Continuing your cancer treatment during coronavirus

• Additional cleaning: Providing safe and clean facilities remains a key focus, and we have increased the frequency of cleaning rounds including in high use areas such as waiting rooms, nursing stations and planning rooms.
• Reinforcing strict hygiene protocols: All employees and guests are asked to practice increased vigilance with hygiene and infection control, with hand sanitizer available throughout our centres, hand washing guides displayed and other reminder notices in centres.
• Pre-visit screening: We are screening patients, companions from their household or support bubble and visitors for symptoms with a phone assessment and in-centre questionnaire on arrival.
• Coronavirus testing: You will also be asked to complete a lateral flow or PCR test and obtain a negative result prior to your visit.
• Restricting visitors: All other visitors and carers are being asked not to attend our centres, unless required for patient safety and then only if they are from their household or support bubble.
• Emergency response plans: GenesisCare has an emergency response plan in place which we will activate if a patient and/or employee comes into contact with the virus.
• Personal protective equipment (PPE): All staff in our centres will wear a surgical mask within the centre and will adhere to social distancing where they are not required to be in close contact in order to deliver clinical care. All clinical staff will also wear gloves and an apron whilst they carry out your care.
• Telehealth: Secure videoconferencing for appointments with your consultant, as they’re in a different location to you. All you need is your computer, laptop, tablet or mobile device. The benefits of telehealth include improved access to your specialist and reduced waiting times, absence from work and travel costs. Visit our Telehealth at GenesisCare page to learn more about this service.

• Call us if you’re unwell: Please contact your centre prior to treatment if you are experiencing symptoms such as fever and/or shortness of breath or cough.
• Practice excellent hygiene: Wash hands frequently with soap and water or use hand sanitiser, avoid touching your face, and cover your mouth and nose with a tissue if you have to cough or sneeze.
• Attend treatment without guests: We ask that any visitors and carers avoid entering our centres during your treatment, unless required for your safety. Our aim is to have your care delivered as promptly as possible, and to limit the number of people you come into contact with.
• Avoid visits from anyone who is unwell: Those affected by cancer disease may be more susceptible to infection, so we kindly request that any visitors displaying symptoms of illness, such as elevated temperature, coughing, sneezing or headaches, postpone their visit.

Are you still open?

Currently all our centres and clinics are open and treating patients. We are carefully assessing each patient’s individual risks to ensure we can provide the best care. We are closely monitoring the coronavirus pandemic globally, implementing the latest Government advice, and adding extra precautionary measures to maintain a safe environment for our patients and staff.

I’m currently shielding (as a vulnerable person) following government guidelines, can I still access care?

Yes, even if you’re shielding, please keep attending your treatment appointments. Our team will let you know if you need to attend any ongoing appointments via our Telehealth service (videoconferencing). If you have any concerns about self-isolating please call your centre.

How will the coronavirus outbreak affect my ongoing treatment at GenesisCare?

During the coronavirus outbreak, we are making every effort to ensure that the wellbeing of our patients remains a priority. Currently all our centres and clinics are continuing to run tests, such as scans and blood tests, as well as treating patients with radiotherapy and chemotherapy. We have robust measures in place to ensure your safety when undergoing tests or treatments at our centres.

Are all GenesisCare oncologists offering Telehealth and how is it done in practice?

We have provided the option to all doctors to offer appointments via Telehealth (secure telephone and videoconferencing) to discuss your treatment options and needs. New or follow-up consultations can be done via Telehealth. All our Oncologists are offering Telehealth; please ask them any questions or raise any concerns you may have. For more information about Telehealth click here.

Can I bring a friend or family member to my appointment still?

To protect our patients, visitors and staff, all visitors and carers are being asked not to attend our centres, unless required for patient safety. If you must bring a companion, they have to be from your household or support bubble.

I have some cold-like symptoms, what should I do?

Please contact your centre prior to your appointment if you are experiencing symptoms such as fever or a cough. Visit the NHS 111 website for information on seeking medical attention for symptoms of coronavirus, and ensure you communicate your current diagnosis and treatments to the clinicians or 111 staff that you speak to.

I’m concerned about coronavirus and putting myself at risk every time I have to travel from home to the centre. How can I minimise my risk of coronavirus while attending my appointments?

We have multiple safety measures in place to protect you and our staff. We also encourage you to practice good hygiene to protect against infections. Good hygiene includes:

• Washing your hands often with soap and water or hand sanitiser
• Using a tissue and cover your mouth when you cough or sneeze
• Avoiding close contact with others, such as touching, and keep to 2 metres (6 ft) away
• Avoid touching your eyes, nose and mouth

Will I be able to continue my radiotherapy treatment?

GenesisCare remains committed to ensuring that cancer patients can continue to receive the care they need in our centres. Currently all our centres and clinics are operating without delay.

We are closely monitoring the coronavirus pandemic globally, implementing the latest government advice, and are adding extra precautionary measures to maintain a safe environment for our teams and patients.

Will I still be able to access palliative radiotherapy during this time?

