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Coronavirus and cancer

27 Mar 2020 • 6 comments

In the present health crisis, cancer patients require special monitoring and adjustment of their care where necessary.

Are you wondering about the risks associated with your treatments and your movements, as well as the special precautions you should be taking? Let us answer your questions!

Coronavirus and cancer

At this stage, is it risky for me to go to the hospital for my radiotherapy or chemotherapy treatments?


If you need to go to the hospital for your radiotherapy or chemotherapy treatment, precautionary measures have been put in place in the oncology departments to reduce the risk of exposure for patients and carers. Although these measures are specific to each centre, they include the following:

  • The patient should come alone, without their carer
  • Visits are limited
  • The patient's temperature and the lack of symptoms - characteristic of COVID-19 infection - are checked before the patient enters the hospital
  • Hand washing with soap or hand sanitising gel is mandatory at the entrance*
  • A mask may be given to the patient if the department has a sufficient supply of masks. Wearing a mask is recommended for cancer patients in general, however, in the face of the current shortage, health professionals in contact with patients may be given priority
  • Recommended distances must be maintained between patients in the waiting room

You may be vulnerable to coronavirus infection when you come off your radiation therapy, especially if it affects the chest cavity. However, there is not enough data available at this time to determine this level of risk, either for radiotherapy or chemotherapy. It is important to adopt barrier gestures respect the self-isolation measures in all cases.

My treatment or surgery has been postponed, is this bad for the progression of my cancer?

In some cases, in order to reduce the risk of exposure to the virus, your health care team may decide to postpone your operation or cancer care. This is a decision that is adapted to each patient, following a mutual agreement between the medical staff and the patient. If your doctor has decided to delay, it is because he or she does not think it poses a risk for the progression of your cancer within the time frame of the health crisis. Operations and care are not systematically postponed.

It is also possible that your care will be modified to avoid the greatest amount of travel. For example, chemotherapy treatment can be taken orally at home instead of intravenously in hospital. But beware, this is not possible for all treatments!

Tele-consultation may also be encouraged to follow up with your oncologist and receive all the necessary explanations for your treatment.

Many oncology departments also provide psychological support for patients, which is especially important when the fear of infection and a change in care is added to your cancer.

Is it bad if my screening is postponed?

Screening can be safely rescheduled, again within the time frame of the health crisis, if you do not experience any particular symptoms that are suggestive of the cancer being screened.

However, if you do have symptoms, it is vital that you have an investigative examination as soon as possible! Don't hesitate to ask your doctor or oncologist any questions you may have, by telephone or tele-consultation.

Does my immunotherapy or hormone therapy make me more vulnerable to the coronavirus?

It is important to distinguish the concept of immunodeficiency from that of immunotherapy!

Immunodeficiency in the context of cancer is often due to treatment (chemotherapy, immunosuppressants, biotherapy, corticosteroids in immunosuppressive doses) and may increase the risk of developing complications following a coronavirus infection.

Immunotherapy (such as KEYTRUDA, YERVOY, OPDIVO) involves stimulating certain immune cells to make them more effective or make the tumour cells more recognisable to the immune system.. There is currently no scientifically proven evidence that immunotherapy increases the risk of coronavirus complications. The same is true for hormone therapy (such as ELIGARD, NOLVADEX, FEMARA).

Whatever treatments you are taking, under no circumstances should you stop or modify your treatment without the advice of your oncologist. Get a medical opinion before taking non-prescription drugs and products.

If you have previously undergone cancer treatments and have not been treated in several years, your risk of coronavirus complications is the same as in the general population.

I have lung cancer, am I more at risk for complications from COVID-19 infection?

Given the recent discovery of the SARS-coV-2 (coronavirus), we do not have enough evidence and data to confirm that lung cancer is a risk factor. However, according to the NHS, people undergoing cancer treatments are at greater risk of developing a serious form of coronavirus infection. 

Should my self-isolation be more restrictive if I have cancer?

Although barrier gestures and isolation measures apply to the entire population to achieve optimal individual and collective protection, cancer patients should limit their movements as much as possible. The NHS in England is directly contacting people who fall into the extremely vulnerable group. If you have been contacted by the NHS, you are strongly advised to  stay at home at all times and avoid any close contact for at least 12 weeks from the day you receive your letter.

Do not hesitate to have your shopping delivered to your home and if possible, ask someone close to you to help you with everyday tasks to avoid going out (avoiding close contact).

If you have been advised to do some kind of physical activity, do not hesitate to do it at home! For example, the University of Texas MD Anderson Cancer Center, Massachusetts General Hospital Cancer Center and other cancer centres offer exercise videos adapted to the needs of cancer patients on YouTube.

I have cancer, do I need to stop working? What is the procedure?

At this time employers should have taken every possible step to facilitate their employees working from home, if the form of work allows. If you are well enough to work and can do so from home, you can continue working if you so wish. 

