Clinical Nurse Specialist Jane Murphy, who looks after Breast Cancer Now’s Helpline and Ask Our Nurses email service, answers some common questions about breast cancer and the coronavirus. Information is regularly reviewed and updated. Last updated 1 June 2020.
It’s important to follow guidance from the NHS on the coronavirus.
You can also read information on the coronavirus for people with cancer from the One Cancer Voice group of charities.
While we cannot comment on individual cases, here are some of the questions we are most commonly asked and what the guidance says, as we understand it. Please refer to your hospital teams or GP, where possible, with specific questions.
- I’m taking hormone therapy. Am I more at risk?
- I’ve had lymph nodes removed from my armpit. Does this affect my immunity?
- I’ve been asked by the NHS to stay at home for at least 12 weeks. Why?
- I'm worried my treatment might be delayed
- I’ve been told my planned radiotherapy may be shortened. Is this safe?
- I’m currently having treatment. Am I more at risk from the coronavirus?
- What if I’m having treatment and live with someone who gets symptoms?
- I’m currently following the shielding advice as I’m on chemotherapy. My children can go back to school but I’m unsure if this is sensible?
Hormone therapies, including tamoxifen, letrozole, anastrozole, exemestane and goserelin, do not affect your risk of getting coronavirus or of becoming seriously ill if you do get it.
Taking hormone therapy does not affect your immune system.
There have been various references in the media made to a possible link between COVID-19 and hormones. In the UK this has recently become part of the data that is being collected by the COVID symptom study group. This group are trying to better understand how hormones, such as oestrogen, might influence the virus. However the study is not looking at how reducing circulating oestrogen with hormone therapy might influence the virus.
Talk to your treatment team or call our Helpline if you are concerned about this.
Having lymph nodes removed does not affect your body’s ability to fight infections such as the coronavirus.
It’s common to have lymph nodes under the arm removed as part of surgery for breast cancer.
While having lymph node surgery increases the risk of a condition called lymphoedema, having nodes removed or having lymphoedema does not affect the overall ability of the immune system to fight infection.
Many people have been contacted asking them to stay home for at least 12 weeks and to avoid face-to-face contact.
This is called shielding and is being done to protect people who are at the highest risk of serious illness from the coronavirus. The guidance on shielding changed on 31 May 2020. You can find out more about this on the gov.uk website.
You may be contacted if you’re having one of the treatments for breast cancer listed below.
We’ve had calls from some people who finished treatment some time ago but have still been asked to stay home. We think this may be because they had chemotherapy or biological therapies in the past. If this is the case for you, you may need to contact your hospital team or GP to ask them to clarify what you should do, you may also have been asked to shield for another reason not related to breast cancer.
Some people due to have hospital treatment for breast cancer might find their treatment is delayed. This could be to help minimise their risk of infection or as the NHS tries to cope with unprecedented demand.
Doctors will decide whether to delay someone’s treatment with the input of the multidisciplinary team and should fully discuss these decisions with all patients.
If you’re concerned about a delay to your treatment, it’s best to speak to your breast care nurse or treatment team.
It’s natural to feel worried if your treatment has been delayed. Our Helpline team are here if you need to talk.
Some people due to have radiotherapy may be told it will be given over a shorter period than originally planned.
For example, your treatment team may recommend five daily treatments over one week (Monday-Friday).
For several years, clinical trials have been looking at giving radiotherapy over shorter periods. One large trial has recently confirmed that people who received the shorter regime (five daily treatments of radiotherapy in a week compared to fifteen daily treatments over three weeks) have similar results. The trial found that giving radiotherapy over the shorter time period was as safe and as effective as the longer period. The trial results so far are based on people who were followed up for five years in the two groups. The results following people up for ten years are to be published shortly.
Based on these trials, radiotherapy experts believe shortening some people’s treatment is an acceptable way to be treated.
Having certain treatments for breast cancer could mean you’re more at risk of getting an infection such as the coronavirus, and more at risk of becoming seriously ill if you do get it.
This includes people having:
- immunotherapy or targeted (biological) therapies such as trastuzumab emtansine (Kadcyla) or everolimus (Afinitor)
- trastuzumab (Herceptin), or trastuzumab with pertuzumab (Perjeta), with or without chemotherapy (the risk is likely to be smaller if you’re not having chemotherapy as well)
- other targeted (biological) therapies which can affect the immune system, including palbociclib (Ibrance), ribociclib (Kisqali) and abemaciclib (Verzenios)
Compared with chemotherapy drugs, targeted therapies tend to have fewer serious side effects. However, they can still cause problems in some people.
Because of this, it’s best to contact your hospital team to check your individual risk.
People on these treatments usually have regular blood tests to check their white blood cell count. A low white blood count means you’re more at risk of infection.
People who have symptoms of the coronavirus are being told not to leave home. Members of their household are also advised to stay home. This is called self-isolation.
The government's guidance on self-isolation includes information on protecting vulnerable people in the household.
For example, if someone in your household has symptoms, you should try to keep 2 metres (3 steps) away from each other and, if possible, not share a bed.
8. I’m currently following the shielding advice as I’m on chemotherapy. My children can go back to school but I’m unsure if this is sensible?
Making decisions at a time like this is very difficult. The advice on shielding is to protect vulnerable people from coronavirus. Chemotherapy can affect the immune system of anyone having it (or anyone who has recently finished it) so shielding is advised. I can understand why you are concerned about sending your children to school as it may mean they could bring the virus home with them.
Some people may feel the best approach would be to wait until they are no longer shielding before sending their children back to school. Others believe that the benefits for their children in returning to school outweighs the risks. There are lots of things to consider so it might be useful to give us a call to talk this through.
Need to talk to someone? Our breast care nurses and highly trained staff on our free and confidential Helpline are here for you.