Hello, and welcome to PBS39 and WLVT community update on coronavirus.

It's presented by Capital Louw and brought you with help from our community partner Lehigh Valley Health Network on this International Women's Day We are live from the PBL Public Media Center in Bethlehem.

I'm Brittany Sweeney.

Our guests today included Cancer Doctor to discuss what Covid-19 and the vaccines mean for those with cancer, as well as someone who has helped breast cancer patients in particular navigate these trying times.

They'll be with us in just a few moments.

If you've a question, you can give us a call.

The phone number is 44 8 2 1 0 0 0 8.

Our guests will answer some of your questions live, plus our daily coronavirus updates.

Be sure to sign for our newsletter.

You can do that at our website coronavirus Lehigh Valley .org.

You can find helpful information there in both English and Spanish.

Now let's take a look at today's top headlines.

Fully vaccinated people can gather with others who are also fully vaccinated without a mask or social distancing.

That's the new recommendation out today from federal health officials.

The CDC also said those vaccinated can be together in a household in the same way with other healthy low risk people.

However, the CDC continues to warn people about traveling, saying when they see a spike in travel, they also see a spike in Covid cases.

Recommendations still stand for everyone vaccinated or not to wear a mask and social distance while in public.

Meanwhile, Pennsylvania today reported 1658 new coronavirus cases and seven more deaths.

That brings the total number of infections since last March to more than 950,000 with 24 thousand 356 deaths over three and a half million vaccinations have been administered through yesterday.

That includes almost a million people who have received two doses and are fully vaccinated against Covid-19.

And in the Philly suburbs, county officials are unhappy over the size of the vaccine allotment they're getting from the state leaders of Bucks Montgomery, Chester and Delaware County say a meeting yesterday with Governor Tom Wolf.

Top health official was, quote, disappointing and frustrating.

They say they're not getting the allotment they should, which has led to long lines, waits and cancellation of second dose appointments.

They also say the state has been unable to explain how each county's allotment is determined.

It's time now to meet our guests for the day.

Dr Lori Alphons is deputy physician in chief with LVHN Lehigh Valley Cancer Institute.

Also here is Lisa Spencer.

She helps breast cancer patients navigate their treatment at the Penn State Health St Joseph's Cancer Center in Reading.

Thank you both so much for joining us today.

Lisa, we'll be with you in just a few minute.

We want to begin today with Dr alfond.

Thank you so much for being here.

Brittany, thank you for having me.

It's a great opportunity.

Absolutely.

We are happy to have you, doctor.

The pandemic has been bad enough, but battling cancer in the midst of all of this, I'm sure that it has to be overwhelming.

So what are some of the considerations cancer patients need to take into account right now and during this whole pandemic Gamma Well, the pandemic has been an unwelcome surprise for many of us.

And lagging on much longer than we expected.

But cancer never stops and we recognize that here at Lehigh Valley.

And so, you know, cancer patients need to consider the treatments that they that they require to cure them of their disease.

And to live a healthy lifestyle.

We're obeying all of the quarantine rules where wearing masks, it's as safe as can possibly be for their treatments.

And so, you know, one of my patients actually said to me it's overwhelming when I think of both Covid and my cancer treatment.

If I think of just Covid, I can kind of be OK about that.

If I think about my cancer treatment, I can handle that.

But it does get overwhelming at times.

And I think we also need to support our patients both from a medical point of view and an emotional point during this rough time.

Sure.

Dr - is having a history of cancer making more susceptible to the coronavirus.

Whether you're in remission or you're going through treatments right now, not necessarily so.

Current cancer treatments may some what increase your risk as they do in non pandemic times.

Certain systemic treatments may compromise your overall immune system, but actually wearing a mask washing hands and maintaining social distancing is helping to maintain that safety for cancer patients.

Once treatment is over, the biggest risk for these cancer patients tends to be the population has chronic medical conditions, heart conditions, lung disease, obesity, things like that.

Continue to be risk factors for not necessarily contracting, but maybe not performing as well.

If Covid is contracted.

Sure.

And when it comes to the vaccine, people who have cancer and or are going through cancer treatments, can they get the vaccine right now?

We feel that's generally safe.

Now we encourage every patient to have the discussion with their provider.

I actually spoke with one of my peers today in medical oncology.

That's the doctor who provides chemotherapy to patients.

And the recommendation is if the patient can get the vaccine, we definitely want them to have that vaccine, but not to obtain either of their injections, number one or number two on the same day as a day of infusion or systemic treatment.

