Colorectal Cancer and Coronavirus

Fight CRC is keeping this webpage on Colorectal Cancer and Coronavirus (COVID-19) updated regularly with the latest updates and expert resources that survivors and their families need to know.

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Unfortunately, coronavirus poses an extra risk for colorectal cancer patients due to the immunosuppressive treatments they receive. As the spread of coronavirus occurs throughout the world, researchers, public health officials, and individuals all play a role in slowing the spread of the virus in order to protect colon and rectal cancer patients, cancer patients at large, and any other vulnerable population.

Preparedness and awareness are paramount in these times. We’ve compiled information from the World Health Organization (WHO), the American Society of Clinical Oncology (ASCO), and the Centers for Disease Control (CDC) about steps to take in an effort to keep you and your loved ones healthy. Read on to find out what colorectal cancer patients should know about coronavirus.

COVID-19 VACCINES ARE AVAILABLE. Visit the CDC’s website to find out more about the vaccines and how to get yours and read our blog post about what CRC survivors need to know.

Vaccine Guide for People With Cancer

Don’t wait to get the COVID-19 vaccine. Patients with cancer and those receiving therapy should get vaccinated as soon as they can, including 3rd doses and booster shots.

August 2021: Booster Shot for Immunocompromised Individuals

Last week, the Food and Drug Administration (FDA) authorized an additional dose of the COVID-19 vaccine for people who are moderately to severely immunocompromised — this includes colorectal cancer patients.

According to the Centers for Disease Control (CDC), this includes those who are in active treatment for solid tumor and hematologic malignancies, those who have received a solid-organ transplant and are taking immunosuppressive therapy, and those who have received CAR-T or hematopoietic stem cell transplants. To read a full list of inclusion criteria, you can visit the CDC website.

According to the FDA, this authorization was updated for the Pfizer and Moderna COVID vaccines. The third dose can be administered at least 28 days after the second dose of the same vaccine to eligible patients 18+ for the Moderna vaccine and 12+ for the Pfizer vaccine. The updated authorization does not currently include the Johnson & Johnson COVID vaccine. 

August 2021: Delta Variant

The following recommendations apply to non-healthcare settings.

Fully vaccinated people can:

  • Participate in many of the activities that they did before the pandemic; for some of these activities, they may choose to wear a mask.
  • Resume domestic travel and refrain from testing before or after travel and from self-quarantine after travel.
  • Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States.
  • Refrain from routine screening testing if feasible.

Infections happen in only a small proportion of people who are fully vaccinated, even with the Delta variant. However, preliminary evidence suggests that fully vaccinated people who do become infected with the Delta variant can spread the virus to others. To reduce their risk of becoming infected with the Delta variant and potentially spreading it to others: CDC recommends that fully vaccinated people:

  • Wear a mask in public indoor settings if they are in an area of substantial or high transmission.
    • Fully vaccinated people might choose to mask regardless of the level of transmission, particularly if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is unvaccinated. People who are at increased risk for severe disease include older adults and those who have certain medical conditions, such as diabetes, overweight or obesity, and heart conditions.
  • Get tested if experiencing COVID-19 symptoms.
  • If you came into close contact with someone with COVID-19 get tested 3-5 days after the date of your exposure and wear a mask in public indoor settings for 14 days after exposure or until a negative test result.
  • Isolate if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms.
  • Follow any applicable federal, state, local, tribal, or territorial laws, rules, and regulations.

July 2021: Update for Immunocompromised Populations

On July 16, 2021, the CDC updated their COVID-19 guidelines to include:

People who are immunocompromised should be counseled about the potential for reduced immune responses to COVID-19 vaccines and to follow current prevention measures (including wearing a mask, staying 6 feet apart from others staying they don’t live with, and avoiding crowds and poorly ventilated indoor spaces) to protect themselves against COVID-19 until advised otherwise by their healthcare provider. Close contacts of immunocompromised people should also be encouraged to be vaccinated against COVID-19 to help protect these people.

May 2021: The CDC released updated guidance on wearing face masks. Fully vaccinated people no longer need to wear a mask outdoors, except in certain crowded settings and venues.

