Questions by cancer patients on COVID-19 (5th June)

Patients experience a wide variation in how much their immune system is affected by cancer treatment. Some patients have very little if any immunosuppression, while others can have a compromised immune system for weeks or even longer. Some breast cancer studies show the immune system can be affected for up to nine months. So the impact depends on the type of cancer together with the therapies received, as well as on the individual patient – for that reason you should talk to your treatment team for an indication about how long you may be affected.

In England prescriptions are free for people with cancer. If you need prescriptions for cancer treatment or some of its side-effects, you can apply for a medical exemption certificate. You need to collect a FP92A form from your GP surgery. This lasts for five years and can be renewed if you are still eligible.

Many cancer trials have continued during the crisis especially those involving radiotherapy or collecting data on disease characteristics. There have also been new trials starting specifically looking at the impact of COVID-19 on cancer patients.

Trials that have been more affected are those testing new drugs, especially drugs that may reduce immunity which could be dangerous for patients if they were to be infected with COVID-19. This is similar to the reluctance to give strong chemotherapy where alternative options have been available. Once the risk of COVID-19 infection recedes then these activities will resume as before.

Having cancer may increase the risk of dying from the COVID-19 infection, the increased risk reduces with time from diagnosis, with no increased risk after five years. For most cancers there is only a small increase in risk, much smaller than the effect of increasing age and similar to the increased risk associated with having well controlled diabetes.

The exception are blood cancers which are associated with a significantly increased risk of dying and these patients are likely to have been advised to shield.

Due to the COVID-19 pandemic and the increased risk of exposure to the virus by going out in public, most hospitals and clinics have changed their policies to restrict members of the public coming into the hospital. Your treatment team may switch some of your appointments to telemedicine.

During a telemedicine appointment, you can stay at home and see your doctor or other health professional through video conferencing using your phone or computer. Your team will let you know what system they are using for telemedicine appointments and they will give you instructions on how to use it.

This enables you to have someone with you as support. Alternatively, special consideration to have someone accompany you can be made in exceptional circumstances and you would need to discuss this with your team.

Any treatment or investigation related enquiries are best discussed with your treatment team as these will always be specific to the individual. Scans are an important part of cancer management and will not usually be arranged without good reason however some routine follow up scans may be delayed during a high-risk period to reduce your exposure to infection without serious consequences.

This will vary depending on your hospital trust and how they are ‘recovering’ their services to business as usual. The Cancer Alliance is aware that support for cancer patients is currently more difficult to access and is working with the patient advisory board to see how they can help but remember the Macmillan helpline is available too.

Yes, you can. All GP websites will have a function to be able to comment and these will be reviewed by their practice management team.

Yes. These are all copied to GPs through our East of England GP forum/advisory board.

Leaflets are all available online. You can download them from www.macmillan.org.uk alternatively your nurse specialist or a member of your treatment team will post them out to you or if you require cancer information and support you can call their support line on 0808 808 00 00 (7 days a week, 8am-8pm).

Whilst some people you see may look thin or undernourished that does not mean that they are not receiving good care or nutrition. The nurses and Doctors looking after patients will be fully aware of each patient's circumstances. If there is concern there is access to nutritional advice.