This is a very difficult and worrying time if you are a patient or friend or relative of a patient with cancer. People across Greater Manchester can be reassured that The Christie is here for them. We are doing all we can to make sure patients get the treatment, information and support they need.
We are also sure people understand that COVID-19 is causing severe pressure on the NHS. All hospitals across Greater Manchester including The Christie have to prioritise treatment of the most urgent cases and change or defer treatment of other patients until the pandemic is over.
Some cancer treatments, particularly chemotherapy and immunotherapy, make patients much more likely to have serious effects from the COVID-19 infection. These treatments reduce the body’s ability to fight infections. This makes it much more likely that a patient on these treatments will catch the COVID-19 infection and also more likely that they will need intensive care in hospital.
For these reasons, cancer patients on some treatments must remain at home and shield themselves for up to 12 weeks. For them the effects catching COVID-19 may outweigh the risks of deferring treatment for a while. This is particularly so as the frequent visits to hospital needed for treatment may bring them into contact with the virus simply by mixing with other people.
At the same time, hospitals across Greater Manchester are seeing vastly increased numbers of seriously ill patients with COVID-19 infection who need oxygen therapy or intensive care. The intensive care beds that might normally be used to care for patients after a cancer operation are increasingly not available as they are needed for COVID-19 patients. Hospitals are also seeing higher than usual levels of staff off work because they or a family member are affected.
Ongoing treatment during COVID-19
At The Christie we have agreed with all the other hospitals across Greater Manchester that we will make our operating theatres available for patients from other hospitals.
Where operations cannot be carried out locally due to staff sickness or intensive care units being full of COVID-19 patients, the most urgent patients can continue to receive treatment in protected theatres at The Christie, Rochdale and for some specialist surgery within Manchester Foundation Trust (including MRI and Wythenshawe Hospitals) and Salford Royal Hospitals. A similar approach has been taken for serious blood cancers such as acute leukaemia which require very intensive treatment. Where local units can no longer provide this care, patients are being transferred to The Christie.
For patients requiring chemotherapy or radiotherapy, our cancer specialists are discussing with each patient whether a different treatment might be more suitable to reduce the risk of COVID-19 infection and yet still be effective for their cancer. This might involve using a less toxic drug, oral treatment, or a shorter treatment duration.
Because of our specialist expertise, we are often able to shorten courses of radiotherapy to provide the same dose in fewer visits than normal, or suggest novel treatments that are more acceptable and with less risk of infection. For some patients we can make radiotherapy available as an alternative to an operation.
Some treatments can also safely be postponed until after the pandemic has subsided. In these cases, patients are routinely monitored so that treatment can be restarted if needed.
By considering each patient, balancing the risks of infection and treatment and moving to less risky treatments if appropriate, we can make sure that treatments can be continued for those who require them urgently to give a good likelihood of cure or long term survival.
Protecting cancer care during COVID-19
To protect cancer care during the COVID-19 pandemic, we are working with other hospitals in Greater Manchester to make The Christie into the hub for cancer care.
We are bringing operations to our site when necessary, using our expertise to select the safest cancer treatments during the pandemic and looking after cancer patients to the best of our ability in the circumstances. This frees up space and people in other hospitals to deal with the many patients who are seriously ill with the virus.
There are many ways we can help cancer patients during the pandemic. All treatment changes are individual decisions discussed between the patient and their specialist team.
Looking at the risks versus possible benefits is part of the normal decision making in cancer medicine. This is the same approach we are following now with the added concerns that the pandemic brings.
The Christie follows the national guidance and best practice in its approach, and Greater Manchester has been recognised as an outstanding example of how to adapt cancer care in response to the pandemic.
We are keeping in contact with our patients so they know we are here for them. All patient communication around such sensitive issues is comes directly from the patient’s consultant. Our approach is one of candid honesty combined with the highest amount of empathy and sensitivity.
National guidance on maintaining cancer care during the pandemic can be found on the NHS website:
- Clinical guide for the management of essential cancer surgery for adults during the coronavirus pandemic
- Advice on maintaining cancer treatment during the COVID-19 response
- Clinical guide for the management of noncoronavirus patients requiring acute treatment for cancer
The Government is advising everybody to:
- Stay at home
- Only go outside for food, health reasons or work (where this absolutely cannot be done from home
- Stay 2 metres (6 feet) away from other people
- Wash your hands as soon as you get home
Please refer to wider Government guidance on:
- Full guidance on staying at home and away from others
- Staying at home if you think you have coronavirus (self-isolating)
- How to protect extremely vulnerable people (shielding)
The Government also have a wide range of information to help people at this time, including on employment, financial support, school closures and childcare. Please see the Gov.UK coronavirus page for more information.
Important information about the coronavirus (COVID-19)
The NHS, The Christie and Public Health England (PHE) are well prepared for outbreaks of new infectious diseases. The NHS has put in place measures to protect patients, our community and NHS staff while ensuring as many services as possible are available to the public.
If you have symptoms associated with coronavirus including a new continuous cough and a high temperature, you are advised to stay at home for 7 days.
Please do not book a GP appointment or attend your GP practice.
If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home. After 14 days, anyone you live with who does not have symptoms can return to their normal routine.
But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start. Even if it means they're at home for longer than 14 days. The most up-to-date public guidance is always online at www.nhs.uk/coronavirus
If your symptoms are serious, or get worse, NHS 111 has an online coronavirus service that can tell you if you need further medical help and advise you what to do.
Only call 111 direct if you are advised to do so by the online service or you cannot go online.