If you are too ill to work, you may qualify for Statutory Sick Pay, which is paid by your employer for up to 28 weeks. You can find more information about eligibility and the procedure for claiming it here.

You can find information on employment and financial support by consulting the Government's guidance for employees.

Who can I contact if I have questions about my care?

In general, you should be contacted and informed by the oncology department that provides your care. If this is not the case, or if you have additional questions, please do not hesitate to contact the department by telephone, or to arrange a tele-consultation with your oncologist.

Feel free to share your own or your loved one's experience with cancer by commenting on this article.
Best wishes to all, take care!

 

avatar Camille Dauvergne

Author: Camille Dauvergne, Junior Community Manager France

Camille Dauvergne is currently a Junior Community Manager at Carenity. She assists the France Community Manager in animating the platform, easing member navigation of the site and encouraging them to interact.... >> Learn more

Comments

suep1974
on 01/04/2020

I actually slipped through the net, and didn't actually start shielding until Saturday when I was in hospital - I was admitted due to an infection. On the ward round, my oncology consultant asked me whether I recieved the letter, but I had received nothing at all. On Monday I talked to my GP, who said that although I am on their higher risk list, they are not sending out the letter as it is easily accessible online! What a cop out, and a very good way of people being missed - how are those who struggle with the internet, supposed to access the information?
I finally got my first official government text TODAY, and only due to me filling out the online form at GOV.UK

Michelle1969
on 01/04/2020

I only received a text about being vulnerable today after filling in an online form. 

I’m in the middle of my chemotherapy treatment and when I asked my nurse about having GCSF injections to boost my immune system as they do in other hospitals, she told me that they don’t do that in my trust as it’s too expensive. My oncologist hasn’t been in touch and I dread going in every week for my picc line care. Last week the nurse who changed my dressing & flushed it out had just returned from Romania a few days before. I’ve been self isolating with my family for weeks now but I’m coming into contact with people in hospital who have just been on flights, it’s so risky. 
I’m feeling so anxious about going to hospital.... I wear a mask and don’t touch anything if I can help it but the fear remains although I guess I should be grateful that I’m still having treatment in this climate. 

Anniejac
on 01/04/2020

I had a call Monday to say my chemo had been postponed this week. I feel so vulnerable and exposed. How can this be allowed to happen? Consultant will call Friday to explain. Hopefully 😤

suep1974
on 02/04/2020
Michelle I had Chemo yesterday, All the nurses were wearing masks etc. They have given me 5 days of GCSF injections, for the first time, to give extra protection. I have also been told that the amount cycles I am to receive are being reduced, as the risks out weigh the benefits.
Sharadella
on 02/04/2020

I believe lots of patients have been missed on the Government List.  Please write you your individual MPS to highlight this situation.  I have manage to sign up myself but have still not received a letter and as the hospitals and GPs don't even understand what is supposed to be happening, I hold out little hope! 

Please send letters to your MPS, there are people who are more vulnerable than us that perhaps do not use the internet that may be really struggling.  Please feel free to copy and paste my letter: 

Hello,

I sincerely hope you can help me and the 1000s of others caught up in the same situation as me.

 I have breast cancer and am currently receiving chemotherapy treatment in Exeter hospital: therefore I should be on the government extremely vulnerable group number 6.

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

 People falling into this extremely vulnerable group include:

Solid organ transplant recipients.

People with specific cancers:

people with cancer who are undergoing active chemotherapy

people with lung cancer who are undergoing radical radiotherapy

people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment

people having immunotherapy or other continuing antibody treatments for cancer

people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors

people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs

People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.

People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell).

People on immunosuppression therapies sufficient to significantly increase risk of infection.

Women who are pregnant with significant heart disease, congenital or acquired.

 I have followed government guidance and attempted to self register as a vulnerable person, but have received a text saying that

‘we’ll share your details with the NHS. If the NHS defines you as clinically extremely vulnerable the NHS will contact you. Your GP will be informed’.

 Please could you find the answers to the following questions for me:

Who, how and when will these letters be send?

 Can you please raise with Government that people have been missed from their list and find out how they aim to fill the gaps... there are plenty of people that will be vulnerable and will not know how to register themselves and my experience that neither the hospitals nor GP surgeries seem to clear about what their role is in this .

 Finally can I stress the importance of this.  I can not get a shopping delivery anywhere.  My usual store is Tesco, Crediton and I have been checking for a week now and all of their slots are fully booked (for the next 3 weeks) and they do not seem to be uploading any more.  If I had my letter I could get a vulnerable booking slot with some companies.  I do not have enough food to last me 3 weeks as I did not panic buy, but quite frankly I am not beginning to panic when I should be trying to reduce my stress levels not raise them.

 I would be very grateful if you could make this a priority... there are many, many more people more vulnerable than me who have no one to support them.

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