I have a friend who has metastatic breast cancer (stage 4) and is on chemo every 3 weeks for life. 5 year survival is pretty bleak, and she is 4.5 years in.

She just got over covid and is days past her isolation period. Of course as is common she is still testing positive. Her oncologist is insisting on 2 negative tests and has suspended her chemo until that happens. I am worried about her. How does this make sense?

She has shared cdc info with her oncologist and the doctor is digging in his/her heels and insisting on negative tests. I don't understand it. I asked her if maybe a consult with another doc was needed; I don't know if she will do that.

Cactus Jack said:

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Neti pot or nasal lavage device may help clear out some of the dead virus that's getting picked up. Just make sure the water is sterile and all directions are followed.

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Shouldn't be required. But could be a last resort, unless the patient doesn't mind switching oncologists.

jopatura said:

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If the oncologist works for a bigger group, she needs to start going above him to his boss. Also may try reporting him to the medical board because he's refusing to treat her.

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I would consider going up the chain as well. Start with her primary doc calling the oncologist and being like "what's up" and work her way up.

Without knowing the exact chemo protocol, the only concern I can think of is that if she is somehow immunosuppressed maybe he somehow thinks she can remain infectious beyond the standard 10 days. Bringing someone like that into clinic with other immunosuppressed individuals could be bad.

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the only concern I can think of is that if she is somehow immunosuppressed maybe he somehow thinks she can remain infectious beyond the standard 10 days. Bringing someone like that into clinic with other immunosuppressed individuals could be bad.

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That was my thought initially but I doubt they have folks doing chemo in close quarters right now. But I have no idea.

Thank you all for your input. I passed the netti pot idea on, I'll pass the rest on as well.

Here is what the oncology nurse said to her when she pushed back and asked about the cdc:

She tried to tell me that you are shedding the virus and since the treatment room is full of people without an immune system they have had spread that way. They won't let nurses come back either without a negative test.

Nurses can't come back without a negative test? That seems extreme. Can't you test positive for up to three months? Just out of curiosity, how big is this oncologists office and what general area is it in?

Jackal99 said:

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Nurses can't come back without a negative test? That seems extreme. Can't you test positive for up to three months? Just out of curiosity, how big is this oncologists office and what general area is it in?

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San Antonio - I believe in the medical center area. I don't know how big the office is.

My friend said she has been talking to her Stage 4 support groups and while this isn't universal it has happened, and has caused some of her friends to have cancer growth due to not receiving chemo for extended periods.

And yes, you can test positive for months and months but CDC says after 10 days you aren't shedding the virus in loads that are contagious.

She called MD Anderson and they have a similar policy.

That's awful. I'm sorry.

88planoAg said:

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Jackal99 said:

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Nurses can't come back without a negative test? That seems extreme. Can't you test positive for up to three months? Just out of curiosity, how big is this oncologists office and what general area is it in?

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San Antonio - I believe in the medical center area. I don't know how big the office is.

My friend said she has been talking to her Stage 4 support groups and while this isn't universal it has happened, and has caused some of her friends to have cancer growth due to not receiving chemo for extended periods.

And yes, you can test positive for months and months but CDC says after 10 days you aren't shedding the virus in loads that are contagious.

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Sorry for your friend. My wife is 19 months into a stage 4 diagnosis. So far, she's battling it well. May I ask you two questions?

1) How did your friend handle COVID? Symptoms? Severity?

2) Can I get the name of the support group? May need that if next set of scans don't show improvement.

Modern day Leprocy.

Blast their assess on social media. Call them out. This is total bullshlt.

Sad story. Strongly recommend a different doctor, but know that takes time for chemo changes; can she just go get an antigen test vs. PCR? She shouldn't, surely/legally, be required to use the oncologist' recommended lab/test.

