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.
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.
1. I’m taking hormone therapy. Am I more at risk?
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.
Keep taking your hormone therapy and follow the coronavirus guidelines from the NHS.
2. I’ve had lymph nodes removed from my armpit. Does this affect my immunity?
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.
3. I’ve been asked by the NHS to stay at home for at least 12 weeks. Why?
Over a million people have received letters 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.
You may receive a letter 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. If this is your case, you may need to contact your hospital team or GP to ask them to clarify what you should do.
4. I'm worried my treatment might be delayed
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.
5. I’ve been told my planned radiotherapy may be shortened. Is this safe?
Some people due to have radiotherapy may be told their radiotherapy will be given over a shorter period than originally planned.
For example, your treatment team may suggest your radiotherapy is given once a week for five weeks. Or they may recommend five daily treatments over one week.
For several years, clinical trials have been looking at giving radiotherapy over shorter periods. Based on these trials, radiotherapy experts believe shortening some people’s treatment is an acceptable way to allow everyone who needs radiotherapy to be treated.
6. I’m currently having treatment. Am I more at risk from the coronavirus?
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.
7. What if I’m having treatment and live with someone who gets symptoms?
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.
Need to talk to someone? Our breast care nurses and highly trained staff on our free and confidential Helpline are here for you.