Victoria worked at the The Christie NHS Foundation Trust in Manchester during the pandemic.
For the latest overview of how coronavirus is impacting cancer services, please visit our February 2021 cancer services article.
COVID-19 has placed a huge strain on cancer services in the UK.
It’s been felt in all areas of cancer care – from screening and diagnosis through to cancer treatment, as we’ve blogged about before. And new figures have revealed the sheer scale of this disruption – estimating that over 2 million people in the UK are waiting for screening, tests and treatments since lockdown began 10 weeks ago.
Our chief clinician, Professor Charles Swanton, has seen first–hand the devastating impact this pandemic is having on patients. “Delays to diagnosis and treatment could mean that some cancers will become inoperable. Patients shouldn’t need to wait for this to be over before getting the treatment they need.”
“We can create a safe environment for both staff and cancer patients if testing efforts ramp up quickly.”
Screening and diagnosis
When you break down the figures, delays to cancer screening is responsible for the bulk of the backlog, with around 2.1 million people waiting for breast, bowel or cervical screening.
Screening services have been formally ‘paused in Scotland, Wales and Northern Ireland due to COVID-19 and are effectively paused in England – with invitations not being sent out from screening hubs.
For every week that’s screening is paused, 7,000 people aren’t being referred for further tests and 380 cancers aren’t being diagnosed through screening programmes.
But while the screening backlog is big, potentially the biggest impact on survival is being felt in cancer diagnosis and treatment.
There’s been a significant drop in the number of urgent referrals for cancer, often reported as ‘two-week wait figures’, with 290,000 fewer people being referred for further tests than normal.
This drop is largely because fewer people are going to their GP with symptoms that might be cancer, but we’ve heard that some GPs are also reluctant to risk sending their patient to hospital for further tests, and some diagnostic services – such as endoscopies – have been put on hold due to the risk of spreading COVID-19.
Urgent referrals dropped to around 25% of usual levels in England at the start of the pandemic but have since started to rebound, with figures at around 50% of usual levels in recent weeks. But for each week referrals stay below 100%, the number of cancer cases that are going undiagnosed will continue to stack up.
The cancer community has been working hard to get the message out there that the NHS is still open for business and that people should contact their doctor if they are worried about symptoms – and this must continue.
But patients also need to be confident that they are safe if they do go to the doctor, so ensuring that hospitals have ‘COVID-protected’ safe spaces to carry out cancer tests will be vital to getting urgent and non-urgent referrals back on track.
Despite national guidelines stating that urgent and essential cancer treatments must continue, the impact of COVID-19 has been felt in cancer wards across the country, with surgery worst hit.
Around 12,750 people are waiting for cancer surgery across the UK, as the number of operations has fallen to around 60% of expected levels. Chemotherapy has also taken a hit, with 6,000 fewer people than expected receiving chemotherapy since lockdown began.
Radiotherapy services have experienced the least disruption, with appointments falling by 10% during the pandemic. But the real impact to the service might be masked by the fact that some people have had radiotherapy instead of other treatments like surgery. It’s estimated that 2,800 fewer people have received radiotherapy because of COVID-19.
While some of this is due to the pressures faced by an overstretched NHS and a lack of recovery or ICU beds, some treatment was delayed because it could make people more vulnerable to severe illness with coronavirus.
“There have been some difficult discussions with patients about their safety and ability to continue treatment during this time,” says Michelle Mitchell, our chief executive. “But we’re over the peak of the pandemic now, and cancer care is starting to get up and running.”
We’re seeing cancer services across the UK adapting to COVID-19, with COVID-protected safe spaces being set up to allow cancer treatment to be delivered safely.
But for this to work, it requires regular testing for COVID-19 in all patients and staff working in these places, whether they have COVID-19 symptoms or not.
The road ahead – more COVID-19 testing
The Government has committed to reach 200,000 tests a day in the UK. But we’ve heard from Trusts that not everyone who needs to get a test are able to access it, and test results are taking too long to come back.
