Acute Oncology Service
Coronavirus (COVID-19) Advice For Cancer Patients
In the Oncology Department at St George’s we understand that if you are a patient with cancer the presence of COVID-19 can be worrying. All of our patients, their relatives and their carers can be reassured that at St George’s we are doing all we can to make sure patients get the treatment, information and support they need whilst reducing the risk of exposure to infection.
What is coronavirus?
The coronavirus is a viral infection that causes symptoms similar to seasonal ‘flu and in most people the symptoms will be mild. COVID-19 is the illness caused by a novel type of coronavirus affecting your lungs, airways and breathing. Although for most people it will be a mild illness, for some the virus can have serious complications.
People with cancer are among those at higher risk of complications. This is because cancer and its treatment can weaken the immune system.
How can cancer and treatment weaken immunity?
The immune system protects the body against illness and infection caused by viruses such as coronavirus. Some people with cancer have a weakened immune system which reduces their ability to fight these infections.
One of the reasons for this can be that treatments, like chemotherapy, can stop the bone marrow from making enough white blood cells. White blood cells are part of your immune system.
Some cancer treatments, particularly chemotherapy and immunotherapy, make patients much more likely to suffer serious effects from the COVID-19 infection because of the body’s reduced ability to fight infections. This may lead to the need for intensive care in hospital.
Which cancer patients are at highest risk during the COVID-19 pandemic?
If you are in one of the following groups, we believe you are at increased risk from COVID-19. These groups of people include patients who are currently receiving or have received in the last three months:
- radical radiotherapy for cancer
- immunotherapy or other continuing antibody treatments for cancer
- other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
Patients with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment can review advice on the haematology website: https://www.stgeorges.nhs.uk/service/cancer-services/haematological-cancer/
If you are unsure what treatment you are having and whether you are in one of these groups speak to the team caring for you. Your Cancer Specialist Nurse at St George’s can help you identify if you are at high risk or not.
You should remain at home as much as possible and adopt shielding (see section below on shielding).
What do I do if I have symptoms or a high temperature?
When you are receiving cancer treatment (particularly those listed above i.e. currently receiving treatment or have been in the last three months), you are at risk of getting infections. The symptoms from any infection and the symptoms from COVID-19 may be very similar. If you have a fever you MUST contact the emergency cancer care line urgently. In these circumstances you must NOT self-isolate at home, as you may have another life threatening infection that requires urgent treatment, you will be advised to come to hospital for urgent review.
The symptoms of coronavirus include:
- · a high temperature or shivering (chills)
- · a new, continuous cough – this means coughing a lot for more than an hour or three or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual).
- · loss or change to your sense of your smell or taste
- · shortness of breath
- · feeling tired or exhausted
- · an aching body
- · a headache
- · a sore throat
- · a blocked or runny nose
- · loss of appetite
- · diarrhoea
- · feeling sick or being sick
Contact the emergency cancer advice line on 07831 147 653, if you have these symptoms and you are having cancer treatment or have cancer that affects your immune system. You should do this as soon as possible if you have symptoms and/or you feel unwell or call 999 immediately if you are seriously ill. If you have symptoms but you are not having cancer treatment, you can call NHS 111. For more information about COVID-19, please visit Coronavirus (COVID-19) – NHS (www.nhs.uk) Will I continue my cancer treatment?
We will continue to provide cancer treatment, but in order to protect you as best we can, we will carefully consider what steps can be taken to minimise your risk and to keep you safe. Looking at the risks versus possible benefits is part of normal decision making in cancer medicine and we continue to adopt this approach in the current environment. We take into consideration the added risks the coronavirus pandemic poses whilst following national guidance and best practice.
All of our recommendations are made on an individual basis and will meet your individual requirements, without compromising your cancer care:
The decision to continue your treatment will be carefully considered by the team looking after you and discussed with you by a member of your team who knows you and your treatment best. In some circumstances the risks from COVID-19 may outweigh the benefit of your cancer treatment and in these circumstances it may be best to discontinue treatment.
For some patients, it may be that your treatment can be safely postponed (by weeks or months) without significantly compromising your cancer care. In some patients we may modify or change the type of treatment that we give in order to minimise risk to you.
For some patients, it may be that a telephone consultation would be adequate prior to receiving treatment and we may be able to deliver your medication in the post.
You will be at the centre of all our treatment decisions and your oncology doctor or another member of the team looking after you will keep you informed and discuss with you which is the safest and recommended course of action during this pandemic.
How might my cancer appointments change?
We will endeavour to minimise your face to face contact at the hospital, however, for some patients your doctor will still need to see you in person. Your team will direct you as to whether you are suitable for telephone consultations or whether you need to come to your appointment in person. A telephone consultation just means that we will phone you at home rather than asking you to come into hospital and discuss all of the same issues that we would normally discuss (such as side effects from treatment, how you are coping generally etc.).
Should I attend for scans and tests?
If your doctor has booked a test or scan, we would strongly encourage you to attend for the scan or test, as these often provide important information to keep you safe and are crucial for guiding your care and they are very important. You may receive a letter or telephone message asking you not to attend for your scan from the radiology department. You should follow this advice.
