Before a cancer patient can come in for treatment or a doctor’s appointment, pre-screening for COVID-19 is the first step.

Nicole Reimer, clinical director of several centers in the Lehigh Valley Health Network Cancer Institute, said pre-screening takes place the day before a patient’s visit. It involves a series of questions to determine if the patient has COVID-19 or has been exposed to the virus.

Pre-screening isn’t perfect, but it does help to discover which patients are having symptoms of COVID-19. Those who are asymptomatic are tougher to find.

“It’s been very challenging,” Reimer said.

Asymptomatic means that a person is infected with the virus, but does not have any symptoms, and probably doesn’t know he or she is infected. It also means that they are contagious.

If a person develops symptoms, then the time before the symptoms appeared is referred to as pre-symptomatic.

The American Cancer Society listed the most commonly reported symptoms on its website. These symptoms include: fever, cough, shortness of breath, chills, muscle aches and pains, sore throat, new loss of smell or taste, feeling very tired, headache, diarrhea, nausea or vomiting, and runny nose. The symptoms usually appear within two to 14 days after being infected.

Serious symptoms that require immediate medical attention include: trouble breathing, constant pain or heaviness in the chest, new confusion or being hard to wake up, and bluish lips or face.

According to the cancer society, some people who have the virus also experienced symptoms of blood clots. One symptom is bluish toes, also called COVID toes. Swelling of the lower leg, shortness of breath, chest pain, or symptoms of a stroke (such as weakness or numbness of an arm or leg, or slurred speech) can also be caused by a blood clot.

The reasons for blood clots in some COVID-19 patients is still being studied.

For people who do not have cancer but are due for a routine cancer screening, going ahead with it requires some consideration.

Dr. Roberto Fratamico, a hematologist and oncologist at the LVHN Cancer Center in Lehighton, said it’s a matter of assessing the risk versus the benefit and having that conversation with the doctor.