Coronavirus advice for people receiving or beginning cancer treatment

Last Reviewed: 18 September

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Some active treatments for cancer, particularly chemotherapy and radiotherapy, can reduce the effectiveness of the immune system during therapy and for a time afterwards normally lasting a number of weeks.

Some types of cancer can also have an impact on the immune system, such as blood cancers that affect bone marrow.

Patients going through cycles of treatments over a number of months may be at greater risk of developing more severe complications from coronavirus (Covid-19) if they become infected during their treatment.

The consequences of infections such as the common cold, vomiting bugs and flu, as well as coronavirus can be more severe for those with weakened immune systems and older people.

Everyone’s risk is different – it depends on your cancer type, your treatment, your age and your general health. If you’re worried, the best thing to do is ask your cancer doctor or oncology nurses who know your medical history.

Health authorities have recommended that extremely medically vulnerable patients should cocoon to help protect themselves from infection as they are deemed to be at very high risk. You can find information on cocooning by clicking here.

Click on the tabs below for detailed information about cancer treatment and coronavirus.

Ireland is currently at Level 2 of the Government’s Plan for Living with Covid-19. Dublin is at Level 3 of the plan until Friday 9 October, with the following specific measures applied to Dublin:

  • Home visits from a maximum of 6 people from 1 other household
  • Travel outside the county is restricted to essential purposes
  • People should work from home unless absolutely necessary to attend in person, and public transport should only be used for essential purposes
  • Visits to nursing and care homes are suspended, except for critical & compassionate circumstances.

Click here for more information on restrictions

Cocooning

Advice on cocooning applies to the following groups of patients with specific types of cancers:

  • People with cancer who are currently being treated with chemotherapy or medication. You may also be advised to cocoon for two weeks before starting your treatment or before coming in for surgery or a particular test.
  • People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment. If you are unsure if your type of blood or lymph gland cancer weakens your immune system, check with your cancer team.
  • People having immunotherapy or other continuing antibody treatments for cancer.
  • You have lung cancer and are being treated with radiotherapy.
  • People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
  • People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.

If you are unsure if you should be following advice on cocooning you should discuss this with your GP or your medical team.

If you are in this group you should take the following steps:

  • Strictly avoid contact with someone who is displaying symptoms of coronavirus. These symptoms include high temperature and/or new and continuous cough.
  • You should continue to stay home as much as possible, limit social interactions to small groups, and always maintain strict social distancing when coming into contact with others.
  • Avoid using public transport where possible, and try to confine your shopping to designated times for vulnerable people.
  • Wear face coverings when in confined public spaces such as shops where social distancing may not be possible.
  • Keep in regular contact with others using remote technology such as phone, internet, and social media.
  • Use telephone or online services to contact your GP or other essential services.
  • Ensure you keep phones/devices charged, and have credit on your phone so that you can stay connected.
  • If other people are living with you they should adhere to social distancing guidelines and try keep 1m apart, and 2m where possible.
  • Keep yourself mobile by getting up and moving as much as possible. If you have a garden or balcony, get out for fresh air.

You can click here for further information on cocooning for people in affected groups, their families and carers.

Extra care for people in risk groups including cancer patients

People with cancer generally are considered a high risk group of developing a serious illness if they contract the coronavirus and so are advised to take extra care.

The HSE has published advice on extra care for high risk groups here.

Steps to protect yourself from infection

In addition to following the advice of the authorities on taking extra care or cocooning as it applies to you, there are other important precautions you can take. 

These are:

  • Regular and thorough hand washing with common soap and warm water and use of alcohol-based hand washes, especially:

    • when in contact with other people
    • before eating or touching your face
    • after using the bathroom
    • upon entering the home 
  • Avoid touching your eyes, nose and mouth with unwashed hands as this can transfer the virus from surfaces. 
  • Limit indoor gatherings to no more than 6 people from up to 3 households. [As per the Government announcement of 15 Sept, this is limited to gatherings of no more than 6 people from 2 households in Dublin.]
  • Avoid using public transport where possible and work from home.
  • Face coverings should be worn when in busy enclosed public spaces such as shops and public transport, and people should continue to work from home where possible.
  • Clean and disinfect frequently touched objects and surfaces. 
  • Do not share objects that touch your mouth – for example, bottles and cups.
  • Avoid unessential overseas travel, and follow Department of Foreign Affairs advice where this is absolutely necessary. Limit direct contact with people who have travelled to Ireland over the last 14 days.

Infections of all kinds are easier to transmit from person to person in the home, so practicing these steps in the home of someone being treated for cancer can help protect them from many different diseases.

These measures are useful for everyone but are particularly important for people who:

  • Are over the age of 60
  • Have other major or chronic illnesses or conditions such as heart disease, lung disease, diabetes or high blood pressure
  • Have recently been treated for cancer

If you develop signs of an infection and are being treated for cancer

The symptoms of coronavirus are similar to the common cold or flu. As with any infection, coronavirus is more likely to progress at a greater speed in a cancer patient. It is important to seek the expert opinion of a cancer doctor at an early stage, and to intervene early so as to best deal with the impacts of falling ill.

