Coronavirus and cancer – latest updates

For the latest coronavirus updates from July, please visit our new COVID-19 updates post. 

With the coronavirus outbreak developing daily, we want to make sure everyone affected by cancer gets the information they need during this time.

We’ll be monitoring the latest government and NHS health updates from across the UK and updating this blog post regularly as new guidance emerges. But for the most up to date guidance, please visit government and NHS websites. You can find a full list of links on our coronavirus information page.

We’d also recommend speaking to your cancer team if you have any questions or worries about coronavirus.

If you’re currently undergoing or about to start cancer treatment, it’s important to keep up to date with NHS guidance to limit the chances of exposure – especially if the virus becomes more prevalent. Your specialist might want to discuss the possibility of delaying treatment in some situations, if they felt the risks outweighed the benefits for you personally.

– Martin Ledwick, Cancer Research UK’s head information nurse.

29 April – Estimates suggest coronavirus pandemic could lead to 18,000 more cancer deaths in England

New figures from University College London suggest there could be 18,000 more cancer deaths in England because of the coronavirus pandemic. The estimates include the indirect impact that COVID-19 is having on cancer services, as well as the number of people with cancer dying of COVID-19. More than 3 in 4 of the deaths were predicted to occur in people with additional underlying health conditions.

It’s devastating to see the impact that COVID-19 is already having on the lives of cancer patients, and these new figures highlight a concerning picture for projected cancer deaths. We can only estimate how many avoidable deaths there might be based on a number of assumptions, but if the government acts now, they can prevent more lives being lost. The sooner we have adequate testing for all NHS staff and patients, including those without symptoms, the sooner COVID-free cancer hubs can diagnose and treat cancer effectively, and patients can be reassured it’s safe to go to hospital. And by ensuring there’s enough staff and kit to work through the growing backlog of patients, the better equipped the NHS will be to deliver vital cancer care.

– Sarah Woolnough, Cancer Research UK’s executive director of policy and information.

29 April – NHS England announces second phase of NHS response to COVID-19

Chief executive of NHS England, Sir Simon Stevens, has written to NHS trusts with information about the next stage of the NHS COVID-19 response strategy.

According to the letter, the aim for the next six weeks is to bring cancer referrals, diagnostic and treatment services back to pre-pandemic levels as soon as possible to minimise potential harms and limit post-pandemic demand. This includes cancer surgery.

Hospitals are being urged to make use of independent hospitals across the UK to achieve this.

The letter also states that bone marrow transplants and CAR T cell therapy should continue where critical capacity is available.

28 April – Coronavirus testing expanded in UK

The Government has announced it’s expanding coronavirus testing to include NHS staff, social care staff and care home residents in England, even if they don’t have symptoms.

Anyone with symptoms who is unable to work from home or over the age of 65 showing coronavirus symptoms and symptomatic members of their household will also have access to testing.

Anyone eligible will be able to book a test using an online portal.

The Scottish Government has also announced that key workers in health and care services will be among those to benefit from expanded testing. Anyone over the age of 70 admitted to hospital will also be tested for COVID-19, even if they don’t have symptoms. They’ll be testing every 4 days through their stay.

And in Wales, critical workers will be able to book a test appointment at a drive through testing centre in West Wales. This includes NHS staff, social care workers and teachers.

Wales have been criticised for their testing policy this week, as the Government announced it would not test anyone over 65, even if they have symptoms. This does not apply to care home residents and critical workers.

27 April – NHS campaigns urge people to get help if they need it

NHS England and Scotland have launched campaigns urging people to seek medical advice if they need it. Since the coronavirus pandemic began, there’s been a drop in the number of people going to their GP with signs or symptoms that could be cancer.

The Health and Social Care Board in Northern Ireland have also urged people not to delay in seeking help from GPs, hospitals or social care services.

It’s understandable that people might be worried about leaving their home during the pandemic or think the NHS is too busy, but you should still contact your doctor if you’re worried about signs and symptoms or notice a change that isn’t normal for you. If you’re reluctant to visit your GP in person, you can contact them for a virtual appointment. In most cases it won’t be cancer, but let your doctor decide as then your case will be tracked and if you do receive a cancer diagnosis, then you will receive treatment as soon as it’s safe to go ahead. The earlier a cancer is diagnosed, the more likely it is treatment will be successful and the higher the chance of survival. So even in these stressful times it’s vital people don’t delay seeking help with cancer symptoms.