Sure, there's been concern over people who are getting a mammogram and some then getting their vaccine or vice versa.

Is there some conflict of interest there?

Is there something that's causing different results for people who are getting a mammogram who may have had the vaccine?

There is and unfortunately, hindsight is 2020 makes sense to us because the vaccine is designed to instill an immune response.

And so people that were actually getting mammograms on their regular yearly screening schedule and had just had one or two doses of their vaccine.

We were seeing an increase in lymph node prominence, particularly under the armpit.

What we call the Xilla sometimes along the chest wall and sometimes above the clavicle.

So what we are recommending first and foremost is if you are asymptomatic, you're not having any problems, you're just going for your regular yearly screening mammogram.

We definitely suggest that you get that mammogram four to six weeks after your second vaccine dose.

More importantly, if you are experiencing a symptom such as a palpable abnormality or you've had cancer and you notice some new change, we are not slowing down diagnostic imaging.

Diagnostic imaging is what we prescribe to patients with a symptom and we do not want you to wait four to six weeks if you are having symptoms such as a palpable mass or a visible abnormality.

But if this is a regular screening test, we want you to wait four to six weeks after both of your injections have been complete.

Dr Alphons, are you seeing patients throughout this pandemic maybe early on?

Have you seen patients who may be put off getting treatment or put off coming in to get something checked out because of the coronavirus for fear that they'll pick it up if they go out or that kind of thing?

Are you seeing kind of a lag in and people coming in?

Unfortunately, in the beginning we did.

And that was for a variety of reasons.

I think patients were fearful because there was an edict for us really to stay home and to not go out and do anything in.

Our network was very, very careful at minimizing provider exposures to the disease by changing visits from in-person to virtual.

We cut back on our visits available for people to get screening tests that they may not have needed.

And we were very careful at rolling out our surgical interventions at that time to minimize exposure.

But as time has gone on and we're getting smarter about how this disease is contracted and of course how the vaccines are coming out, I think people are being a little bit better about getting the health care that they need.

Knowing that we're taking every precaution to keep them safe, wearing masks, even our waiting rooms are socially distant.

Are mammographic screening equipment is cleaned between every single patient and the waiting rooms.

You'll see the chairs are spread out.

Everybody's wearing a mask, an appropriate eye protection.

So I think in the beginning it was kind of a delay on both ends, us wanting to provide safe care for our patients until we had better recommendations and from a patient point of view, fearfulness of contracting the disease.

But I think we've gotten smarter and I think that lag is slowly but surely catching up.

Sure.

What are some of the biggest challenges that have faced people who are fighting cancer right now and through this pandemic?

What some of the challenges they've had?

I have to say the biggest challenge that I have seen and heard from patients is the inability for them to have the family support that they need from social distancing point of view from having to come in for surgery and not being able to have a loved one, stay with them coming in for systemic treatment and not being able to bring somebody to sit with them while they're getting their IV chemotherapy and social support and emotional support is so important when you're going through cancer because it doesn't just affect one person.

And I think that's probably the single most difficult thing that our patients have had to deal with during this pandemic.

Aside from worrying about maintaining their safety, getting their treatments and staying healthy from pandemic Covid point of view, absolutely.

Moral support is so important in any health aspect, but especially when you're going through something like that.

Let's get back to the vaccines.

Is there one particular vaccine that cancer patients should or should not get that's on the market right now?

We have the three we have Moderna, we have Pfizer, we have Johnson and Johnson.

they lean towards one overhould- another?

There's no evidence that suggests that one over the other is safer, better, more important or less effective for cancer patients.

I encourage our patients to definitely get the vaccine when they can.

I've been vaccinated through Lehigh Valley as a health care provider and it was able to sign up.

And the day that I went I got a Moderna vaccine and our network does ensure that you're going to get the second Maduna a vaccine or if you've got the first phizer you're going to get the second phizer.

So we're very careful about making sure that the secession of vaccines is appropriate.

But there's no one vaccine that is more effective or less effective, particularly for% cancer patients.

OK. And does cancer does having cancer prioritize you for getting the vaccine?

And in addition to that, is there any major difference side effects that's happening to people who are getting the vaccine and fighting cancer at the same time?

Cancer can prioritize them for getting the vaccine.

And for instance, if patients sign up through my LVHN, there's a host of questions that they will have to answer.

And one of those questions or one of those answers or one of those topics should be emphasizes that I do have a current cancer because that is something that will prioritize them just a bit for getting the vaccine sooner if they're not in the appropriate tier or age bucket at the current time.