If you have advanced cancer, you may be receiving radiotherapy without a curative intent (called palliative radiotherapy) and we will continue this. If you are concerned about attending a treatment centre, we can reassure you that the infection control measures that we take to protect our staff, patients and doctors from infection are robust and consistent.

Should people be splitting their radiotherapy and having a break of a couple of weeks before finishing, or is that not advised?

We do not recommend splitting treatment or taking a break. If you are receiving treatment, we recommend you continue your course of treatment, as prescribed, to make sure you receive the best possible health outcome. In some cases, there are some flexibilities built into the treatment plan that would allow delays or changes so we can continue treatment after a break and get the optimal treatment outcome. This will be discussed case by case, and only in the circumstances when you fall sick or feel unwell.

What happens if I am having radiotherapy treatment and I contract coronavirus? Would I have to stop treatment?

This depends on the severity of your coronavirus symptoms. You can continue treatment if you are asymptomatic (not showing any coronavirus symptoms), and we have precautions in place to provide ongoing treatment safely. If you are not feeling well enough to come for treatment or you are in hospital, we will discuss the best way forward with your consultant. It is likely to involve delaying treatment and compensating for it when you are better, if appropriate.

Does radiotherapy affect the immune system?

Targeted radiotherapy treatment delivered in fewer sessions or otherwise called stereotactic radiotherapy, doesn’t generally make a major impact on the immune system. Some prolonged radiotherapy treatments over many weeks may affect the number of white cells in your blood which help you fight infections.

Your consultant will advise you on the radiotherapy treatment plan most suitable for you, balancing the benefits and risks of treatment.

Am I at a higher risk of becoming seriously ill if I contract coronavirus, because of my radiotherapy treatment?

Short targeted radiotherapy treatments that last for few days don’t have an adverse effect on your immune system. This means that your body is likely to fight the virus as well as people not undergoing radiotherapy.

Prolonged radiotherapy treatments that last over a number of weeks and treat large areas in your body, may lower your body’s immune defence and clearing the virus may take longer or you may develop worse symptoms.

Your consultant will advise you on the radiotherapy treatment plan most suitable for you, balancing the benefits and risks of treatment.

I’ve had radiotherapy in the past. Could my immune system still be compromised and put me at a higher risk of coronavirus?

Having previously had radiotherapy treatment does not necessarily mean you will be more at risk of becoming ill from coronavirus. Your risk of becoming ill from coronavirus due to cancer treatment is higher if you:

• Are having chemotherapy, or have received chemotherapy in the last 3 months
• Are having immunotherapy or other continuing antibody treatments for cancer
• Are having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors
• Are having intensive (radical) radiotherapy for lung cancer
• Have had bone marrow or stem cell transplants in the last 6 months, or are still taking immunosuppression drugs
• Have a type of blood cancer which damage the immune system, even if you have not needed treatment (for example, chronic leukaemia, lymphoma or myeloma)

If you are very concerned about your risk of becoming ill from coronavirus, please contact your GP or consultant for more advice.

As someone undergoing cancer treatment, am I more at risk of contracting coronavirus?

Some people with cancer are extremely vulnerable to becoming seriously ill if they contract the coronavirus infection, including:

• People having chemotherapy, or who have received chemotherapy in the last 3 months
• 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
• People having intensive (radical) radiotherapy for lung cancer
• People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
• People with some types of blood cancer which damage the immune system, even if they have not needed treatment (for example, chronic leukaemia, lymphoma or myeloma)

If you are in this category, you should have received a letter by NHS England or have been contacted by your GP to be advised about how to protect yourself from coronavirus.

If you believe you fall into this category and have not been contacted, please discuss any concerns with your GP or GenesisCare consultant.

Find out more about government advice for clinically extremely vulnerable people on the gov.uk website.

What is shielding?

Shielding is a protocol used to protect particularly vulnerable people from coming into contact with coronavirus. For up to date government advice on shielding measures, please visit the gov.uk website.

Am I in a vulnerable group?

Some people with cancer are more at risk of becoming seriously ill if they contract coronavirus, including:

• People having chemotherapy, or who have received chemotherapy in the last 3 months
• 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
• People having intensive (radical) radiotherapy for lung cancer
• People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
• People with some types of blood cancer which damage the immune system, even if they have not needed treatment (for example, chronic leukaemia, lymphoma or myeloma)

People also falling into this clinically extremely vulnerable group include:

• Solid organ transplant recipients
• People with severe chest conditions
• People with rare diseases/metabolic conditions that increase the risk of infection
• People on immunosuppression therapies
• Pregnant women with significant heart disease
• People who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions

 Find out more about government advice for clinically extremely vulnerable people on the gov.uk website.

Am I in a vulnerable group if I have blood cancer?

If you have a cancer of the blood or bone marrow – such as leukaemia, lymphoma and myeloma – you’re considered clinically extremely vulnerable, whatever stage of treatment you’re in. Public Health England have advised that you should follow current governmental guidance to protect yourself from infection.

Am I in a vulnerable group if I have lung cancer?