On May 16, 2021, the Centers for Disease Control and Prevention (CDC) released updated guidelines for those who are fully vaccinated.

  • If you are fully vaccinated, you can resume activities that you did prior to the pandemic.
  • Fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.
  • If you haven’t been vaccinated yet, find a vaccine.

In general, people are considered fully vaccinated:

  • 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
  • 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

If you don’t meet these requirements, regardless of your age, you are NOT fully vaccinated. Keep taking all precautions until you are fully vaccinated.

What you can start to do if you’ve been fully vaccinated:

  • You can resume activities that you did prior to the pandemic.
  • You can resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.
  • If you travel in the United States, you do not need to get tested before or after travel or self-quarantine after travel.
  • You need to pay close attention to the situation at your international destination before traveling outside the United States.
    • You do NOT need to get tested before leaving the United States unless your destination requires it.
    • You still need to show a negative test result or documentation of recovery from COVID-19 before boarding an international flight to the United States.
    • You should still get tested 3-5 days after international travel.
    • You do NOT need to self-quarantine after arriving in the United States.
  • If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms.
    • However, if you live or work in a correctional or detention facility or a homeless shelter and are around someone who has COVID-19, you should still get tested, even if you don’t have symptoms.

What you should keep doing if you’ve been fully vaccinated:

  • You will still need to follow guidance at your workplace and local businesses.
  • If you travel, you should still take steps to protect yourself and others. You will still be required to wear a mask on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and stations. Fully vaccinated international travelers arriving in the United States are still required to get tested 3 days before travel by air into the United States (or show documentation of recovery from COVID-19 in the past 3 months) and should still get tested 3-5 days after their trip.
  • You should still watch out for symptoms of COVID-19, especially if you’ve been around someone who is sick. If you have symptoms of COVID-19, you should get tested and stay home and away from others.
  • People who have a condition or are taking medications that weaken the immune system, should talk to their healthcare provider to discuss their activities. They may need to keep taking all precautions to prevent COVID-19.
How Does COVID-19 Affect My Cancer Treatment?

We understand that our community may have many questions about how the coronavirus will affect their treatment plans, from surgery to chemotherapy/immunotherapy, clinical trials and maintenance therapy, and even screening. We spent some time discussing how COVID-19 affects treatment with our medical experts.

Colorectal Cancer Screening Delays

Many Americans are facing decisions about their cancer screening and prevention schedule. According to the American Cancer Society, Dr. Rich Wender, Chief Cancer Control Officer for the ACS, stated:

“The American Cancer Society recommends that no one should go to a health care facility for routine cancer screening at this time…Remember, these screening tests save lives. When restrictions lift, it’s important to reschedule any screening test that you’re due to receive…Getting back on track with cancer screening should be a high priority.”

This statement does not refer to individuals who are being screened for cancer recurrence or who are being screened as a diagnostic measure due to signs and symptoms of CRC. Talk to your doctor if you have a screening scheduled in the near future.

Do CRC Patients Have an Increased Risk of Contracting COVID-19?

Anyone can get the new coronavirus, but cancer patients and survivors have an increased risk of complications and severe events from coronavirus due to treatments that suppress the immune system.

Additionally, people over age 60 and people with comorbidities (such as diabetes, heart disease, etc) who contract coronavirus are at an increased risk of complications. According to a recent ASCO article the steps cancer patients and survivors (whether in treatment or not) should take to avoid coronavirus are the same for the general public.

How Can I Get Tested for COVID-19?

If you want to get tested for COVID-19, call your healthcare provider. Additionally, you can visit your state or local health department’s website to look for local information on testing. To test whether or not you have a current COVID-19 infection, you will have a viral test conducted. Antibody tests are performed to see if you had a previous infection.

If you have questions about different testing types, including the COVID-19 test to antibody tests, the American Clinical Laboratory Association has an informative FAQ sheet detailing the differences between each type of test.

What About the Flu?

