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

BRCA gene mutations

Page updated 31st July 2020

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

Many ovarian cancer patients will need to follow special shielding guidance during the coronavirus (COVID-19) pandemic in order to stay safe and well. Shielding guidance helps protect people whose specific medical condition or treatment places them at risk of serious illness if the catch coronavirus, by lowering their chances of coming into contact with the virus. 

The Government regularly updates their shielding guidance for at risk or 'clinically extremely vulnerable' people. Ovarian cancer patients in England are currently being advised to continue shielding until the 1st August, when shielding will be paused across the country, except in Leicester, Luton, Blackburn with Darwen. Please scroll down to read the latest national guidance and regional advice, which we'll be regularly updating as the situation changes. 

Shielding FAQs for England 

Am I 'extremely vulnerable'? Do I need to shield?

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 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.
When or how you need to shield will depend on the latest advice from the government. At the moment, ovarian cancer patients in England are being asked to continue shielding until 1st August. 
When and where is ending in England?

Shielding will be paused in England (except for in a small number of areas) from 1st August. This is because infection levels in the community have fallen significantly, meaning the risk of catching Coronavirus is much less than it was before. Only people on the Shielded Patients List (SPL) in Leicester, Luton, and Blackburn with Darwen should not follow the national pausing of shielding that will take place on 1st August. If you live in one of these areas, you will receive a text and a letter with information on the local measures being taken in your area, and where you can find further guidance and support. Please see our regional FAQs below for tailored information. 

What does the shielding guidance say?

From Monday 6th July until 1st August those shielding from Coronavirus can gather in groups of up to six people outdoors (while maintaining social distancing). You also no longer need to practice social distancing with those in your household.

If you are shielding and live alone, or are a single parent with children, you will be able to form a ‘support bubble’ with another household of any size. This means you can spend time in the other household and stay the night without social distancing.

To ensure your ongoing safety while restrictions are eased, it's important not to forget:

  1. While meeting people outdoors, take extra care to minimise contact with others by keeping 2 metres apart.
  2. Wash your hands regularly with soap and water for at least 20 seconds or use a hand sanitiser. Do this after you blow your nose, sneeze or cough, before you eat or handle food.  Ask carers or support workers who visit your home to do the same. 
  3. Avoid touching your eyes, nose, and mouth with unwashed hands, and clean and disinfect frequently touched objects and surfaces in your  home - fridge doors, touch bins etc.
  4. You should not attend any gatherings, including gatherings of friends and families in private spaces, for example, parties, weddings and religious services.
  5. You should strictly avoid contact with anyone who is displaying symptoms of COVID-19 (a new continuous cough, a high temperature, or a loss of, or change in, your sense of taste or smell).

From 1st August patients will no longer be advised to shield. This will mean from then you can start participating in more activities, such as going to the shops, exercising and visiting places of worship. You will also be allowed to return to work if you are unable to work from home. However you should stay at home as much as possible, while following the advice above to reduce your risk of catching the virus after shielding ends. Our advice from this date is to enjoy the freedom but remain cautious as ovarian cancer patients are still at risk of severe illness if they do catch COVID-19.

Where can I get support?
Everyone who has received a letter advising that they are clinically extremely vulnerable is able to access extra support if you need it. This may include having essential groceries delivered to your home or setting up regular calls with an NHS volunteer if you are experiencing feelings of isolation. This Government shielding support package will remain in place until the end of July. All the information you need to sign up for extra support can be found here.

From the 1st August, those who are shielding will still keep their priority supermarket delivery slots and be able to access help with shopping,  medicines delivery and transport to appointments.

We understand this will be an incredibly frustrating and difficult time for many of you, especially those who feel well. Your emotions will probably range from anxious to downright bored. Your mental health will be just as important as your physical health at this time. 

We have 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

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 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

https://111.nhs.uk/covid-19/

. 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.

I haven't received a letter but think I should have - what should I do?

The criteria for cancer patients were carefully defined, based on those with greatest clinical risk.  

Some people received letters later than others, but all letters should have now arrived. If you haven't received a letter and you think you should have you should contact your GP urgently. A second wave of letters have now been sent out.

If you are unsure of your risk and what measures you should be taking, you should speak with your hospital specialist.  If this is not possible, you should contact your GP.

I received a letter but don't think I should be shielding - what should I do?

We understand that the restrictions imposed by shielding are difficult, both for you and for your family members. The Government has issued shielding guidance based on careful criteria, strongly advising you to stay at home and avoid face-to-face contact as much as possible. This is the safest thing to do to protect you from illness/ complications of COVID-19. It is unlikely that you have received a letter in error, but if you think you have do speak to your GP.