– Michelle Mitchell, Cancer Research UK’s chief executive

22 April – COVID-19 testing network opens in UK

The Government has announced the opening of 3 COVID-19 testing labs – based in Milton Keynes, Glasgow and Cheshire. The hubs will analyse samples from drive through testing sites, allowing NHS and other frontline workers to be tested rapidly to ensure they can safely return to work. The labs will be staffed by volunteers from industry and universities, including some Cancer Research UK-funded researchers.

Scaling up COVID-19 testing will be vital to the success of COVID-free ‘cancer hubs’, which are being set up to deliver cancer treatments.

22 April – Northern Ireland report almost 70% drop in ‘red flag’ referrals this year

Government officials, researchers, and charity heads in Northern Ireland have warned about the effects of the pandemic on cancer diagnosis and treatment services. Health officials have revealed a fall of between 60 and 70% in the number of people with potential cancer symptoms being referred for further tests. Health Minister Robin Swann said that “if people are feeling unwell or worried about their symptoms, they should seek medical advice without delay”.

21 April – How coronavirus is impacting cancer services in the UK  

As the coronavirus pandemic continues to develop, cancer services are facing difficult challenges. We’re trying to build a full picture of these challenges to help identify and share solutions for getting cancer services back on track – and quickly. 

We’ve summarised how coronavirus is impacting cancer screening, diagnosis and treatment across the UK.

21 April – Advice on alternative treatment options during COVID-19

The National Institute of Health and Care Excellence has updated its advice on chemotherapy treatment changes that can be made during the COVID-19 pandemic. The changes allow for greater flexibility during the pandemic and include options like switching from intravenous drugs to oral alternatives, using shorter treatment regimens or decreasing the frequency of immunotherapy treatments. There are also treatment suggestions for some individual cancer types.

The individual treatment changes suggested in the update have been endorsed by NHS England and so will be available to patients in England. The proposed changes may also be reviewed for implementation in Scotland, Wales and Northern Ireland.

20 April – 72% fall in urgent cancer referrals reported in Scotland

Scotland’s interim chief medical officer announced a 72% drop in urgent suspected cancer referrals in Scotland. Dr Gregor Smith said that GPs were also reporting a fall in the number of people coming forward with potential cancer symptoms.

It’s hugely concerning there has been such a dramatic drop in the number of urgent suspected cancer referrals. It’s clear the pandemic has left cancer diagnosis and treatment in a precarious position. If lots of suspected cancer cases are not investigated until a later date, there’s a risk of breaking an already flooded NHS system. Patients who have worrying symptoms should not be deterred from getting in touch with their GP. Many GP practices are offering telephone and video conference facilities so those who are worried about breaching social isolation guidelines can still access support. While the threat posed by Covid-19 could change a patient’s treatment options, it’s vital that cancer is diagnosed as early as possible.

– Marion O’Neill, Cancer Research UK’s head of external affairs in Scotland.

17 April – Cancer care needs mass COVID-19 testing, says charity

Cancer Research UK has called for widespread COVID-19 testing to prevent unnecessary cancer deaths. Thousands of cancer patients in the UK have had their treatment stopped or delayed because of COVID-19, and while the NHS in England is developing ‘COVID-free’ centres and hospitals, these will only be feasible with widescale and frequent testing of NHS staff and patients.

This pandemic is having a major impact on patients suffering from cancer and the direction it’s heading is really concerning. Delays to diagnosis and treatment could mean that some cancers will become inoperable. But it’s not too late to turn this around. Cancer patients shouldn’t need to wait for the pandemic to pass before getting the treatment they need. We can create a safe environment for both staff and cancer patients now that testing efforts are escalating quickly. Staff in hospitals around the country are working extremely hard and with more testing of staff and patients – with and without symptoms – we will have hospitals and centres relatively free from COVID-19 where patients can be treated safely, and post-operative complications can be minimised.

– Professor Charles Swanton, Cancer Research UK’s chief clinician.

15 April – Screening healthcare workers for COVID-19 could prevent hospital transmission, says chief clinician

Our chief clinician, Professor Charles Swanton, has underlined the importance of screening healthcare workers for COVID-19 in an article in the Lancet. Swanton spearheaded the temporary transformation of the Francis Crick Institute’s labs into a COVID-19 testing facility, and now writes that mass testing of symptomatic and asymptomatic healthcare workers will help hospitals avoid unnecessary quarantine, reduce COVID-19 spread among people without symptoms and protect the healthcare workforce.

Testing will also be vital in helping the NHS deliver cancer care through COVID-19 free hospitals.

15 April – More shielding letters sent out in Wales

The Welsh Government has announced it’s reissuing a number of shielding letters to those who are at high risk of severe illness due to an underlying health issue. The letters advise people to stay at home for 12 weeks and contain additional information on how to access food and medication if no family or community support is available.