We’ve estimated that between 21,000 and 37,000 COVID-19 tests must be done each day to ensure COVID-protected safe spaces for cancer diagnosis and treatment. This assumes that staff are tested weekly and patients are tested before they come into hospital and potentially when they are there for treatment – but more regular testing will be needed.
While testing is vital, this must also be supported by staff having enough PPE and embedding infection control measures consistently.
Securing safe spaces for cancer services is an urgent the first step that must be taken to support the recovery for cancer services. It is critical that testing is ramped up as quickly as possible.
“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 free of COVID-19 where patients can be treated safely,” says Swanton.
Miss P Grice June 25, 2020
Can’t the Military Hospitals and Doctors help out in our NHS Hospitals or open their Hospitals to us the general public?
Helen williams June 20, 2020
Please help me I need to stop this crying inhale been so brave thanks alot helen Williams xxx
Katie Roberts June 22, 2020
Thanks for getting in touch, if you’d like to speak to someone about your diagnosis you can chat to one of nurses, Monday to Friday, 9-5pm, on freephone 0808 800 4040.
Katie, Cancer Research UK
Helen williams June 20, 2020
I have polycythaemic blood cancer I am feeling so emotional I have had this 4 months please could you email notes to read please I have got some I need more I am so emotional & I feel ill thank you helen xxx
Helen June 20, 2020
I have polycythaemic blood cancer I am going to loose it can,t stop crying please can you send me more to read about this please thank you helen Williams xx
Sara June 16, 2020
My mum is nearly 80 and back in March she was told by her doctor that she needed to be seen within two weeks. It’s now June and she is still waiting for her appointments.
Sara June 16, 2020
My mum is nearly 80 and back in March she was told by her doctor that she needed to be seen within two weeks. It’s now June and she is still waiting for her appointment.
Nicola Prinold June 10, 2020
Sadly my daughter is awaiting her mastectomy.
Only one breast will be done now but the other one we worry about as her cancer had spread and as a brca one genetics patient a swift surgery was needed.
Jeanette Addist June 8, 2020
Harefield Hospital cancelled lung treatment 2 weeks ago as scan revealed I need more chemotherapy. I would like urgent action to get all cancer services running again.
Mr Raymond Hawkins June 8, 2020
Yes I agree having gone through two lots of cancer one where I have had a lung removed, and I only have one my left the smallest one left. But if it wasn’t for going too my doctors and then quickly to the hospital I would not be here now that was in 2006. For the last two years I have been have been getting treatment for bladder cancer again all going well just a few more months of a three year course to have when things get back to normal.
If everybody was treated as well as I have by a great team of medical people thier would be more people be alive today thank you all.
karen dawes June 7, 2020
As with others posting here, I had a mastectomy last year and still under surgeon. I doubt I will get my follow up this year. I was informed last year the cancer care team no longer follow up on well being, to ring if I had concerns… Makes little difference now if I do, who will listen? I should also have a yearly mammogram, I am worried something may be missed if I don’t get an appointment for that this Year. I would be happy to support any cancer care ideas going forward.
Peter Condon June 7, 2020
Too late for my wife Marion. She died of Ovarian Cancer
Pip61 June 7, 2020
My partner has just been diagnosed with Chronic Myeloid Leaukemia, he was originally sent for blood tests last October,November,December and January, his hospital appointment was booked for March that was cancelled due to covid, then Mays appointment was cancelled ,next video call in June consultant confirmed CML, I am so angry as he has lost 8 months when he could have been receiving treatment, surely he should have seen consultant long before the covid outbreak.
Gordon June 7, 2020
This is all personal, for me, too — I have had a biopsy to investigate (possibly cancerous) prostate-changes, and I am still under review. However, simply bombarding “the politicians” with “demands” that they simply do not have the means to deliver, while we have our current problems, is helping nobody!
