and stay home whenever possible, especially if you’re at high risk of having complications from getting this virus.”
- wash your hands thoroughly and often
If we all do our part, we can protect ourselves, our families, and our communities from this pandemic.
Adam Leitenberger, editorial director
This content was developed with contributions from the following experts:
Marisa Weiss, M.D.， 首席医疗官
布赖恩S.沃伊切霍夫斯基，医学博士, medical adviser
World Health Organization COVID-19 pages:https://www.who.int/emergencies/diseases/novel-coronavirus-2019
U.S. Centers for Disease Control and Prevention COVID-19 pages:https://www.cdc.gov/coronavirus/2019-ncov/index.html
Johns Hopkins Coronavirus Resources Center:https://coronavirus.jhu.edu/map.html
Harvard Health Publishing Coronavirus Resource Center:https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center
Science MagazineCoronavirus Research, Commentary and News:https://www.sciencemag.org/coronavirus-research-commentary-and-news
New England Journal of MedicineCOVID-19 page:https://www.nejm.org/coronavirus
National Comprehensive Cancer Center Network COVID-19 Resources:https://www.nccn.org/covid-19/
Annals of Internal Medicine。“A War on Two Fronts: Cancer Care in the Time of COVID-19”:https://annals.org/aim/fullarticle/2764022/war-two-fronts-cancer-care-time-covid-19
American Society of Plastic Surgeons Statement on Breast Reconstruction During COVID-19 Pandemic:https://www.plasticsurgery.org/documents/medical-professionals/COVID19-Breast-Reconstruction-Statement.pdf
This special content made possible in part through generous support from AstraZeneca; Daiichi Sankyo; Eisai; Genentech; Lilly Oncology; Pfizer; Seattle Genetics; an independent educational grant from Merck & Co., Inc.; and individuals like you.
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