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Cancer patients are living in turmoil as pressurised hospitals make the difficult decision to delay vital surgery and treatment during the coronavirus outbreak.
If medics bring sick people into hospital for treatments such as chemotherapy or radiotherapy, they risk exposing them to Covid-19, highly dangerous for those with compromised immune systems. But if the choice is made to delay treatment, it could come at a possible detriment to their life. Doctors also fear they may not be able to guarantee patients a bed if they become seriously ill.
NHS England has told hospitals essential and urgent cancer treatments must continue but that specialists should discuss with their patients whether it is riskier for them to undergo or delay treatment at this time.
Some newly diagnosed cancer patients have already been informed that treatment such as surgery will be delayed while others have had chemotherapy cancelled. But they fear they may become the hidden victims of the pandemic if diagnosis or treatment is delayed, or if the halting of preventive chemotherapy leads to cancer returning.
Early diagnosis and treatment are crucial to improving survival rates, particularly when it comes to breast, bowel and ovarian cancers.
Liz Alderton, a district nurse in north-east London, revealed she had assessed three newly diagnosed cancer patients in one day who had been told they would not have treatment due to Covid-19. She said: “All will die sooner than they would have. These are the figures that are not recorded.”
Liz is a Queen’s Nurse, a title bestowed upon nursing staff who have given exceptional service to patients.
HuffPost UK spoke to three cancer patients going through the agonising experience of either having their treatment delayed – or going ahead with it despite the potential risk of becoming ill with the virus.
“I am terrified and these 12 weeks will be horrific. Every pain and twinge I get, I’ll worry it means the cancer has come back.”
- Roisin Pelan
Roisin Pelan was just 32 and heavily pregnant with her daughter Ivy when she was suddenly diagnosed with breast cancer.
Just days after giving birth to Ivy, Roisin underwent a mastectomy followed by chemotherapy.
After months of treatment and anguish, she was given the all-clear and went into remission, returning to life as normal with her partner Michael Brown and daughter.
However, in January 2018, Roisin was dealt a bitter blow when the cancer returned.
Roisin, now 38, who lives in Preston, told HuffPost UK: “I’d had a few pains in my left arm and under my arm but doctors thought I was fine. But a few days later, I found a big lump in my neck and they discovered the cancer had returned and spread.”
Roisin was told she had advanced metastatic breast cancer which was incurable and couldn’t be operated on. When a devastated Roisin asked how long she had, she was told to aim for three years as a milestone.
“It was horrendous news,” she recalled. “I couldn’t eat or even look at Ivy as I felt I was going to ruin her life by leaving her.
“Michael is the one who makes Ivy laugh but I’m the one she comes to for a cuddle or when she has a bad dream. She’s a real mummy’s girl. The thought of leaving my child was unbearable.”
Roisin was filled with a determination to beat the cancer and stay with her family as long as possible.
She began googling the stage 3c cancer she had and found some hope as, although the cancer was classed as incurable, it hadn’t spread to her organs.
Roisin sought a second opinion and saw a new oncologist at a different hospital. She pushed for surgery and the cancer from her neck was removed, leaving her with a massive scar.
She then had numerous sessions of chemotherapy followed by radiotherapy and responded well to all the treatments.
As a result, she is now classed as stable, meaning doctors can’t see any cancer on her scans.
But to make sure the cancer is kept away, Roisin has chemotherapy every month and goes to hospital to be given it in tablet form.
She is also given a monthly injection to shut down her ovaries as the cancer she had was fed by hormones in pregnancy.
Just days ago, Roisin received a telephone call from her oncologist telling her that, due to coronavirus, he would have to stop her chemotherapy for 12 weeks.
“I felt a huge lurch in my tummy when I was told my chemo was being stopped,” Roisin told HuffPost UK. “This is what is keeping me alive and preventing the cancer from coming back.
“It is such an aggressive cancer. I have fought so hard for the last two years and I am scared it will return due to my treatment being stopped because of coronavirus.”
But Roisin says she also understands the dilemma faced by cancer specialists. “The oncologist told me it was not an easy conversation to have and he knew it was a frightening time.
“He said that, as there was no sign of cancer on my scans, it was safer not to go ahead with the chemotherapy.
“I am at such high risk to coronavirus as, being a cancer patient, my immune system is so low. The particular chemo I am on also lowers your immune system significantly.
“If I did go into hospital for my chemotherapy, I would be terrified about being exposed to coronavirus and becoming dangerously ill.
“My oncologist said if I did get ill, they wouldn’t be able to guarantee me a hospital bed. They are so stretched and worried about resources when the hospital gets too full.”
Roisin was planning to marry Michael, her partner of 12 years, in July. They have now cancelled the wedding and rebooked for next year because of the pandemic.
Although a district nurse will come to their home to give Roisin an injection to shut down her ovaries, the prospect of not having her monthly chemotherapy – which would leave her too vulnerable to Covid-19 – terrifies her.
“These next 12 weeks will be horrific.” she said. “Every pain and twinge I get, I’ll worry it means the cancer has come back.”
““This virus is making every decision feel like the toss of a coin. I feel relieved that I am having chemotherapy for the cancer – but I am going to have no immune system just as coronavirus is hitting its peak.””
- Bradley Jones
Bradley Jones was 20 and working part-time at a supermarket while at college when he was suddenly gripped by a sharp pain in his testes which led to him collapsing.
“It was very sudden and came out of nowhere and was a sharp, stabbing pain.” he told HuffPost UK. “I was in severe pain and was sweating and work sent me home.”