Barbara knight June 6, 2020
We know about the Covid 19 what about us with cancer we want to live as well trust us go on the Bk burner we should have tests radiotherapy pills injections waste of time everybody before us
Sharon June 6, 2020
Cancer patient need there treatment
Also safe places for them
Before lockdown husband was going to be put forward for Clinical trials but have been suspended. So put on a drug as which is a last resort. Things need to happen for Cancer patients . They are going through enough
Helen June 6, 2020
Having been unwell myself for the past few months with new symptoms developing, I can tell you that accessing the GP’s is a nightmare and almost impossible. I only managed to see a GP on three occasions due to persistance and near enough begging for help, I dread to think how other patients are fairing???
Oliver Schick June 6, 2020
Far more will die because of this failure to keep on top of cancer treatments and routine testing than will die of COVID , especially in the under 65 age ranges.
I cannot understand why routine screening has been stopped especially for bowel cancer which requires stool samples to be sent by post .
As for those with diagnosed or deferred operations, why cannot private hospitals be used as they have been taken over by the NHS
Philip June 6, 2020
My cea blood test and phone consultation with my oncologist has been put back 14 weeks , same as my CT scan . I have no complaints as they notified me fairly quickly. I have had superb treatment over the last four years and have just gone into my fifth year of remission with bowel cancer. I do feel for those people who are waiting for tests , surgery , chemotherapy, radiotherapy etc , it is very worrying in the early years of diagnosis.
Francis Richard Norman ( 80 years young ) June 6, 2020
In 2001 I was operated on for bowel cancer and ended up witha a colostomy a year later another operation to remove a 1/3 of my left lung due to lung cancer,I cannot praise the medical staff @ kettering general hospital for their outstanding care i received. I am still here, 20 years of extended life . THANK YOU ALL.
David Hawkins June 6, 2020
I was due for an MRI Scan at the end of May but I cancelled it as I was not happy to go to the Hospital with this Corona virus still around.
I had a brain tumour removed again after it had regrown since it was first removed in 2006 last September.
Now I have to wait until this virus is gone and my surgeon has to refer me to the MRI Department.
Ruth Kendrick June 6, 2020
I’ve recently had a suspected growth removed from my foot at Royal South Hants hospital Southampton & was impressed with their professionalism. My temperature was taken, hand gel given & offered a mask, although I had my own. I had to wait a week after my E consultation with GP before my appointment with the hospital & it was removed the same day. I have now to wait 2 weeks for my results. I can’t find fault with my treatment so far from the hospital. I was told several years ago that it was a wart, my GP refused to send me for removal so I’m hoping it isn’t cancerous!
john norris June 5, 2020
I was ref to the Bournemouth Hospital in March for investigations into my enlarged prostate and was given an appointment via the fast track system. A week prior to my appointment i was contacted by the hospital to inform me that my appointment was cancelled due to the COVID 19 outbreak. I have been in contact with my G.P. who is now in the process of arranging a new referral and am now awaiting a new appointment but not sure how long i will have to wait. It is obvious that the COVID virus has taken over the health system and is without doubt costing lives. This has to be rectified now and needs urgent attention. How many lives are going to be lost due to this lack of treatment and screening of people with Cancer or Cancer symptoms? COVID 19 is not the only thing that kills people.
Andrea robinson. June 5, 2020
I was really surprised that I didn’t get my recall for my 1st year after being diagnosed in 2019 with DCIS. Not as serious as other breast cancers but still went through a stressful time with the operation and radiotherapy. With the fuss caused and quickness of treatment, can’t believe myself and everyone have been put on hold . It’s stressful enough to know your under the hospital for the next 5 years but now feel dumped as such . My mental health feels like it’s been affected with not hearing anything, not even a letter to say, I havnt been forgotten . I did actually phone the department to find out if I’d missed an appointment and they had a little laugh about it . So I was a bit stunned at the response. I can’t understand what these people would be doing in these departments apart from Manding the phones .
Graham Rhodes June 5, 2020
I really feel something should be done. I have to rely on phone consultation, which I do not feel safe with. I become very anxious as I do not feel I can safely diagnose myself.
Harry narayan June 5, 2020
Agreed, I in remission, GOT THE VERY BEST TREATMENT IN THE WORLD IN NOVEMBER 2017, AT MRI AND THE CHRISTIE IN MANCHESTER,.