If you have lung cancer and you’re undergoing chemotherapy or prolonged radiotherapy treatments that last over a number of weeks and treat large areas in your body, you’re considered to be clinically extremely vulnerable, as per Public Health England guidance. These treatments may lower your body’s immune defence and clearing the virus may take longer or you may develop worse symptoms. It is advised that you should follow this governmental guidance to protect yourself from infection.

Current NHS guidance states that all other lung cancer patients aren’t considered to be more vulnerable because of their condition and don’t need to take extra precautions.

Am I in a vulnerable group if I am undergoing chemotherapy for lung cancer?

If you’re a lung cancer patient and receiving radical chemotherapy, you’re considered to be clinically extremely vulnerable – it has been advised that you should follow the governmental guidance. If you’d like further information about your treatment, or want to discuss your own personal risk, please contact your consultant.

Am I in a vulnerable group if I am undergoing immunotherapy?

If you’re currently undergoing continuous antibody treatment, then you’re clinically extremely vulnerable to coronavirus. Public Health England has advised that you should follow the current guidance to protect yourself. If you’d like further information about your treatment, or want to discuss your own personal risk, please contact your consultant.

Am I in a vulnerable group if I am undergoing PARP inhibitor or protein kinase inhibitor treatment?

If you’re currently receiving targeted cancer treatments which can affect your immune system, such as protein kinase inhibitors or PARP inhibitors, Public Health England has advised you’re clinically extremely vulnerable and should follow governmental guidance to protect yourself. If you’d like further information about your treatment, or want to discuss your own personal risk, please contact your consultant.

What is coronavirus?

Coronavirus (COVID-19) is a respiratory illness caused by a new virus. Symptoms range from a mild cough to pneumonia. Some people recover easily, others may get very sick very quickly. There is evidence that it spreads from person to person. Good hygiene can prevent infection.

What are the symptoms of coronavirus?

Symptoms can range from mild illness to pneumonia. Some people will recover easily, and others may get very sick very quickly. The main symptoms of coronavirus are:

• A high temperature – your chest or back feel hot to touch
• A new and continuous cough – coughing a lot for more than an hour, or three or more coughing episodes in 24 hours
• A loss or change to your sense of smell or taste – you cannot smell or taste anything, or things smell or taste different to normal

Other symptoms include fatigue, vomiting, diarrhoea, indigestion, headaches and shortness of breath.

Who is most at risk of contracting coronavirus?

Anyone can be seriously affected by coronavirus, however, older people and people with pre-existing health problems (such as asthma, diabetes, heart disease) seem to be more susceptible to becoming severely ill with the virus.

How does coronavirus impact people with pre-existing health conditions such as cancer and heart disease?

While more than 80% of confirmed coronavirus cases are considered not severe, the virus has proven to be dangerous, and at times fatal, in immunocompromised individuals, including the sick and elderly.

People with pre-existing health conditions, including cardiovascular disease, cancer or respiratory illnesses such as asthma and COPD, are at higher risk of developing more severe symptoms from coronavirus.

Cancer treatments such as chemotherapy and radiotherapy can weaken your immune system, making you more vulnerable to infections like coronavirus.

Similarly, patients with asthma or COPD are often treated with high-dose steroid medication which can also dampen the immune system and put them at increased risk of infection.

How does coronavirus spread?

The virus spreads from person-to-person and is most likely spread through:

• Close contact with an infectious person
• Contact with droplets from an infected person’s cough or sneeze
• Touching objects or surfaces (like doorknobs or tables) that have cough or sneeze droplets from an infected person, and then touching your mouth or face

What can I do to protect myself?

Everyone should practice good hygiene to protect against infections. Good hygiene includes:

• Washing your hands often with soap and water or hand sanitiser
• Using a tissue and cover your mouth when you cough or sneeze
• Avoiding close contact with others, such as touching
• Avoid touching your eyes, nose and mouth
• Limit social gatherings and time spent in crowded areas
• Clean objects and surfaces that are frequently touched

In addition to the tips above, everyone should follow current governmental guidance.

Can I contract coronavirus from an asymptomatic carrier (someone who doesn’t show symptoms)?

The main way coronavirus spreads is through small droplets expelled by someone who is coughing, so the risk of you catching coronavirus from someone with no symptoms at all is very low though still possible. However, you should still follow current governmental guidance.

In order to ensure patients can quickly access the diagnostic tests and treatment they need, we are continuing to to run rapid access diagnostic clinics for breast, urology and prostate patients in Cambridge, Maidstone, Milton Keynes, Oxford and Windsor centres.

Additionally, it’s also important for everyone to try to keep their wellbeing front and centre during what can understandably be a stressful time. This could mean remaining active, calling a friend or doing something else you enjoy. GenesisCare is here to support our people, our patients and our communities in whatever way we can, so please reach out to your local centre if you have any questions, comments or concerns.

GenesisCare delivers care both privately and on behalf of governments in many locations around the world. We acknowledge the demand that this outbreak is having on the broader public health system internationally and will continue to work closely with health departments to provide rapid access to high quality oncology and cardiology care.