The Centers for Disease Control and Prevention (CDC) in the U.S. recommend some guidelines for cancer patients, which they consider a high-risk population, and their caregivers to protect them from COVID-19. The basic recommendations are the same as what they suggested to the general public, which includes watching out for fever (38ºC or higher), knowing the signs and symptoms of infection, cleaning your hands often, avoiding touching one's face, using a face covering, avoiding people as much as possible, and keeping a distance of at least 6 feet (2 m).

Basic Recommendation

1. Due to the highly contagious nature of COVID-19, its spread in the general public is very rapid. It is highly likely that newly diagnosed and existing patients with cancer might not get treatment on time. Additionally, mental stress about getting the infection during this infectious disease outbreak could drastically impact cancer patients' decisions to go to the hospital for follow up visits and treatment. 
2. Ethical considerations 
3. Recommended to increase the use of telemedicine in cancer care. 



Treatment Challenges

- This analysis aimed to compare characteristics of COVID-19 patients with and without cancer and assess whether cancer is associated with COVID-19 morbidity or mortality.
- COVID-19-positive patients with an inpatient or emergency encounter at the Mount Sinai Health System between March 1, 2020, and May 27, 2020, were included and compared across cancer status on demographics and clinical characteristics. 
- Patients with cancer were statistically significantly older, more likely to be non-Hispanic Black and to be admitted to the hospital during their encounter, and had more comorbidities than noncancer COVID-19 patients.
- COVID-19 patients with cancer may have a higher risk for adverse outcomes. Although there was no statistically significant difference in mortality, COVID-19 patients with cancer have statistically significantly higher risk of thromboembolism and sepsis.


Clinical Course of Cancer Patients With COVID-19: A Retrospective Cohort Study

- General Cancer and Radiological Treatment
- Surgical Oncology Treatment Changes

Changes to Treatment and Communication Related to Cancer in the COVID-19 Era

- This node acts as a general summary of the comorbidity of cancer and COVID-19 from a paper that analyzed many other papers detailing the same thing at its time of release.
- Via a pooled meta-analysis of studies from around the globe analyzing the prevalence of cancer in COVID-19 patients, it was found that the prevalence of cancer in COVID-19 patients is about 2%, which is higher than the overall prevalence of cancer in the population (I think).
- This leads to a hypothesized conclusion that while there is not a lot of data for COVID-19 infection and cancer patients, there is an elevated risk for these patients. However, due to inconclusive and generally lacking data on this topic, this conclusion is not concrete.
- Many major cancer centers worldwide have taken extra precaution when it comes to the treatment of these patients as many cancer treatments (e.g., chemotherapy) weaken the immune system as a side effect.
- There has currently been no order to withhold chemotherapy, radiotherapy, immunotherapy, or delaying adjuvant therapy to treat cancer patients, however extra care must be taken by patients and physicians alike to not allow these high-risk patients to become infected.

Cancer as a Comorbidity of COVID-19 

- Many cancer treatments work by suppressing rapidly-dividing cells. Note that cancer cells divide rapidly, but some healthy cells (e.g., white blood cells) also divide rapidly. Hence, the immune system weakens, making the patient more likely to get infected and experience severe COVID-19 complications.

University of Michigan - Ann Arbor

Emory University

- Cancer is a term that refers to a collection of diseases in which some of the body's cells divide uncontrollably and invade surrounding tissues. 
- Cancer can metastasize, i.e., spread to other parts of the body. Metastatic cancer is hard to treat and tends to be fatal. Most cancer deaths are caused by metastasis.

This node should be a relation node, but I can't delete it since it's a root node of the "cancer" tree and it has two upvotes.