The new coronavirus is not something to be compared to influenza; however, it is important to recognize that the steps we are taking to limit the spread of COVID-19 are the same steps we should be taking each year to limit the spread of the flu. Check out this Q&A from the CDC about the flu and cancer patients, and then read Fight CRC’s blog.

Social Distancing & Reducing Your Risk

The CDC recommends social distancing and describes it as “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance” whenever possible to limit the ability of the virus to spread. If you do go outside, remain at least 6 feet apart from anyone you are not living with to minimize exposure.

Specific treatments or vaccines have not been developed yet, and the data on how this specifically affects colorectal cancer patients is limited. For these reasons, it’s important for colorectal cancer patients, survivors, and the general public to continue social distancing efforts – especially as many people show no symptoms of being infected and can unknowingly pass the virus along to others.

  • Follow the guidance on travel restrictions issued by the U.S. Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO).
  • Wash your hands often with soap and water for at least 20 seconds, about the amount of time it would take to hum the “Happy Birthday” twice. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
  • Avoid touching your eyes, nose, and mouth.
  • If you must cough or sneeze, use a tissue. Then throw the tissue away and wash your hands. Or, cough or sneeze into your elbow rather than your hand.
  • Avoid close contact with people who are sick.
  • Clean frequently touched objects and surfaces with household cleaning spray or wipes. These surfaces and objects include doorknobs, counters, toilets, keyboards, tablets, phones, and more.
  • The CDC has advised that everyone (except infants) wear a cloth face-covering in public places where social distancing measures cannot be maintained. They have not recommended the use of surgical masks or N-95 respirators – these are critical supplies that should be reserved for healthcare workers and other medical first responders.

Download our Fact Sheet About Social Distancing

When Should I Call the Doctor?

If you think you may have been infected with COVID-19 (through travel or contact with a person known to have COVID-19), call your doctor if you have a fever and/or other symptoms such as a cough or shortness of breath.

Fight CRC’s partnership with the Cancer Support Community hotline has temporarily extended its hours during this crisis, and staff is prepared to answer questions about coronavirus and coping with social isolation. This is a free call line available in English and Spanish, which offers translation services for more than 200 languages. Live assistance is available from 9 a.m. – 9 p.m. ET Monday through Friday, and 9 a.m. – 5 p.m. ET Saturday and Sunday. TOLL-FREE LINE: 1-877-427-2111

Managing Anxiety

Anxiety is often described as a feeling of unease, worry, or fear, and it truly is a natural human response to a threat – and the new coronavirus is certainly a threat.

Anxiety focuses our attention on problem-solving and kicks off our innate “fight or flight” reaction. For many people, occasional emotions of anxiety and panic are not a result of an underlying anxiety disorder. If you are feeling anxious – don’t feel bad about it and don’t ignore it! It may be a good idea to focus on reducing those feelings through action and putting your attention on preparedness instead.

Find Fight CRC’s series of health and wellness resources to care for your mental health during coronavirus.

Support Programs

  • The COVID-19 Emergency Food Assistance Program – In collaboration with Team Rubicon (TR) and Patient Advocate Foundation (PAF), this program provides assistance to immunocompromised patients living with cancer, multiple sclerosis or rheumatoid arthritis whose ability to access or afford food and other nutritional needs is at risk due to the COVID-19 pandemic. For more information and to apply:https://teamrubiconusa.org/news-and-stories/news-emergency-food-assistance-program/

Fight CRC COVID-19 Resources

COVID-19 Study by Fight CRC

Click to download a report on how COVID-19 is affecting the CRC community. We’re using this feedback to continue providing relevant, reliable resources to help our relentless champions of hope.

Myth Busting with Dr. Lisa Richardson of the CDC

Town Hall: Surviving CRC Through COVID-19

On June 25, 2020, The Colon Club and Fight Colorectal Cancer partnered to host the Town Hall: Surviving Colorectal Cancer Through COVID-19. During this interactive session, those touched by colorectal cancer (CRC) had the opportunity to ask leading medical experts about the many ways in which the novel coronavirus pandemic continues to affect their lives, their treatment, and their cancer survivorship, and what we can expect to see in the coming months.