Dr Victoria Lavin, Christie consultant
Dr Victoria Lavin is a consultant clinical oncologist at The Christie. Here, she talks about the changes made to patient care due to the COVID-19 pandemic, and the progress of The Christie at Macclesfield cancer centre development.
We are now over a year into the COVID-19 pandemic and cancer services continue to adapt and recover from the pressures faced during the peaks of infection. The last 12 months have seen significant changes in the way cancer care is delivered, with many of these changes being positive for patients. As we enter Bowel Cancer Awareness Month this April, I want to highlight some of the changes for patients receiving treatment for bowel cancer.
Firstly, we have, where possible offered patients’ telephone or video consultations to avoid busy waiting rooms – many patients have found these more convenient without the stresses of parking and clocking up miles to and from hospital appointments. Of course, many appointments still need to take place face-to-face but thanks to these measures, waiting times have generally been reduced.
One of the main concerns at the peak of the pandemic was around the effect of chemotherapy treatment on patients’ ability to recover from COVID-19 due to the effect the cancer treatment had on their immune system. To offer more flexibility, the National Institute of Care Excellence (NICE) approved some interim treatment options. These have included giving injections routinely after chemotherapy to boost a patient’s immune system.
NICE also enabled the option of using targeted antibody treatments intermittently or immunotherapy for certain subtypes of bowel cancer. These treatments generally have fewer side effects and this flexibility has been beneficial for many patients. The rapid roll out of the COVID-19 vaccine to vulnerable cancer patients on treatment has also meant increased protection in the last few weeks.
Clinical trial publications have continued despite the restrictions imposed by the pandemic and the treatment of bowel cancer has continued to evolve. In particular, the way we treat rectal cancer is changing, with a recent study demonstrating that giving a short course of radiotherapy (five treatments) followed by chemotherapy for those with more advanced disease can increase the proportion of patients in whom all the disease goes away compared to a longer course of radiotherapy (25 treatments). This is important as more patients may be able to avoid surgery and stoma formation with this treatment regimen in the future.
The key to the successful treatment of bowel cancer is catching the disease at an early stage. The bowel cancer screening programme is up and running again, having been delayed during the pandemic. However, there will be a backlog of people waiting for appointments. It is important to remember that screening is for people without symptoms.
If you have any worrying symptoms you must contact your GP – the NHS is open for business and here to help you - please don’t be embarrassed or ignore any symptoms. Help us help you.
The three key things to look out for are persistent blood in your poo for no obvious reason, a change in your bowel habit which is usually having to poo more or the poo being more runny, or persistent lower abdominal (tummy) pain, bloating or discomfort caused by eating and may be associated with a loss of appetite or significant unintentional weight loss.
How The Christie at Macclesfield will benefit patients
Finally, the development of The Christie at Macclesfield cancer centre has continued throughout the last 12 months. The building itself is now really starting to take shape and we are looking forward to welcoming our first patients to the cancer centre in December 2021.
The building will house two radiotherapy machines and a CT scanner as well as a new state of the art chemotherapy unit. This will have enormous benefits for people receiving cancer treatment in Cheshire, the High Peak area of Derbyshire and parts of North Staffordshire - not least reduced travel times and improved access to specialist treatment and more clinical trials.
We are also focussing on developing services for our more frail patients and have developed reliable methods for identifying those who may need extra help to get through their treatment and where to get that help.
That said, our charity, which is funding £23m towards the overall £26m cost of The Christie at Macclesfield, has seen its income fall by a quarter compared with a normal year. Many of the key fundraising events have been cancelled as a result of the pandemic.
The Christie charity works hand in hand with the hospital to support patients during treatment so they can receive the very best care, benefit from the latest research, the most advanced equipment and support services that make life a little easier.
And whilst we know that many of our supporters and fundraisers have been struggling as a result of the pandemic, we know that cancer doesn’t stop for a pandemic. With work being completed on The Christie at Macclesfield this year, there has never been a more important time to support this appeal and to make a difference in the lives of those affected by cancer.