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.

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 – 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.

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.

 

How do I know if I’m ‘extremely vulnerable’?

The latest Public Health England guidance applies to the following groups:

  1. Solid organ transplant recipients.
  2. People with specific cancers:
    • People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer.
    • People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.
    • People having immunotherapy or other continuing antibody treatments for cancer.
    • People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
    • People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD.
  4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID)
  5. People on immunosuppression therapies sufficient to significantly increase risk of infection.
  6. Women who are pregnant and have significant heart disease.

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.

How can cancer affect the immune system?

Some types of cancer – like leukaemia and lymphoma – can lower your ability to fight infection by affecting your immune system.

Some cancer treatments can also weaken the immune system. Chemotherapy, for example, can stop the bone marrow making enough white blood cells, which are a vital part of the immune system. This effect is most prominent during treatment, but the effects can last for some time afterwards.

For more information visit our coronavirus and cancer page, which we’ll be updating with the latest advice.

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