If you are not sure if you should attend, please contact your specialist nurse.
Getting tested for Covid-19 if needed
COVID-19 tests are no longer free for most people. Some people can still get free COVID-19 lateral flow tests from the NHS.
You can get free NHS tests if you have a medical condition (i.e. cancer), which means you’re eligible for COVID-19 treatments.
You may also be able to get free NHS tests if you’re going into hospital for appointments and will get a free PCR test if you’re for planned hospital admission.
As high-risk patients, what should we do?
For most people who are at high risk of getting seriously ill from coronavirus (COVID-19), vaccination has significantly reduced this risk. You can follow the same advice as everyone else on how to avoid catching and spreading COVID-19. But some people continue to be at high risk from COVID-19, despite vaccination.
If you continue to be at high risk from COVID-19, there are extra steps you can take to help reduce your risk of getting COVID-19 and keep yourself safe.
- · get vaccinated against COVID-19 – everyone aged 5 and over can book vaccination appointments now
- · continue to wear a face covering in shops, on public transport and when it’s hard to stay away from other people (particularly indoors or in crowded places)
- · continue to stay at least 2 meters away from people (particularly indoors or in crowded places)
- · try to work from home if you can, or talk to your employer about how they can help reduce your risk at work
- · wash your hands with soap and water or use hand sanitiser regularly throughout the day
- · limit the number of people you meet inside and avoid crowded places
- · meet people outside if possible
- · open doors and windows to let in fresh air if meeting people inside
- · think about asking people to wear a face covering if meeting them inside
- · think about asking people to take a rapid lateral flow test if meeting them inside
- · try not to meet people who have tested positive for COVID-19 until 10 days after they got their positive test result
- · try not to meet people who have symptoms of COVID-19 and have a temperature or feel unwell until they feel better
More information Guidance for people whose immune system means they are at higher risk on GOV.UK
I have cancer but I’m not in one of the vulnerable groups, what should I do?
If you are not in one of the above vulnerable groups, you should follow guidance for social distancing. The aim is to reduce your risk of catching and spreading the coronavirus.
Social distancing means reducing your social contact with other people. The guidance includes:
- · steps you can take to reduce your social interaction
- · the importance of looking after your mental wellbeing and keeping in touch with others
- · advice for visitors and informal carers
Advice on keeping yourself safe if you’re at high risk from coronavirus (COVID-19) – NHS (www.nhs.uk)
Coping with worry and anxiety and maintaining a healthy mind, including “how to get back to normal”
The impact and experience of the COVID-19 outbreak has been different for everyone, as has how we have reacted, but there’s no doubt it’s been a really difficult time for us all.
That’s why it’s so important to do what we can to look after our mental health and wellbeing, now more than ever.
For more information about COVID-19 and wellbeing, visit:
Coronavirus (COVID-19) and mental wellbeing – Every Mind Matters – NHS (www.nhs.uk)
Easing of restrictions has allowed us to get back to the people and things we love, but it’s OK if adjusting has brought challenges too. You might be worried about the pace of the changes or what the future may bring.
It’s important to be patient with yourself and with your feelings. The coronavirus (COVID-19) outbreak has been hard for us all, and we have all experienced the effects differently, including those of us who have been shielding.
Even positive change can lead to anxiety, and it can take time to readjust to things we have not done for a while.
Feelings of anxiety are likely to pass with time as we get used to the “new normal” but it’s important to do what we can to take care of our mental health.
There are lots of things that can help you to manage these feelings and make it easier to adjust.
For more information about COVID-19 and about getting “back to normal”, visit: How to cope with anxiety about getting “back to normal” – Coronavirus – Every Mind Matters – NHS (www.nhs.uk)
Useful sources of information
Cancer Research UK has a Freephone helpline on 0808 800 4040. They are available from Monday to Friday, 9am to 5pm or you can send them a question online.
There are also different charities and organisations that offer online support or telephone support.
Mind mental health charity https://www.mind.org.uk/information-support/coronavirus/coronavirus-and-your-wellbeing
Contact us If you have any questions or concerns about COVID-19 and cancer, please contact Acute Oncology Service (AOS) hotline on 07831 147 653 (24/7 telephone service).
For more information leaflets on conditions, procedures, treatments and services offered at our hospitals, please visit www.stgeorges.nhs.uk
Patient Advice and Liaison Service (PALS)
PALS can offer you on-the-spot advice and information when you have comments or concerns about our services or the care you have received. You can visit the PALS office between 9.30am and 4.30pm, Monday to Friday in the main corridor between Grosvenor and Lanesborough wings (near the lift foyer).
Tel: 020 8725 2453 Email: firstname.lastname@example.org
NHS Choices provides online information and guidance on all aspects of health and healthcare, to help you make decisions about your health. Web: www.nhs.uk
You can call 111 when you need medical help fast but it’s not a 999 emergency. NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones. Tel: 111
You can download accessibility guides for all of our services by searching ‘St George’s Hospital’ on the AccessAble website (www.accessable.co.uk). The guides are designed to ensure everyone – including those with accessibility needs – can access our hospital and community sites with confidence.