At first, doctors thought Bradley had a twisted testicle and operated. But when the pain persisted, they carried out further surgery and biopsies, and in October 2018 Bradley was diagnosed with testicular cancer.
“My world just collapsed around me,” remembered Bradley. “Everything you planned and expected in life just goes out of the window.”
Bradley was told he had a “germ cell cancer” that was fairly aggressive. By the time he began treatment in December 2018, it was discovered the cancer had started spreading around his body, which worsened his prognosis.
“The specialists told me it was going to be a case of battling a lot of chemo and seeing what the cancer did and didn’t respond to.”
Bradley, now 22, has tried numerous types of chemotherapy but each time, within a month, the cancer markers will go up – meaning it has been continuing to spread throughout his body.
Bradley, who lives in Sutton, was due to begin a different type of chemotherapy – but a couple of weeks ago, doctors discussed cancelling it as they did not know if they would have enough resources with staff stretched so thinly.
Tests showed Bradley’s cancer was spreading rapidly so the hospital managed to fit him in and he is now undergoing the chemotherapy treatment.
“Doctors realised my tumour markers were increasing rapidly. Two weeks ago, they were at 600. But now they are at 1,600, so they knew I needed treatment urgently.”
Although Bradley feels relieved that he is having the cancer treatment needed, he feels mixed emotions as he is going into hospital daily and risking exposing himself to coronavirus.
“I am going to have no immune system just as the virus is hitting its peak.” he said. “I sympathise with the doctors and can understand why it is so hard to make a decision.
“If they go ahead with the chemo, they are putting me at risk as my immune system is shot to pieces. But if I don’t have the chemo now, they risk the cancer spreading and becoming something they can’t control.”
Bradley is going to hospital as an outpatient for the chemotherapy daily. Each cycle lasts for two weeks and he will have at least three cycles, potentially rising to six depending on how he responds.
Bradley travels to hospital by public transport and although he takes precautions by wearing a mask and carrying hand sanitiser, he admits that every time he leaves the house, he feels like he is “taking his life into his hands”.
“This virus is making every decision feel like the toss of a coin at the moment.” he said. “As I go further into my treatment, I will have no immune system and even if I didn’t get coronavirus, a simple cold would knock me off my feet and land me in hospital.
“But not having the cancer treatment now is a bigger risk.”
“It is hard to accept mentally as you had prepared yourself to have the treatment. But there will be thousands of others in the same position and I completely trust the doctors.”
- George Hayes
George Hayes, 20, who lives in North Wales, was diagnosed with thyroid and neck cancer in February this year.
George, who is in the forces, was at work when one of his colleagues noticed a lump in his neck.
“It was hard to notice if you looked in the mirror straight on,” he explained. “I had to turn my head to one side for it to come out.”
George was referred to hospital and had CT scans, biopsies and other tests. The lump was around the size of his palm.
Tests revealed it was cancer that had begun as thyroid cancer and then spread to his neck.
In February, George had surgery to remove his thyroid and any cancer tissue around his neck.
He was then due to have radioiodine therapy at Royal Liverpool Hospital – but this has now been cancelled.
“The hospital called me and were very apologetic, but explained that with Covid-19, they didn’t want to risk me getting coronavirus from anyone at the hospital.
“They told me most of their manpower had been transferred to wards where people had the virus.”
George says it is difficult to deal with the delay of cancer treatment when you are mentally prepared to go ahead with it.
But he told HuffPost UK he has the utmost faith in his doctors and knows the NHS is under a great amount of pressure.
“There will be thousands of people in the same position who have had their treatment delayed,” he said. “The doctors were happy with how much cancer they were able to remove during the operation.
“I am happy with the reassurance I have had and completely trust my doctors.
“The plan is to put me on a call list for three months’ time and if the situation has changed, they will get me in for treatment then. If not, it will be pushed back a few more months.”
George added: “Everyone in the NHS is amazing for everything they are doing during this crisis.
“They are very brave when they have their own families to worry about. Having cancer during the coronavirus outbreak adds a layer of stress on top of all the other worries. But it is a difficult time for everyone.”
Rachel Kirby-Rider, chief executive at young people’s cancer charity Clic Sargent, told HuffPost UK coronavirus had doubled the worry for many patients.
“Families are not only having to worry about cancer but now coronavirus too as they isolate in their hospital rooms and at home,” she said.
“Cancer doesn’t stop for coronavirus and the young cancer patients and families we support are facing a real crisis.
“Some young cancer patients have had treatments delayed and for those children and young people we support who are receiving end of life care, they’re not able to make the memories they desperately want with their loved ones. It’s completely heartbreaking.
“We also have families facing decisions around whether to have treatment or not due to the risk coronavirus is bringing to both NHS resources and to their immune system.”
Clic Sargent has given out more than £45,000 in emergency hardship grants since the start of the coronavirus outbreak to families in crisis struggling to afford food and bills.
The charity had launched an emergency appeal to raise the funding needed to carry on supporting families but admitted it is facing a staggering 60% drop in income during the crisis.
Martin Ledwick, head information nurse at Cancer Research UK, told HuffPost UK: “It’s completely understandable that anyone who has had changes to their cancer treatment because of Covid-19 may be worried.
“And how long these changes to cancer care may last for are not yet clear.”
But he added: “Some trusts are looking at delivering chemotherapy services on other sites and other innovative ways of trying to keep people as safe as possible.”
He added that any concerned cancer patients should contact their specialist cancer team and that everyone was encouraged to follow the government advice to stay at home – to protect themselves and cancer patients.