Ovarian cancer and COVID-19 (coronavirus): advice for patients in England

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Page updated 16th October 2020

Information for ovarian cancer patients in England who are currently receiving treatment

When lockdown began in March, many ovarian cancer patients were advised to stay at home and ‘shield’ to avoid catching Covid-19. The government introduced shielding as an extra way to protect cancer patients and other 'clinically extremely vulnerable people' whose medical condition or treatment meant they had a higher risk of becoming seriously ill if they caught coronavirus.

New three-tiered alert system introduced 

A new three-tiered alert system of local lockdown measures has been introduced in England to help control the spread of coronavirus. Different parts of the country have been placed under ‘medium’ (tier one), ‘high’ (tier two), or ‘very high’ (tier three) alert depending on how serious the Covid situation is in the area. Each tier has different lockdown regulations. The higher the tier, the stricter the measures. 

You can read about the measures for each tier here.

The government has also updated their guidance for all 'clinically extremely vulnerable' people, with new advice for vulnerable people living in each tier and information on where to find support.

Read the guidance for people on the Shielded Patients List here.

National shielding has not been restarted, but vulnerable people living in some of the worst affected areas may be asked to shield again for a limited period of time. You will only need to follow shielding guidance if you receive a new letter asking you to shield. 

Shielding FAQs for England 

Am I 'clinically extremely vulnerable'?

Medical experts have identified the people who need to follow shielding guidance to stay safe as their specific medical condition or their treatment places them at risk of serious illness if they caught coronavirus.  

You will be on the patient shielding list and asked to follow the latest shielding guidance if you have been diagnosed with ovarian cancer and you are currently having: 

  • chemotherapy, or have had chemotherapy in the last 3 months.
  • treatment where they are taking a PARP inhibitor (Olaparib, Niraparib, and Rucaparib).
  • immunotherapy or any treatment that affects their immune system.

If you have had ovarian cancer in the past and made a full recovery, you will not be part of the shielding group. You should still follow the Government guidance on social distancing to stay safe, but you are not at any more risk than the general public.

When or how you need to shield will depend on the latest advice from the government.
Do I need to shield?
You will only need to shield if you are on the Shielded Patients List and the government reintroduces shielding in your area. If this happens, you will receive a new shielding letter explaining what you need to do and the support that's there to help you. 

Local shielding is only being reintroduced in some of the worst affected areas for a limited period of time, based on advice from the Chief Medical Officer. Shielding will not automatically start if you are in a ‘very high alert area’. 

Where can I find the latest guidance for clinically vulnerable people?

You can read the latest guidance on shielding and protecting for clinically extremely vulnerable people from Covid-19 on the government website

How can I find out which Covid alert level I live in?

You can find out which tier your area falls into by checking a full list of alert levels by area on the government website or by using the postcode search tool

https://www.gov.uk/find-coronavirus-local-restrictions

.

Where can I get support?

Whatever the current local COVID alert level in your area, it is important that you continue to receive the care and support you need to help you stay safe and well. Providers of social care and medical services are making every effort to ensure services remain open and as safe as possible.

You should continue to seek support from the NHS for your existing health conditions. You can access a range of NHS services from home, including ordering repeat prescriptions or contacting your health professional through an online consultation. To find out more visit the NHS website or download the NHS App. If you have an urgent medical need, call NHS 111 or, for a medical emergency, dial 999.

The NHS Volunteer Responders Programme will continue providing support with shopping and medicines delivery. You can contact them by calling 0808 196 3646 (8am-8pm, seven days a week) or by visiting their website

The government also encourages people who require additional support to follow the guidance in very high alert areas to contact their local authority if they need assistance. You can find the contact details by looking on your local council’s website.

If you are still concerned and need help, you should contact your local authority. You can also find out what support services are available in your area by using this search tool.

We have also launched the Staying Connected programme in partnership with Ovacome to support ovarian cancer patients during this time. This includes support, patient information, updates to government guidance and fun things to keep you entertained during this time.

Ovacome's support line is now open extended hours, and you can call them for free on 0800 008 7054

You can sign up to receive our weekly Staying Connected emails for tips on navigating the shielding period, as well as updates on the Government guidance at the bottom of the page. If there’s anything in particular you’d like to see from us, tell us on info@ovarian.org.uk

Can I access more support if I'm asked to shield?

If shielding is introduced in your area, the government will write to you setting out how you can access support if you need it in order to follow advice, for example, support to access food, medicines deliveries, advice or any additional wellbeing or practical support you may need.

Where can I find mental health support?

We understand that it is normal to feel anxious or go through feelings of depression at this time. There are a number of organisations and services who are there to help support your mental health and wellbeing. If you’re feeling anxious or low, visit Every Mind Matters orgov.uk for advice and support. 

If you feel like you are still struggling to cope, you can also speak to your GP. 

What about my treatment? Will it be safe to go into hospital?

The NHS is currently moving into the next phase of its response to the COVID-19 outbreak: to restore and recover NHS services so that they start to operate as they did before the pandemic. This means that cancer diagnosis, treatment and care are continuing, and the NHS is working to ensure that these services return to operating as they did before. 