A sudden fever (feeling very hot, or very chilly and sweating) can be a sign of many different types of infection and requires medical advice. Infections during cancer treatment are unfortunately common and may not necessarily be caused by coronavirus. All infections in cancer patients must be thoroughly investigated due to the risk that they may become more serious.

If a patient being actively treated for cancer develops signs of infection, for example high temperature (fever), coughing or shortness of breath, they should urgently make contact with their oncology unit through the liaison phone number they have been given. The nurse or doctor will advise on measures that need to be taken and what this means for your treatment.

Patients who have not recently received treatment for cancer and show signs of infection should follow the usual advice of making contact with their healthcare provider, GP or out-of-hours service. Testing for suspected cases of coronavirus is not being provided by out-of-hours services at the current time.

Anyone in this category who potentially has symptoms of coronavirus (cough, shortness of breath, fever) should:

  • isolate themselves from other people - this means going into a different, well-ventilated room, with a phone. Anyone else in the same household should restrict their outside movements.
  • phone their GP who can organise for a coronavirus test if needed
  • in a medical emergency (if you have severe symptoms) phone 112 or 999

Presenting at emergency departments is NOT recommended due to the high likelihood of coming into contact with other infections in such areas, as well as the possibility of an infection being transmitted to other people who are unwell or medical staff.

Hospital treatment

Hospitals continue to function and deliver quality cancer treatment, and have introduced a number of additional measures aimed at reducing the risks of coronavirus infection. Some of these measures include:  

Coronavirus screening  

Most cancer treating hospitals are now pre-screening and screening patients for coronavirus before they come into their clinic.    

For pre-screening a nurse will call you 1-2 days before your treatment and ask you a number of routine questions about your health to assess if you are showing any signs of coronavirus infection.  

As you enter your hospital or treatment clinic a nurse may check your temperature, and again assess if you are showing any signs of infection. This is to ensure that you are not affected by coronavirus before you start your treatment and to stop the potential spread of infection to other patients and hospital staff.  

Changes to treatment plans 

Coronavirus infection will continue to be a risk over the next number of months. As a result your treatment team may need to discuss with you and your family how best to adjust your treatment plan to balance different treatment options, scans and appointments so as to keep the risk of you contracting the infection as low as possible, while still giving you the best possible care for your stage and type of illness.

For some patients there may be delays on some routine procedures and scans in order to reduce the chances of you being exposed to possible cases of coronavirus in the hospital.

There might also be a recommendation to delay treatment for a period of time. While this may cause worry it should only happen where it is safe for the patient, and it should recommence as soon as is safely possible.

For some other rare cancers your doctor may suggest that you forgo certain parts of your treatment plan, especially treatments that could compromise your immune system.  Again, this is intended to balance the need for treatment with the risk of infection.  

These discussions will only impact a minority of cancer patients, and if they are relevant to you your doctor will discuss these in detail with you so that you can arrive at the best decision for your circumstances together.

Ireland has world-class specialists and expertise across the whole range of cancer care areas, and our doctors and nurses continue to link in with national and international experts to give the best care possible. 

Moving of treatment clinic within your hospital  

In some hospitals cancer treatment facilities are being moved to new locations, sometimes to within the hospital campus and in other cases to other hospitals nearby, to help prevent infections by keeping different groups of patients separate, including anyone in need of isolation.

You will be kept informed of these changes and given the new location of your clinic if this affects you

Virtual and telemedicine clinics 

For some routine treatment check-ups patients are receiving their consultation over the phone or using telemedicine facilities, where these are appropriate for standard follow-up care. A healthcare professional from your clinic will contact you in advance by phone to set this up where this service is needed.  

Visitor restrictions  

All hospitals now have restrictions on visitors and accompanying persons. You should contact your hospital for further details if these restrictions could cause difficulties for you.  

Looking after yourself

This is a particularly worrying time for cancer patients, but there are resources available to help them cope with any added stress caused by the current situation. 

The Irish Cancer Society is providing remote counselling sessions for people who are affected by cancer and who cannot access face to face services as result of the coronavirus pandemic. To access this service, please call our Freephone Support Line on 1800 200 700.

St Vincent’s University Hospital clinical psychologist Dr Paul D’Alton recently spoke to the Irish Cancer Society about how cancer patients can look after their mental and physical wellbeing amid the coronavirus outbreak which you can read here.

The National Cancer Control Programme has also developed guidance on coping with stress which you can read here.

While it might be more difficult to see them, stay in touch with friends and family who are a vital support at this time.

More information

Information on coronavirus for cancer patients their families and carers can be found at the following webpages: 

Information on health, education and employment is available on the Citizens Information website: https://www.citizensinformation.ie/en/health/covid19_overview.html#l97a70

For details on global travel information please see https://www.dfa.ie/travel/travel-advice/coronavirus/ or download the Department’s Travelwise app https://www.dfa.ie/travelwise/.

Contact the Irish Cancer Society Support Line

The Irish Cancer Society continues to be available to provide support and information on this matter or any other queries related to cancer through its Freephone Support Line on 1800 200 700.

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