Doctors adjust cancer patient care amid COVID-19 pandemic

The fear of contracting COVID-19 has kept Thom LaBruzzo from leaving his house unless it's to receive chemotherapy at the Perlmutter Cancer Center location in Huntington. 

"At this point, I don't go anywhere, and it's put a damper on life," said LaBruzzo, of East Northport, whose treatment for non-Hodgkin lymphoma includes four straight days of chemotherapy followed by 28 days of rest. "It's definitely a scary situation. I've always loved to cook and have done the food shopping. But right now, my partner does the shopping. I can't risk it."

Long Island cancer center doctors said they're adjusting treatments in an attempt to limit patient exposure to COVID-19. Changes include holding off on cancer surgeries that can wait, conducting follow-up visits virtually, and limiting how often some patients come for chemotherapy.

But many patients are still forced to venture out for chemotherapy, radiation and, if it's deemed urgent, surgery.

"Unfortunately, cancer doesn't wait," said Dr. Ben Neel, the director of Manhattan-based NYU Langone's Perlmutter Cancer Center. "The mortality for cancer patients who contract COVID is higher, and while we don't know exactly why that is, we do try to limit their exposure whenever possible."

Neel said reasons for the higher mortality rate are unclear, since so much is unknown about COVID-19. But doctors said a cancer patient's suppressed immune system could play a role.

Nancy Hamilton of Whitestone, Queens, a patient at the Perlmutter center in Lake Success, said her multiple myeloma diagnosis has left her homebound.

"A while back, my daughter and her husband came over for lunch," she said. "They set up a table and sat outside. I stayed inside on the other side of the window. My husband was out by the front door."

For now, alternatives are necessary, even for some necessary treatments, said Dr. Richard Barakat, physician-in-chief and director of the Northwell Health Cancer Institute and senior vice president of the health system's cancer service line. 

"Perhaps the chemotherapy can be given orally instead of an infusion," Barakat said. "In other cases, we can adjust the treatment, so instead of having it every week, maybe we adjust dosage and do it every few weeks. But that's also not always an option."

He added that Northwell is conducting more consultations and routine check-ins with patients over the phone or through video conferencing.  

Mount Sinai South Nassau moved its infusion suite to the front of the hospital, while its area to provide radiation has its own entrance behind the hospital, said Dr. Rajiv Datta, the Oceanside-based hospital's cancer program medical director. 

South Nassau, like nearly all cancer care and health care facilities, also has severely restricted who can enter. Patients can't bring a partner with them for treatment.

The inability to bring support to people is another stress point, doctors said. 

Catholic Health Services has a team of psychologists, social workers and nurse navigators who generally support cancer patients, said Dr. Bhoomi Mehrotra, chair of cancer services at the Rockville Centre-based health system, which operates six hospitals on Long Island.

"We can't completely lower a patient's anxiety," Mehrotra said. "But we can help, because it's natural for anyone to be concerned with their safety and well-being. That's even more the case with a cancer patient.

"But we are fortunate, because our cancer patients aren't usually near the hospitals," Mehrotra said.

Rosemarie Oliver, an ovarian cancer patient from Farmingdale who gets her care at Catholic Health, said it's hard not to notice the extra safety measures taken by nurses and other staff.

"I've always been conscious of flu season, and tried to avoid getting sick," she said. "But this? It's a whole different ballgame. There is a nurse at the entrance, fully gowned, checking our temperature and asking questions before we even go in.

"I just wonder if we will ever be able to hug anyone ever again," she said.