It's like being in prison inside a prison. Having advanced cancer while being wary of the COVID-19 virus really sucks. I am speaking both as a doctor and as a person with cancer – since 2016, I have lived with stage 4 lung cancer.
The threat of cancer hangs in the air like a gun to your head. It makes you think about risks and survival odds. It forces you to confront the fact that you may die sooner than you'd imagined.
It's a terror that the coronavirus is only making more palpable. COVID-19 is another reminder of the fragility of our lives. And even if a person with cancer manages to look away from the idea of mortality, the virus will bring it back into view.
Your body is already tired from "fighting" cancer. And your mind has very little bandwidth to decide, if the question arises, which enemy is more dangerous: the cancer cells or the virus.
In fact, for people with malignancies, especially those treated with chemotherapy, it is impossible to separate the two threats. They are among the most vulnerable in this epidemic because chemo can weaken the immune system. They are exposed to a higher risk than the general population, and we need to pay attention to them.
Even before this epidemic, people with cancer already had many challenges and unmet needs. Cancer and its treatment often leave patients with pain, fatigue, and limitations in terms of what they can do on a day-to-day basis. Many patients deal with emotional and mental health difficulties.
Financial stress is a challenge for most but the affluent, especially if they have to reduce their work hours or stop working altogether.
Navigating the complex health system and the often inadequate health insurance only adds to the burden of living with the illness.
This epidemic will make the struggle of cancer patients worse. In places where social distancing is recommended, they need to stay home. They may be forced to stop working if they can't work from home, or they may face layoffs. They could end up losing their health insurance.
Patients who depend on others for basic needs, like shopping and transportation, may find less reliable help as their aides isolate themselves or become sick.
Those who receive emotional support and information from centers that provide in-person services could be cut off from immensely needed resources.
Most important, medical care will likely be jeopardized when the health-care system becomes overwhelmed. Many experts have started talking about advanced cancer patients not receiving life-saving care if the situation of scarcity becomes real. This is all scary to the cancer community.
Yet people with cancer are perhaps better prepared than many to face an existential threat. We've developed resilience and learned to live in the here and now. When you confront your mortality, you realize that life is finite — there no time but to become your true, authentic self. You start to judge what you do by your own standards and express yourself truthfully.
You also become empowered to claim a voice to advocate for yourself and the community. Because if you don't speak up, perhaps no one will.
This epidemic is isolating people who were already isolated, and we need to find ways to stay connected with them. Reach out virtually to your friends, especially the ones who are struggling or those who have serious illnesses. Say hi and tell them you are thinking of them.
We can try to make room for everyone to express their raw emotions, their honest feelings. Let's find creative ways to do that. Art and writing can help some, and so does humor. Listening to the person who is suffering is also good. Do not jump to volunteer solutions. Just be there and listen.
We can stand in solidarity with those who suffer. We can advocate to ensure accommodations are made for those who need them and that the essentials are available for everyone.
I am sure someone needs grocery shopping, transportation or a cooked meal. If you have two rolls of toilet paper or two containers of hand sanitizer, give one of each to someone who needs them more.
I drove around Seattle tonight, and oh, how much I miss the old city! And it's only been a couple of weeks. I know that our resilient city will again be lively and active. But in the interim, we mustn't forget those living on the margins.
This epidemic reminds us that no one is immune to illness. When we are busy trying to survive individually, let's not forget the other person, and especially let's not forget those who have been ill for a while.
As our society faces an illness that is serious and devastating, we, cancer patients, can share a few lessons from dealing with our infirmities. With support and care, you can find the strength to carry on. You keep going, and you give it your best shot. And always try to remember: Today is a gift.
Morhaf Al Achkar is a practicing family physician and a faculty member at the University of Washington. He is the author of Roads to Meaning and Resilience with Cancer.