Cancer

Pathania, A. S., Prathipati, P., Abdul, B. A., Chava, S., Katta, S. S., Gupta, S. C., Gangula, P. R., Pandey, M. K., Durden, D. L., Byrareddy, S. N., & Challagundla, K. B. (2021). COVID-19 and Cancer Comorbidity: Therapeutic Opportunities and Challenges. Theranostics, 11(2), 731–753. https://doi.org/10.7150/thno.51471

COVID-19 and Cancer Comorbidity: Therapeutic Opportunities and Challenges

COVID-19 and Cancer Comorbidity

- Note: Having some cancer symptoms/signs doesn't mean one has cancer. Also, many cancers don't have clear signs/symptoms, especially during the early and middle stages.

General Signs/Symptoms of Cancer
- Unexplained weight loss
- Fever
- Fatigue
- Pain
- Skin changes

Signs/Symptoms of Specific Cancers
- Changes in bowel/bladder functions
- Sores that don't heal
- White patches in mouth or on the tongue
- Unusual bleeding/discharge
- Thickening or lump in part(s) of the body
- Persistent Indigestion or swallowing difficulties
- Persistent, "nagging cough or hoarseness"
- Other major changes in how one feels or one's body functions

Signs and Symptoms of Cancer

- Treatment resistance
- Types of treatment (e.g., surgery, chemotherapy, radiotherapy)
- Treatment approaches/aspects (e.g., palliative care, precision medicine)
- Other treatments (e.g., hyperthermia, complementary medicine)

Cancer Treatment

User-Created Sources
- Cancer Tutorial | Sai Chengalvala

Primary Sources
- PeeWeeToms

General 
- Alliance for Aging Research
- American Association for Cancer Research (AACR)
- American Cancer Society
- Cancer.Net
- Demystifying Medicine
- Doc Unlock
- HealthCareInsider
- Healthcare Triage
- Mayo Clinic | Mayo Foundation for Medical Education and Research (MFMER)
- MD Anderson Cancer CEnter
- NIH - National Cancer Institute
- Rogel Cancer Center | Michigan Medicine

Journals Used
- The Lancet 
- The Lancet Oncology
- Nature Reviews | Clinical Oncology

*Note: This list excludes the references that are only used for the node "COVID-19 and Cancer Comorbidity" and its children. If I include them here, this list will get too crowded and hence will become less useful.

Cancer | References Used

According to the American Cancer Society (original source) and https://cancer80.weebly.com/ (secondary source), 
- In the USA, 1 in every 3 people will get cancer at some point in their lives, and cancer causes 1 in every 5 deaths. 
- Most of us will have a parent, sibling, relative, or friend who eventually dies from cancer.
- Cancer takes a financial, emotional, and psychological toll on patients and caregivers.

Impact of Cancer

According to the American Association for Cancer Research (AACR),
- 4 in every 10 cancer cases are preventable.
- Tobacco smoking (19%), excess body weight (8%), alcohol (6%), UV radiation (5%), poor diet (5%), infections (4%), and sedentary lifestyles (3%) are the main preventable risk factors for cancer.
- Numbers in parentheses indicate % of US cases in adults age >30 attributable to the indicated risk factors.

The above content is copied verbatim from Venkata Chengalvala's website https://cancer80.weebly.com/prevention.html.

Preventable Causes of Cancer

Financial toxicity is when patients struggle with the severe financial burden of cancer treatments. It causes severe distress -- sometimes more than the cancer itself -- even pushing many patients to skip treatment.

Cancer | Financial Toxicity

Cancer health disparities are differences among populations in their treatment and diagnosis of cancer. This is due to social, environmental, and economic disadvantages. 


Cancer Disparities 

Mutant HTT (huntingtin) directly interacts with p53, a tumor suppressor whose mutation is responsible for breast cancers, in mice and flies. Although not always, the phosphorylation of HTT can also induce neuro protectiveness in individuals with Huntington’s and can help regulate cell differentiation and localization. Overall, there is 80% less rate of cancer amongst people with Huntington's than the normal population.

Connection Between Cancer and Huntington's

Cancer forms in the cells of the breasts. Breast cancer can occur in women and rarely in men. Symptoms of breast cancer include a lump in the breast, bloody discharge from the nipple, and changes in the shape or texture of the nipple or breast.

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