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‘Cancer doesn’t stop’ with coronavirus. Here’s how Tampa Bay patients manage the risk

Essential treatment often can't be postponed, so doctors are having to tweak treatments for high-risk patients during the pandemic.

Austin Gavin was on vacation in South Carolina when the coronavirus began to spiral out of control in his home state of New York.

Cases were spiking in March. So was the death toll. An emergency hospital tent was built in Stony Brook, his hometown. Gavin, 72, was supposed to return in May to begin chemotherapy to treat his prostate cancer.

He searched Google for the best cancer hospitals in the country. Instead of going back to Memorial Sloan Kettering Cancer Center in New York as planned, Gavin went to the Moffitt Cancer Center in Tampa, which he thought was a safer choice.

“The whole world changed for all of us,” Gavin said. “And the whole world had to deal with the virus, and then for those of us going through cancer treatment, we had to worry about not only COVID-19 but cancer as well.”

As the world continues to adjust to the ongoing coronavirus pandemic, patients and families in need of critical cancer care have had to take extra precautions. The essential treatment cancer patients seek often can’t be postponed, so clinics like Moffitt have had to operate under stringent new protocols to continue to provide needed care while keeping staff and patients safe.

“Cancer doesn’t stop with COVID-19,” said Dr. Jeffrey Lancet, an oncologist and researcher at the Moffitt Cancer Center. “People are dealing with very serious advanced illnesses that require treatment and need to be addressed sooner rather than later.”

Like other hospitals in the area, Moffitt staff are taking extra steps to lower the risk of virus transmission, which includes requiring masks, relying on more on telehealth consultations and limiting visitors. But doctors have also had to get creative in how they treat patients, many who are are high risk for contracting COVID-19 because of their compromised immune systems.

Bone marrow treatments, which are a commonly used in some cancer patients, have been delayed because of the high risk of immunosuppression that can last for months if not years, Lancet said.

“For patients in whom transplant is more elective, it may not need to be done next month as opposed to six months from now,” Lancet said.

In adapting to the pandemic, Dr. Nikhil Khushalani, an oncologist who specializes in solid tumors at Moffitt, has opted to use oral medication over more invasive immunotherapies because it lowers the risk of inflammation in the body.

“This is a higher risk population that we just have to be more cautious about,” Khushalani said.

In March, Amy Sapien, 40, was diagnosed with invasive lobular carcinoma, a form of breast cancer. She began chemotherapy in July, and has been holed up in insolation for months to protect both herself and her eight-year-old son, Landen, who is also undergoing treatment for T-Cell Acute Lymphoblastic Leukemia.

The pandemic impacted Sapien’s treatment plan at Moffitt. A double mastectomy wasn’t an option, her surgeon said, because the hospital couldn’t afford to double the operating time and resources during the pandemic when only a mastectomy was needed.

Because of coronavirus, she also went into surgery alone.

“They removed part of my body and I didn’t get to see anyone I knew in person for an entire day,” Sapien said. “(I) woke up nauseous and in pain. I had strangers to comfort me wearing masks so I couldn’t see their expressions.”

The risk of contracting the virus also impacted Sapien’s routine at home, she said. She hasn’t been inside a grocery store in a year, and more recently has stopped chatting with the Shipt delivery driver. She pulled her children out of school and daycare. Meals dropped off by well-meaning friends are left untouched on the doorstep.

A sign on the front door of the Sapien home in Tampa, warns visitors of the treatments being received by Landen Sapien, 8. His mother, Amy,  is also receiving cancer treatments.
A sign on the front door of the Sapien home in Tampa, warns visitors of the treatments being received by Landen Sapien, 8. His mother, Amy, is also receiving cancer treatments. [ SCOTT KEELER | Times ]

When she isn’t at doctors appointments, she’s caring for her ill son. She administers his chemotherapy shots at home and prepares his daily medication. In her few minutes of spare time, she’s online researching how coronavirus affects children.

“(Landen) is very frustrated because you know, I made a lot of promises about life turning back to normal,” she said. But then “COVID-19 happened and all of it went away.”

He can no longer visit his cousins because of the health risks, Sapien said. He spends most of his time playing video games online as a way to make friends.

Sapien, a social worker, also posts regular videos on Facebook pleading for people to wear a mask to keep her son safe. Even if the odds are low of contracting COVID-19 because of their extra precautions, she said the rising numbers across the state still terrifies her.

“I’m putting on a very brave face but I’m absolutely terrified every day,” she said. “There’s a virus that we could have done something about and people were so selfish.”

Sapien added: “I just assume that if it makes its way into our house there’s going to be a fatality.”

Gavin, the cancer patient from New York, packed his car and drove to Tampa in late March with his wife and two dogs without even knowing where they would stay. At the time, Florida was mandating visitors from New York to quarantine for two weeks and with his New York license plate, Gavin worried he wouldn’t get through. A social worker at Moffitt helped him, he said.

After more than two months and 32 radiation treatments, Gavin returned to his vacation home in Myrtle Beach. His last day of treatment in Florida was June 4.

“I wrote a proclamation on my last day,” he said. “I plastered it all over the hospital walls on the hospital doors, elevator doors just thanking everybody for what they did.”

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