There's no real difference side effect that a cancer patient undergoing any kind of cancer treatment will get that the average person not having cancer or not currently undergoing treatment would get.

But people respond differently.

And if you think about cancer treatment in general, we can give the same IV therapy to 10 different patients and they can all react a little differently because our genetic makeups are systems are different also.

So I do tell patients that because I'm a surgeon and so I tell them to please get your vaccine when you can but plan not to get it the day before our planned surgery because I want them to feel good and I want them to come to surgery feeling as competent, as rested as they possibly can.

And sometime 18F, sometimes low grade fever, sometimes chills, sometimes just not feeling well can happen after a vaccine.

Even something as simple as a sore arm can make you feel uncomfortable and unsteady.

If you know you have a surgery planned or a cancer treatment plan.

So I do tell them to kind of keep an eye.

Be conscious of when your vaccine is planned and we'll work around it.

But there's no real different side effect that a cancer patient will have after the vaccine that somebody's not currently undergoing treatment may not have the same thing.

Dr found some great information there.

I've heard throughout this pandemic of some places sending the chemo treatment home with patients for them to do it at home because of the coronavirus.

Did you have that experience at patients Gamma What does that entail?

If you did well, we had a lot of modifications that were necessary and most of them were spreading out treatments, making infusion hours a little bit longer.

There are some infusion treatments that can be given from home and our infusion nurses are great at providing what we call toeach sessions where we actually sit down with the patients and teach them how they're going to do their infusion, how they're going to care for their IV site.

Most of these patients have infusion ports that are underneath their skin that can be done.

There's a a immune booster, a Whitesell booster that we give to breast cancer patients that can now be done from home and that really was available kind of right before the whole surge pandemic can happen.

So we don't send patients out with a piece of paper and a medicine bag and say, OK, good luck.

It's always better if we can observe them because if they're going to have a side effect or a reaction, we'd like to know about it and be there to be Finally, Dr Alphons, I just wanted to ask how you think cancer treatment will be changed forever because of this pandemic.

What are some of the things you think will remain in place after this year?

The number one thing that I think is going to be part of our future, particularly as health care providers and especially cancer providers is that I'm may be able to see my patients full face because they not may not be wearing a mask, but I'm pretty sure health care providers are going to be wearing masks.

Well, into the next months and even years, just from a safety point of view, I think we may keep social distancing for an extended time period and pay closer attention to making sure that our patients visits are safe and spread out.

In terms of waiting rooms, I think those kinds of things are not going to go away.

I also think there are some patients for a variety of reasons who if they can minimize their exposure to the health care forum and have virtual visits, have visits with their doctor just like we're doing right now.

This is a you know, a safe way to have a visit go over any questions, make recommendation for patients where they can see their doctor from the privacy of their own home.

And I don't think virtual medicine is going to go away anytime soon.

And that may benefit from the pandemic, especially for perhaps our patients who have problems, transportation or mobility.

But I think the mask I think some attention to keeping social distancing and definitely virtual medicine is going to be part of our future.

Sure.

A bit more convenient, so to speak.

Well, Dr Lori Alphons from Lehigh Valley Cancer Institute, thank you so much for joining us today with that great information.

Thank you.

Brittany, as we continue this community update on coronavirus on PBS39, you can hear the rebroadcast on the radio tonight at 9:30 90 1 3 WLVT R. Now let's bring in our next guest.

Lisa Spencer is a breast cancer patient navigator at Penn State Health, St Joseph and Reading.

She has helped many breast cancer patients through the past year.

Lisa, again, welcome.

Thank you for joining us today.

Oh, thank you so much for helping me.

It's a real property that I can talk about.

What I do for patients.

I'm a supporter of things.

Absolutely.

We are very interested in what you have to say.

And on this international women's Day, I'm hoping you can give us an idea or some example of the resiliency of women that you've seen in this past year.

Can we start there Gamma Oh, my goodness.

There has been so much.

I mean, my patients say come for their treatments, gotten their testing everything while trying to stay healthy and to social distance.

We did have a stop of screening mammograms for a couple months from March to me last year.

But as soon as women were able, they started coming in for their screenings to make sure that their breast helped was good and that they had their yearly exams.

So women this past year and every year or some.

Absolutely.

Lisa, if you could just get into a little bit of what's a breast cancer patient navigator does for the patient, for someone who's going through maybe treatment or just learn that they have cancer Gamma Sure.

Here at Penn State, a health St Joe's, I connect with the patients almost literally on their day of diagnosis and sometimes actually on the day of diagnosis.

