We look at how the coronavirus pandemic is impacting the treatment and care of breast cancer patients.
The impact of coronavirus on the breast cancer workforce
Living with breast cancer can be incredibly difficult, but the right care, support and treatment can make a real difference. From the initial consultation appointment with a GP, to seeing an oncologist, to the care and support provided by a nurse – it is the breast cancer workforce that are at the heart of making a difference to people living with breast cancer.
Everyone with breast cancer should feel they receive the right information and support to manage their diagnosis and treatment. Staff like Clinical Nurse Specialists (CNS) take on this crucial role for people living with the disease. For people living with secondary breast cancer the support a CNS can provide is particularly important to make sure they receive the support they need throughout their lifelong treatment.
The breast cancer workforce was already stretched before the coronavirus pandemic. To help us understand the impact of coronavirus on people’s treatment and care between March and August we asked people with breast cancer to tell us about their experiences.
I used to see someone every three weeks
We spoke to Jean and Nadia who told us about the changes to care and support they were receiving from the breast cancer workforce.
Jean lives in Welwyn Garden City with her husband, has two daughters and four grandchildren. Jean was diagnosed with secondary breast cancer 8 and a half years ago.
“I went in for treatment in March. A nurse practitioner said we needed to discuss my treatment and I was then just told it was suspended. I was too high risk but I didn’t want the treatment to stop. It felt like my choices were dying of cancer or dying from the pandemic. I got very emotional and upset. The nurses who I had become friendly with were upset and they said it would be okay, but it felt like they were taking my lifeline away.”
“I used to see someone every three weeks. If it wasn’t my oncologist, it would be a nurse practitioner. I've not seen anyone face to face since March, only the chemo nurse.”
“I only have contact with someone now every four or five weeks. Before I was treated as a person and now I feel like I've become more of a number and a bit irrelevant.”
It was frightening to have to go to appointments by myself
Nadia is 23 years old and works as an assistant psychologist for a child protection charity. She lives with her parents and her older sister.
“I was diagnosed on 16 June 2020, it was a complete shock. No one expected it, even the doctors.”
Nadia had her initial phone consultation on 28 April. She said, “I would really have preferred a face-to-face appointment. I found the phone consultation very difficult and I struggled to describe the lump over the phone.”
Nadia describes having, “had some real ups and downs. I’ve found that my mood has changed a lot and I have a lot of anxiety. I have been trying to seek counselling but I’m finding it difficult as there isn’t a lot of support and most of it is online.”
“The breast cancer nurse that I saw works at Macmillan and she recommended the Mulberry Centre and Breast Cancer Haven however I haven’t been able to access these services face to face.”
“The biggest impact for me is that I can’t take people with me for treatments. Sometimes it’s a positive thing as I don’t have to worry about how someone else is feeling but at the beginning it was frightening to go to appointments and have treatment by myself.”
The pandemic has been a source of anxiety for many patients
The pandemic and the resulting changes to treatment and care have been a source of anxiety for many people with breast cancer. Jean and Nadia’s experience show how distressing these changes can be.
They are not alone. In our July and August survey 60% of all respondents said they were feeling stressed or anxious. 58% reported being worried about the future and 38% said they were feeling isolated.
Due to current restrictions, people living with breast cancer have had to face receiving treatment alone, without the support of friends and family. Jean and Nadia’s stories show how central Clinical Nurse Specialists are when receiving treatment and care, especially with the new restrictions in place.
We spoke to Sarah Adomah, Clinical Nurse Specialist. She said, “My workload didn’t change but it did intensify. It was harder to give patients comfort. It completely breaks you.”
It is vital that additional funding to recruit and train more clinical nurse specialists is made available to ensure that everyone with breast cancer and secondary breast cancer is supported by a CNS.
The breast cancer workforce plays a vital role for patients
Many respondents to our survey were also concerned about the potential impact of changes to their treatment and care.
Jean did not want to stop her treatment. She felt less in control of her choices and has struggled to contact her clinical team.
Like Jean, only 43% said they definitely felt as involved as they wanted to be in decisions about their treatment and care. Many respondents also said that they have had less contact with healthcare professionals.
The combination of not being involved in decisions and less contact with healthcare professionals suggests that with the right support from staff, patients can feel more involved and in control of their breast cancer experience.
It is clear that with current workloads and increased pressure on the workforce, it is harder for staff to involve and support patients during their treatment.
The cancer workforce has a vital role to play in supporting and caring for people living with breast cancer from diagnosis, throughout treatment and beyond. This workforce is already overstretched and under pressure.
In Autumn's Spending Review (CSR) we called on the Government to press play on recruiting and training more staff with the help of over 5,000 of our supporters. The Spending Review included £260 million pound investment for Health Education England, the body responsible for recruiting and training healthcare staff.
However, long-term funding and a strategic plan is still desperately needed to tackle the existing pressures on the NHS workforce which have been exacerbated by the COVID-19 pandemic.
In 2021, we will continue to campaign to make sure the cancer workforce is supported to deal with the delays and provide care to those who need it most.
If you would like to join us and make a positive difference to people affected by breast cancer this year, sign up to receive our campaign updates.