Most people will have received their letter at the beginning of April, but the latest batch will be with individuals no later than Friday 17 April.

9 April – Updated advice and support for people with cancer in Northern Ireland and Scotland

The Scottish Government have updated its COVID-19 information leaflets for people affected by cancer. And the Scottish Cancer Coalition has updated information and support resources for people living with cancer during the coronavirus outbreak. This includes the details of telephone and online support groups from a range of cancer charities.

The Northern Ireland Cancer Network has also updated its coronavirus advice for people with cancer.

7 April – Northern Ireland temporarily pauses screening

Northern Ireland’s Health Minister, Robin Swann, has announced that the country will be pausing a number of routine health screenings in order to reallocate resources to frontline staff tackling COVID-19. This includes bowel, breast, and cervical cancer screening programmes. This comes just weeks after the country halted non-urgent appointments and procedures, in line with the rest of the UK.

Scotland and Wales have already paused their cancer screening programmes. Screening appointments may also be affected in England, although no official announcement has been made.

7 April – Cancer Research UK announces cuts to research funding

We’ve taken the difficult decision to cut funding to our existing grants and institutes by up to 10% and our national network of Centres by around 20%. This works out as a £44 million cut to our research portfolio across the year.

Our blog post has more on the impact of coronavirus on our research.

COVID-19 has left the whole world in uncharted waters. And the unprecedented measures to control the global COVID-19 pandemic have had a huge impact on both our researchers’ ability to carry on in the lab, and on our ability to fundraise. Faced with a predicted loss of 20-25% of fundraising income, we are forced to look for savings across our current portfolio.

Cancer Research UK funds nearly 50% of the cancer research in the UK and making cuts to research funding is the most difficult decision we have had to make. We don’t do so lightly. We are hopeful that limiting our spending now will enable us to continue funding life-saving research in the long run. Cancer doesn’t go away during or after COVID-19, but we’re incredibly proud of our community of researchers who have been very quick to respond to the crisis, using their kit, skills and talent to support the NHS and the COVID-19 response. Our mission is so important to people all over the UK and by helping the global effort of tackling COVID-19, we hope we can get back to beating cancer as soon as possible.

– Iain Foulkes, executive director of research and innovation at Cancer Research UK

6 April – NHS England issues new advice to Trusts on maintaining cancer treatment

According to the letter from NHS England, essential and urgent cancer treatments must continue, and cancer specialists should discuss with their patients whether it’s riskier for people to undergo or delay treatment at this time. It also advises that trusts should urgently consider consolidating cancer surgery into a COVID-free hub. And where referrals or treatments are impacted, safety netting must be put in place to follow patients up.

6 April – Food and medicines deliveries for high risk groups in Northern Ireland, Scotland and Wales

The Scottish Government have announced a plan for local services to supply groceries and medicines to those who are at the highest risk of severe illness from coronavirus, including some people with cancer.

Anyone eligible for the deliveries will have received a letter from Scotland’s Chief Medical Officer with more information about the service.

And the Welsh Government have announced that extremely vulnerable individuals in Wales without any other support have been able to request weekly free food boxes since March 31st, providing essential food for one person. Anyone who qualifies for this service should have received a letter by Monday 6th April and you can contact your local authority for more information on how to apply.

The Minister for Communities in Northern Ireland has also announced a £10 million scheme to deliver food parcels to people most at risk from COVID-19.

A similar scheme was rolled out in England in March.

2 April – Francis Crick Institute and UCLH launch coronavirus testing service for NHS staff and patients

The Francis Crick Institute’s lab facilities have been temporarily transformed into a COVID-19 testing facility, to help combat the spread of infection. The Institute estimates the testing service, developed in partnership with University College London Hospitals (UCLH), will have initial capacity to conduct around 3,000 tests a week. But researchers are aiming to reach 2,000 tests a day in the future. The Crick will offer testing to UCLH and other hospitals.

Our funded scientists at the Crick are playing a vital role in the national COVID-19 testing effort. They are providing desperately needed capacity at a time of national crisis, and testing NHS staff quickly so they can decide if they can return to their life-saving work. As well as the Crick, many Cancer Research UK laboratories throughout the country are providing vital testing kit and skills. And we are proud of our scientists, some of the best in the world, who are turning their focus to COVID-19 during this global pandemic. As a scientific research community, we need to beat the pandemic together – the sooner we do that the sooner our researchers can get back to beating cancer.