However, this is guidance and whether you follow the guidance or not is a personal decision for you to make. You may decide, having weighed up the risks and the implications of shielding, that you do not want to follow the guidance. Before deciding, we would ask you to discuss the matter with your GP or hospital specialist and those that may provide care for you. This may be particularly relevant for patients who are receiving end of life care. Please do talk to somebody before you decide what to do.

If you are unsure of your risk and what measures you should be taking, you should speak with your hospital specialist.  If this is not possible, you should contact your GP.

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.

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 should I do about work?

Your letter is evidence, for your employer, to show that you cannot work outside the home. You do not need to get a fit note from your GP. You can continue to work from home if you feel able to.

From the 1st August you will be able to return to work if you can't work from home - but only if your workplace is COVID secure and following guidance to make workplaces safe.  

Where can I read the latest shielding guidance?

You can read the latest shielding guidance for England on the Government website

There is separate guidance for people in Wales, Scotland and Northern Ireland.

Why did the Government update their shielding guidance for vulnerable people? UPDATED

The initial shielding period was originally set for 3 months, from the end of March to the end of June. The Government decided to relax their shielding guidance for vulnerable people from 1st June as the levels of COVID-19 are much lower now than when shielding was first introduced. This new update (22nd June) for July reflects the lower levels of the virus in the community, while still trying to keep those most clinically vulnerable safe.

We know the news that people can now go outside for the first time since March will be a welcome change for many people. Simple things like going for a walk or having a change of scene can really help you stay well physically and give your mental health and mood a boost. 

Please know, however, that it’s still very important to keep up with social distancing measures if you choose to go outside. While the risk of catching Coronavirus has dropped, people classed as 'extremely vulnerable' still have the same risk of falling seriously ill should they contact it. That's why it's important continue to follow social distancing precautions and stay home as much as possible, to help keep you or your loved ones safe.

You can read the Government's advice on keeping well and safe here

Could the guidance change again?

Yes - the guidance is regularly updated based on the latest data available. If there is a second wave and the risk of those who are clinically vulnerable catching the virus increases then the guidance will be adjusted again.

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.

What about people who have had treatment in the past but are not part of the shielding group?

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.

Local shielding FAQs 

The Government will be using local measures tackle Coronavirus if there's a rise in the number of cases in certain areas of the country. At the moment, new local measures are being introduced in response to an increase in cases in Leicester, Luton, and Blackburn with Darwen. This means that if you live in these areas and are on the Shielded Patients List (SPL), you will be asked to follow different guidance to the rest of the country for a while. 

We understand this may be frustrating or worrying for many people, particularly if you were looking forward to lockdown measures easing. Please know that the local guidance is tailored to help keep you safe and well, and we’ll keep you up-to-date on new information. 

Leicester

What's the latest shielding advice for Leicester City, Oadby and Wigston?

If you live in Leicester City, Oadby and Wigston, the government is writing to advise you to continue shielding until at least 17th August. Levels of the virus remain high and shielding guidance will not be relaxed at this time. Instead, the new advice is:

  • you are strongly advised to stay at home as much as possible and keep visits outside to a minimum
  • if you wish to spend time outdoors this can be with members of your own household or, if you live alone, you may choose to spend time outdoors with one person some another household (ideally the same person each time). You should maintain social distancing and avoid gatherings of any size
  • you are advised not to be part of a support bubble with another household.
What's the latest shielding advice for the Blaby and Charnwood area?

The government is writing to you to advise that you should continue shielding until 17th August and after that date will be paused. The government will relax shielding advice in the Blaby and Charnwood area in two stages on 3rd August and 17th August, because the number of people with Coronavirus in these areas has fallen. 

From 3rd August:

  • you may, if you wish, meet in a group of up to 6 people outdoors, including people from different households, while maintaining strict social distancing;
  • you no longer need to observe social distancing with other members of your household;
  • If you are a single adult household (either an adult living alone or with dependent children under 18), you may from this date, if you wish, also form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each other's homes, including overnight, without needing to socially distance.
From 17th August shielding will be paused. From this date, along with the wider population, the government advises you to strictly follow social distancing rather than full shielding measures. This means you can go out to more places and see more people but you should take care to minimise your contact with others outside your household and support bubble.
Will I receive a new letter from the government about shielding?

Yes, the government will write to you about the new shielding guidance in your area. Your new letter dated 27 July will replace previous government letters and can be used as evidence for your employer to show that you cannot work outside your home until 17th August, including for statutory sick pay purposes. 

Government's letter to residents in the Leicester City, Oadby and Wigston area > 

Government's letter to residents in the Blaby and Charnwood area >

Where can I find support if I'm shielding or self-isolating in the Leicester area?

If you are currently receiving free government food boxes, medicine deliveries or care through the national shielding service, you will continue to receive this support until the end of July. Priority supermarket delivery slots provided by seven supermarkets will continue to run beyond the end of July for people already signed up to that support.