I work closely with the surgeons and the radiologist here that do the biopsies and I often sit with the patients and the physicians when they're getting their diagnosis.

I tell the patients I kind of become their go to girl.

I'm their point of contact.

I help them schedule appointments.

I make sure that they're getting appropriate care.

They can call me literally any time to ask questions to get clarification, to get just a little bit of support when they're going through a hard time.

I also run the multi disciplinary breast clinic here for newly diagnosed women.

We have a team that meets weekly and will see the patient and give the recommendation shin of an entire team of physicians.

Jones that include the pap colleges, the radiologists, the medical oncologist, the radiation oncologist who.

And all the surgeons, plastic surgeons.

Whoever might touch a breast cancer patient during the initial phase of diagnosis.

So I just do whatever is needed to get them through diagnosis into treatment.

And beyond really.

Lisa, we just heard Dr Alphonse say one of the biggest challenges is that these patients, many cancer patients can not have their family with them when they're going in for treatments, that kind of thing.

I can only imagine that that's made your role even more vital, more important.

Have you seen that first-hand?

Absolutely.

A lot.

My patients are lonely.

Sometimes they can be in the infusion room for five, six, seven, eight hours.

And often I will circulate through the infusion stop and talk to all the patients, not just the breast cancer patients.

I sit with some of them that need a little special attention.

This past year I've gone with patients to surgeons subpoint and it's since I'm here that way I can come in and I can put family members on a cell phone and just help the patients to know that somebody is there that understood stands.

The information that they were given can repeat it back to them or tell their family.

So it's really been a very busy year trying to support everybody through such a really tense and stressful time.

It was really tense in the beginning.

Sure.

And not only a pandemic, but then if you're going through cancer, that's a really scary situation as well.

I couldn't imagine.

And then you throw a pandemic on top of that.

So what are you hearing from your patients?

different now than it was a year ago.

But what have you heard from your patients throughout this entire pandemic?

Oh, gosh, The stress was really terrible in the beginning.

Patients didn't want to come in for their treatments.

I had to assure them that we were cleaning and trying to keep it as safe as possible for.

For everybody we have patients that lost jobs, lost insurance and became financially strapped and were afraid to continue their treatments because of eye pain.

I had patients who delayed their surgeries and were just afraid to proceed.

They were more afraid Covid than their cancer in the very beginning.

So it's been a lot of your for hours and hours of phone calls and face to face discussion and convincing people that they need to get the care they need for their cancer.

And we would take care of trying to keep them safe from Covid when they were here.

So between stress and being afraid to come into the hospital, it's been really quite interesting and very, very hard on the patients.

I'm sure.

I'm sure, Lisa and I'm sure that makes the victories, the successes is the.

I beat it that much sweeter when you hear from your patients.

Oh, absolutely.

You know, I'll get a call from somebody now saying I can believe I went through all of that when the rest of the world was dealing with their pandemic.

And I to go into the hospital no matter what because I needed my treatment.

But everybody is lay out.

They kept going.

And though women they had started their treatments last year, some of them are just finishing now and everybody is pretty much stayed safe, fan and healthy, had been able to get through it with just a few bumps along the way shore, Lisa.

And we talked about what a patient navigator does.

But how has your job changed because of all of this?

What's different now Gamma Well, I guess I this past year I have done much more in relation to helping patients get insurance.

A lot of Medicaid applications I've had to search for financial grants and things to help because let's say a spouse has lost their job or they're hours work Hellertown.

So I'm done much more.

Financial Hina and things.

I would have to say that I though I'm always Kaner and the cheerleader mode.

I have to really work hard encouraging women to come in and get their treatment done and kind of power through it and dyball so Hampton sit more with patients during appointments and Taina taking the place of a family member, some aspects.

So it's been a busy year.

Absolutely.

Lisa, it seems like your role now is more important than ever.

We want to thank you so much, Lisa Spencer from Penn State Health St Joseph's Cancer Center for joining us today.

Thank you.

And we want to thank both of our guests for being with us today.

And we thank you for joining us for Community Update Coronavirus.

We'll be here at 4pm each Monday, Wednesday and Friday on PBS39 and on the radio 9/30, those same nights on WLVT News.

We'll be back Wednesday at 4:00 to talk about how meals on Wheels is contributing to get more people vaccinated against Covid-19.

If you have a question, you can always give us a call at 4 8 4 8 2 1 0 0 0 8.

Leave it on social media or our website PBS.

39 .org for PBS39 WLVT News, I'm Brittany Sweeney Stacy.