– Iain Foulkes, Cancer Research UK’s executive director of research 

1 April – NICE issues guidance for delivering stem cell transplants

The National Institute of Health and Care Excellence (NICE) have issued new guidance for healthcare professionals giving stem cell transplants in England. Patients are very vulnerable to picking up infections after a stem cell transplant, and would be much more likely to develop serious consequences if they became infected with coronavirus. Because of this, NICE have recommended that all but the most exceptional stem cell transplants are delayed until after the coronavirus outbreak.

Decisions on whether a stem cell transplant should go ahead will be made on a case-by-case basis by specialists, if you’re concerned about your treatment being delayed talk to your cancer team.

The guidance also includes minimising face-to-face contact by offering video or phone consultations, reducing the time people spend in waiting areas and asking people to attend their appointments alone if possible, to reduce the risk of spreading infection.

Guidelines for delivering systemic anticancer therapies and radiotherapy were issued in March.

NICE guidelines are usually adopted in Wales and Northern Ireland. We anticipate that the Scottish Cancer Treatments Response Group will review these guidelines for implementation in Scotland.

30 March – Scotland, Wales and Northern Ireland’s Southern Health Trust pause cancer screening

The Scottish Government have announced it will temporarily pause breast, cervical and bowel cancer screening programmes. This follows Public Health Wales’ announcement earlier this month to pause all screening programmes, with the decision being reviewed in 8 weeks.

Please do not complete and send in your bowel cancer screening kit. Please wait until further instructions once the COVID-19 response period has settled. This is likely to be at for approximately a 12 week period. https://t.co/zUbzTFQrJc pic.twitter.com/cpSqYn6nQy

— Public Health Wales (@PublicHealthW) March 25, 2020

And on Friday 27 March, The Southern Health and Social Care Trust in Northern Ireland announced it was postponing all NHS breast screening appointments for 3 months on advice from the Public Health Agency. This is the only official mention of screening in Northern Ireland made so far, but information on other cancer screening programmes and breast screening in other Trusts may be shared in the coming days.

Cancer screening appointments may also be affected in England, although no official announcements have been made.

The NHS has to make difficult decisions in this time of crisis, but if the NHS do suspend cancer screening programmes this is not one they would make lightly. It would mean that the NHS staff who help run screening programmes can be there to support the vital services needed during this unprecedented time. Screening is for people without symptoms so it remains vital that anyone who is worried about possible cancer symptoms is still able to seek help from the NHS and have their symptoms investigated promptly. If anyone affected by cancer is worried about the impact of COVID-19, there is more information on our website. And anyone with specific health concerns should speak to a health professional.

– Sarah Woolnough, Cancer Research UK’s executive director of policy and information

30 March – NICE issue guidelines for delivering radiotherapy

The National Institute of Health and Care Excellence (NICE) have issued new guidelines for health professionals delivering radiotherapy in England. It includes minimising face-to-face contact by offering video or phone consultations, reducing the time people spend in waiting areas and asking people to attend their appointments alone if possible, to reduce the risk of spreading infection.

Similar guidelines were issued earlier in the month for delivering systemic anticancer therapies like chemotherapy. NICE guidelines are usually adopted in Wales and Northern Ireland. We anticipate that the Scottish Cancer Treatments Response Group will review these guidelines for implementation in Scotland.

29 March – Food parcel deliveries for clinically vulnerable people begin in England

The first 2,000 food boxes have been to people at highest risk from coronavirus over the weekend. Anyone who has been advised to stay at home for the next 12 weeks in England can register for this support online.

23 March: London NHS trust postpones treatment for 2 weeks

A hospital in London has announced it has postponed outpatient chemotherapy appointments and cancer surgery for 2 weeks to protect people with cancer who may be at high risk of developing severe illness from coronavirus. Urgent operations will go ahead.

While a commitment to continuing cancer treatment in England was announced last week, NHS England has advised specialists to discuss the possibility of delaying treatment if the benefits outweighed the potential risks. They’ve also issued guidance on managing cancer treatment and care during the coronavirus pandemic for health professionals. Decisions will be made by specialists and local NHS Trusts, so it’s worth speaking to your cancer team if you have any questions about your treatment.

As the virus becomes more common across the UK, it’s likely to add more pressure to cancer service delivery across the UK. It’s our understanding that case by case treatment decisions, based on patient risks and benefits, are still being made across cancer services in Scotland, Northern Ireland and Wales. If you’re concerned, we’d recommend you speak to their doctor and follow any updates to NHS guidance.