PCR cycling false positives are a known problem for previously infected persons, and one would think the doctor would know this but again doctors are often not diagnostic test/statistics experts.

https://health.ucdavis.edu/health-news/newsroom/different-types-of-covid-19-tests-explained/2020/11

Aries said:

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I am an oncology nurse for a free standing out patient clinic. This is absolutely not what the cdc says. After 10 days as long as there isn't a fever, she is cleared. We do not require any negative tests on patients or employees after 10 days because the CDC says it isn't required.

When tests were required this summer, we had a patient test + for 6 weeks. After that we said screw it & just stopped testing her.

She needs a new oncologist.

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The problem is she called MD Anderson which is her fallback and found they have basically the same requirements. She doesn't know where to turn and is just hoping for a negative test soon.

aggiebrad94 said:

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88planoAg said:

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Jackal99 said:

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Nurses can't come back without a negative test? That seems extreme. Can't you test positive for up to three months? Just out of curiosity, how big is this oncologists office and what general area is it in?

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San Antonio - I believe in the medical center area. I don't know how big the office is.

My friend said she has been talking to her Stage 4 support groups and while this isn't universal it has happened, and has caused some of her friends to have cancer growth due to not receiving chemo for extended periods.

And yes, you can test positive for months and months but CDC says after 10 days you aren't shedding the virus in loads that are contagious.

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Sorry for your friend. My wife is 19 months into a stage 4 diagnosis. So far, she's battling it well. May I ask you two questions?

1) How did your friend handle COVID? Symptoms? Severity?

2) Can I get the name of the support group? May need that if next set of scans don't show improvement.

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I'll ask for the names of the support groups. She has described them as a mixed blessing, because she loses friends so often.

Re covid, she described it as bad 'much rather have the flu'. She was prescribed medications - steroid, antibiotic and nebulizer. No hospital and she recovered within the 10-12 day timeframe but fatigue and out of breath with exertion have lingered.

She says this is a good place to start. This one is general, there are others that are more specific re: subgroups like age and religion. They are all closed groups so no direct link available.

88planoAg said:

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Aries said:

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I am an oncology nurse for a free standing out patient clinic. This is absolutely not what the cdc says. After 10 days as long as there isn't a fever, she is cleared. We do not require any negative tests on patients or employees after 10 days because the CDC says it isn't required.

When tests were required this summer, we had a patient test + for 6 weeks. After that we said screw it & just stopped testing her.

She needs a new oncologist.

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The problem is she called MD Anderson which is her fallback and found they have basically the same requirements. She doesn't know where to turn and is just hoping for a negative test soon.

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The real problem is that she probably didn't get a complete answer. A PCR positive after 2 or 3 weeks post-symptoms wouldn't mean anything to an oncologist/epidemiologist who knows what he/she is talking about regarding covid PCR testing.

The person who answered the phone was probably reading over a flowchart response without such clinical awareness.

Bassmaster said:

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That is not MD Anderson's policy. My wife works there. Tell her to talk to someone else. MD Anderson requires them to wait 20 days and no negative test required.

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Thank you! Will pass that on!!!

Bassmaster said:

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That is not MD Anderson's policy. My wife works there. Tell her to talk to someone else. MD Anderson requires them to wait 20 days and no negative test required.

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Is there a name I can pass on to her, someone specific to talk to? Or a written policy I can point her to?

Yes probably.

88planoAg said:

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I have a friend who has metastatic breast cancer (stage 4) and is on chemo every 3 weeks for life. 5 year survival is pretty bleak, and she is 4.5 years in.

She just got over covid and is days past her isolation period. Of course as is common she is still testing positive. Her oncologist is insisting on 2 negative tests and has suspended her chemo until that happens. I am worried about her. How does this make sense?

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Dad's oncologist suspended chemo after third administration.

Dad had some significant side effects from the chemo and the oncology team stated they just do not know the long term risks associated with Covid positive patients continuing chemo.

As far as Covid, dad did not show serious side effects requiring hospitalization.

Chemo (doxorubicin/sisplatin) caused significant drop in heart rate, oxygen saturation and BP.

One thing we do on all doctor visits is have someone either with Dad or listening on the phone and writing everything down that is discussed.

Good luck!