From 1 August, weekly food box and care support will be provided by Leicester City Council to support you to remain at home until 17th August and they will contact you to discuss your needs. Please be aware that your food box may arrive any time during the week. If you are not yet registered for support but are concerned that you will need help, you can contact the council via email at c19support@leicester.gov.uk.

Patients who are considered clinically extremely vulnerable are encouraged in the first instance to see if their medicines can be collected from the pharmacy or dispensing practice and delivered by family, friends, a carer or a volunteer. If this is not possible, free medicines delivery from your local pharmacy will continue whilst you are being advised to shield. Please contact them to let them know you would like this to continue.

NHS Volunteer Responders are also there to help collect shopping, medicine and other essential supplies that need delivering. They are also there to check in with you if you would like a chat and some company. You can call them for free on 0808 196 3646 (8am - 8pm).

I’m not sure if I’m in the Leicester area – how can I check?

You can check if you live in the area where new restrictions apply by entering your postcode on the Local Lockdown Postcode Checker.

You can also find a map of the areas restrictions apply to on the Leicester City Council website.

Where can I find more information about the situation in Leicester?

Detailed advice is available at Leicester.gov.uk/coronavirus.

You can also sign up for Coronavirus updates on the Leicestershire County Council website.

Leicestershire County Council has also put together commonly asked questions on the Leicester lockdown, which you can find on their website. They have answered what the new restrictions mean for you and where you can find support. 

Luton

What's the latest shielding advice for the Luton area?

In Luton the advice to shield will remain in place after 31st July. This means that if you live in the Luton area and are on the Shielding Patients List (SPL), you are advised not to follow the national pausing of shielding that will take place on 1st August. The local guidance will be:

  • you may, if you wish, meet in a group of up to 6 people outdoors, including people from different households, while maintaining strict social distancing;
  • you no longer need to observe social distancing with other members of your household;
  • If you are a single adult household (either an adult living alone or with dependent children under 18), you may from this date, if you wish, also form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each other's homes, including overnight, without needing to socially distance.
Will I receive a new letter from the government about shielding?

Yes, you will be sent a text and a letter dated 28 July about the new shielding advice in your area. This new letter will continue to act as evidence for your employer to show that you cannot work outside our home until 17th August, including for statutory sick pay purposes. You will receive another letter before 17th August providing the evidence for your employer from this date is advice to shield remains in place. 

Where can I find support if I'm shielding or self-isolating in the Luton area?

If you're currently receiving free government food boxes, medicine deliveries or care through the national shielding service, you'll continue to receive this support until the end of July. Priority supermarket delivery slots provided by seven supermarkets will continue beyond the end of July for those already signed up for support.

Where can I find more information on coronavirus in Luton?

Please visit the Luton Borough Council website for the latest information on coronavirus, including local guidance on restrictions, social distancing and testing to help keep you and others safe. 

Blackburn with Darwen

What's the latest shielding advice for Blackburn with Darwen?

If you are on the Shielded Patients List (SPL), you will be sent a text message and letter from the government advising you to continue shielding until at least 17th August. You should not follow the national pausing of shielding that will take place on 1st August. Instead, the advice is:

  • you may, if you wish, meet in a group of up to 6 people outdoors, including people from different households, while maintaining strict social distancing;
  • you no longer need to observe social distancing with other members of your household;
  • If you are a single adult household (either an adult living alone or with dependent children under 18), you may from this date, if you wish, also form a ‘support bubble’ with one other household. All those in a support bubble will be able to spend time together inside each other's homes, including overnight, without needing to socially distance. 
Will I receive a new letter from the government about shielding?

Yes, everyone on the Shielded Patients List (SPL) will be sent a text and letter dated 28 July from the government about the new local advice. This new letter will continue to act as evidence for your employer to show that you cannot work outside your home until 17th August, including for statutory sick pay purposes. You will receive another letter before 17th August providing the evidence for your employer from this date if advice to shield continues. 

Where can I find support if I'm shielding or self-isolating in Blackburn with Darwen?

If you are finding it hard to cope in the current pandemic please visit www.gov.uk/find-coronavirus-support.

If you urgently need food or care, please contact Blackburn with Darwen Borough Council’s Help Hub by calling 01254 588111 (Monday to Friday, 9am-5pm) or by visiting www.blackburn.gov.uk/helphub. The Council can put you in touch with local organisations who can help provide food, deliver meals and collection shopping.

You can also contact NHS Volunteer Responders for help collecting shopping, medicine or other essential supplies that you need delivered to your home, or for someone to check in with you if you would like a chat. You can call them for free on 0808 1963646.

Where can I find more information on coronavirus in Blackburn with Darwen?

You can visit the Blackburn with Darwen Borough Council website for more information about the local response to coronavirus, as well as guidance and testing information. 

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.