The coronavirus pandemic has placed unprecedented pressure on our health service, and although the NHS is doing everything in its power to give routine cancer care as usual, there are difficult decisions that NHS Trusts and health boards are being forced to make. People with cancer are among those at higher risk of complications because cancer and treatment can weaken their immune systems. Doctors will be taking this into consideration when deciding treatment can safely go ahead. If anyone affected by cancer has received specific guidance and is concerned, they should speak to their cancer specialist.

– Martin Ledwick, Cancer Research UK’s head cancer information nurse.

21 March: New ‘shielding’ measures introduced by Public Health England

Public Health England have introduced new ‘shielding’ measures for people at high risk of developing severe illness from coronavirus because of an underlying health condition.

The new guidance says people should stay at home at all times and avoid face-to-face contact for 12 weeks. Visits from people who provide essential support – such as health professionals or social care – should continue, according to the latest guidance.

Anyone who should be adopting this advice should receive a letter by Sunday 29 March or be contacted by their GP, if you haven’t received a letter but think you fall into one of the categories listed below, please discuss your concerns with your GP or clinician.

Nicola Sturgeon announced similar guidance for Scotland, with up to 200,000 people with ‘extreme health vulnerabilities’ being contacted in the next few days. And 70,000 letters will be sent in Wales, advising the ‘most vulnerable people’ to stay indoors for 12 to 16 weeks. Northern Ireland have also published more information on who is considered vulnerable, with around 40,000 letters being sent to those considered at most risk with more detailed advice.

 

21 March: Guidelines for delivering chemotherapy issued by NICE

The National Institute of Health and Care Excellence (NICE) have issued new guidelines for health professionals delivering systemic anticancer therapies like chemotherapy in England. It includes minimising face-to-face contact by offering video or phone consultations, reducing the time people spend in waiting areas and asking people to attend their chemotherapy appointments alone if possible, to reduce the risk of spreading infection.

NICE guidelines are usually adopted in Wales and Northern Ireland. Scotland is developing separate guidelines.

20 March: Clinical trials update

Yesterday, the National Institute of Health Research announced plans to pause the set up of new clinical trials or new trial sites, except for nationally prioritised coronavirus (COVID-19) studies. The aim is to free up staff to focus on coronavirus studies or care for patients during the outbreak.

And if you’re currently taking part in a clinical trial, the protocol may change to help minimise hospital visits. It’s best to check in with your trial team about how this might affect you.

The COVID-19 outbreak is a rapidly evolving situation, and it’s placing unprecedented strain on healthcare systems around the world. So local NHS trusts and health boards are making decisions around clinical trials on a case by case basis. For the most part recruitment has paused for the time being, but there are some trials which will be still running. For

patients currently on trials, these trials may be more flexible on protocol during this period including switching face to face hospital check-ups to over the phone, and finding different ways to get drugs to patients without them coming into a hospital. Patients need to speak to their doctor to find out if this applies to them.

– Stephen Nabarro, head of clinical operations and data management at Cancer Research UK.

19 March: Northern Ireland outlines new response measures

Health Minister, Robin Swann, has outlined new COVID-19 plans for Northern Ireland. They include halting non-urgent appointments and procedures, taking Northern Ireland in line with measures implemented in the other UK nations earlier this week. Cancer surgeries and other urgent procedures will continue.

18 March: Boris Johnson releases new advice for ‘vulnerable groups’

The UK Prime Ministers says the country is taking ‘drastic measures’ to help curb the coronavirus outbreak, including recommending that vulnerable groups avoid social contact for 12 weeks.

17 March: ‘Vital cancer treatments will continue’

NHS Scotland has announced it will postpone non-urgent elective care as part of its ongoing coronavirus preparations. But “vital cancer treatments, emergency, maternity and urgent care” will continue.

Similar measures have been announced in Wales and England, with the commitment to continuing cancer treatments in England outlined in a letter from NHS chief executive, Simon Stevens.

But while there is a commitment to continuing cancer treatment, NHS England has advised specialists to discuss the possibility of delaying treatment if the benefits outweighed the potential risks. They’ve also issued new guidance on managing cancer treatment and care during the coronavirus pandemic for health professionals. Similar guidance is likely to be developed by NHS services in Scotland, Wales and Northern Ireland, but these have yet to be published.

A national cancer treatment response group has been established in Scotland, which will provide advice around cancer treatments and ensure measures are being taken to protect those living with cancer. Here’s where you can find the latest NHS advice in Scotland.

16 March: UK Government advises social distancing

UK Government has issued advice for everyone in the UK about social distancing to reduce the spread of coronavirus. This includes advice for cancer patients.

Katie

If you have questions about cancer, you can talk to our nurses Monday to Friday on freephone 0808 800 4040.