Changes are being made to the way services are delivered to keep patients and staff safe. For example:

  • COVID-protected hubs have been established across the country to ensure that cancer treatment continues.  The hubs support hospitals across the NHS and independent sector to work together to maximise capacity and ensure that people receive the treatment that they need.  Some patients may start to see their treatment move to a different hospital as these hubs are set up.  You will remain under the care of your treating hospital and clinical specialist team and should contact them with any questions about your treatment and care.
  • Most hospitals are now using more telephone or internet consultations to avoid unnecessary trips to the hospital. You may be called to arrange your treatments in this way, and planned treatments may need to be moved to help with running a smooth service. You can read a helpful guide put together by Ovacome about how to prepare for these appointments here.
  • Some patients may have their chemotherapy at home or have fewer radiotherapy appointments, to reduce visits to hospital while continuing with their treatment.  
  • For some people, it may be safer to delay surgery. Your doctor may suggest a different treatment in the meantime, such as chemotherapy or hormonal therapy. 
Wider measures are also being taken by all hospitals that are treating COVID patients to ensure that COVID and non-COVID patients are kept separate. For example, there may be separate entrances for COVID and non-COVID patients, all patients admitted to hospital as an emergency will be tested for COVID, and patients going into hospital for surgery or another elective procedure will be asked to isolate for 14 days and be offered a COVID test wherever possible.

If you have an urgent medical question relating to your ovarian cancer please contact your specialist hospital care team, directly. Where possible, you will be supported by phone or online. If your clinician decides you need to be seen in person, the NHS will contact you to arrange a visit in your home, or where necessary, treatment in hospital.

For more guidance, information and sources of support please visit the British Gynaecological Cancer Society's patient information page on their website.

Will there be any problems accessing my cancer drugs?

The government is helping pharmacies to deliver prescriptions which will continue to cover the same length of time as usual. If you do not currently have your prescriptions collected or delivered, you can arrange this by:

1. Asking someone who can pick up your prescription from the local pharmacy, (this is the best option, if possible);

2. Contacting your pharmacy to ask them to help you find a volunteer (who will have been ID checked) or deliver it to you.

You may also need to arrange for collection or delivery of hospital specialist medication that is prescribed to you by your hospital care team.There are currently no medicine shortages as a result of COVID-19. The country is well prepared to deal with any impacts of the Coronavirus and we have stockpiles of generic drugs like paracetamol in the event of any supply issues.

The Department of Health and Social Care is working closely with industry, the NHS and others in the supply chain to ensure patients can access the medicines they need and precautions are in place to prevent future shortages.

There is no need for patients to change the way they order prescriptions or take their medicines. Patients should always follow the advice of doctors, pharmacists or other prescribers who prescribe and dispense their medicines and medical products. The NHS has tried-and-tested ways of making sure patients receive their medicines and medical products, even under difficult circumstances. If patients order extra prescriptions, or stockpile, it will put pressure on stocks, meaning that some patients may not get the medicines or medical products they need.

What is happening with clinical trials?

You should contact your clinical team with questions about your individual treatment including any trials you are part of.

The National Institute for Health Research (NIHR) issued guidance earlier during the pandemic response which recognised that much research would need to pause, not least because many clinical research teams were asked to redeploy to help with providing patient care. The NIHR has now published a framework to support work towards the restoration of research that they fund and/or support.

What do I do if I have COVID-19 symptoms?

If you are experiencing symptoms of any infection or illness, including Coronavirus, you should contact your cancer team know as you would normally.  You can do this as well as using the NHS 111 online Coronavirus service. If you do not have access to the internet, call NHS 111. Make sure you mention that you are an ovarian cancer patient who has been considered to be at risk. Do this as soon as you get symptoms.

If you fall ill from COVID-19, or any other condition, and require treatment in hospital, you will still be treated as normal and will absolutely not be denied any medical intervention because you are in the shielding group.

What should I do if I'm experiencing ovarian cancer symptoms?

The following advice is from the British Gynaecological Cancer Society.

Some existing cancer patients have open access to their gynae-oncology service, normally via the Clinical Nurse Specialist (CNS). If you have already had a gynaecological cancer diagnosis and have symptoms concerning for recurrence (such as persistent bloating and stomach pain), please get in touch with your CNS via their usual contact details. Please be aware that many staff have been re-deployed to look after acutely unwell patients, so there may be a delay, or a CNS from another cancer team may be covering the gynaecological cancer team.  Please be understanding with us if this is the case. We will try our very hardest to look after you and get back to you as quickly as we can.

Sometimes you may be referred to another hospital in your area, if your normal hospital is very busy. We have been working together to help get you seen and treated as soon as we can. We are all one big NHS team, now more so than ever. Please bear with us and be understanding, if this is the case.

Could the guidance change again?

Yes - the guidance is regularly updated based on the latest data available and can be changed by the government.

All four nations of the United Kingdom together are looking at implementing individualised risk assessments - a tool which is currently under development - so that if rates of infection do increase they won't have to advise everyone who has been shielding has to shield again. The goal is for patients to receive their own individual risk assessment based on their medical condition, stage of treatment and location. This is not currently in place, but the  Government is hoping that any future needs for shielding can use this tool instead to determine who needs to shield.

If you have a question that hasn’t been answered, have a look at our wider Coronavirus FAQs and if we still haven’t covered it please email us at info@ovarian.org.uk - we may not know the answer straight away, but we will do our best to find out.

Government guidance is regularly being updated. Sign up here to be kept up to date with the latest government advice, information and advice from experts, and tips on your wellbeing during this uncertain time.