March 16, 2020

Bowel Cancer and Covid-19

We have collated some information on COVID-19 for bowel cancer patients and their whānau, or those concerned they have bowel cancer symptoms during the lockdown. Remember, if in doubt, speak to your medical team – they are in the best position to help you.

What do bowel cancer patients need to know?

Cancer patients who finished treatment a few years ago or longer have immune systems that have most likely recovered, but each person is different. Some people with bowel cancer are more at risk of becoming seriously ill if they contract the COVID-19 infection (commonly known as the coronavirus), including:

  • People having chemotherapy, or who have received chemotherapy in the last three months
  • People having immunotherapy or other continuing antibody treatments for bowel cancer
  • People having other targeted bowel cancer treatments which can affect the immune system
  • People having intensive (radical) radiotherapy
  • People who are taking immunosuppression drugs

Hospitals and cancer clinics are still safe places to have your treatment, but it’s very important that you phone ahead before you visit. Do not go to a cancer clinic without an appointment.

Most outpatient appointments will change to virtual consultations (such as telephone or video appointments). You will be contacted with details. If you’re unwell, please contact your cancer treatment team to let them know and if you are sick, the hospital is still the safest place for you but please phone first.

Other changes and these may vary for each DHB, are:

  • You may only be allowed to take one support person to appointments, and in some regions, you won’t be able to take any.
  • You will be screened for COVID-19 symptoms and exposure (such as being asked questions or having your temperature taken) before you go into a clinic.
  • Your clinic could be moved to another location within the hospital, to allow for social distancing.

As always we advise people to contact their oncologist if they have concerns, or where that is not possible their GP, to get specific information for their individual situation. The government is continually updating its advice in relation to COVID-19 and provide the most up-to-date information currently available.

What is happening with the National Bowel Cancer Screening Programme?

The national bowel screening programme has been paused. If you have received a free screening kit in the mail just before or during the lockdown please do not send it back. People who have been sent kits should get a reminder letter, advising them to put their kits aside until the Covid-19 alert level was reduced to level two or below. The kit is valid for up to six months from the time you received it.

Clinical director of the National Screening Unit Jane O’Hallahanhas said the decision was effective from March 24 to April 20, applying to bowel, breast and cervical cancer screening programmes.

People who have been picked up as needing further urgent assessment will still get that help, and kits already in the post when the lockdown occurred will be processed.

Further information is available on the Time to Screen website.

What support is available for bowel cancer patients and their families?

Bowel Cancer NZ has an online support group and nurse support service which are here for you during this time – to find out more about these services please go to ‘Finding Support’ on our website.

What should I do if I have bowel cancer symptoms?

It’s important to still see your GP urgently if you have bowel cancer symptoms. Give your doctor a call – you may be able to have an appointment with them over the phone or via video.

Your GP can still refer you to the hospital and some tests may still be able to be done during the lockdown.

How do I get a colonoscopy?

At public hospitals, only urgent- acute work is happening and most, if not all, private colonoscopy around the country, are closed due to Covid-19. If you have bowel cancer symptoms you should talk to your Doctor ASAP and ask them to speak to the gastroenterology department at your local hospital. This may mean your colonoscopy is done sooner.

What happens if my colonoscopy is delayed due to a positive screening test?

We completely understand that waiting for a colonoscopy after you have had a positive screening result is stressful. The Ministry has advised that your DHB colonoscopy team would be expected to contact you shortly after the lockdown, within 4 weeks.

If your bowel symptoms get worse you should talk urgently to your GP, as they can follow up with the hospital for you.

Should I get the flu vaccine?

If you are going through treatment at the moment, your doctor will most likely recommend you have a flu vaccination. Anyone who has cancer is entitled to a free vaccine. You should talk to your cancer doctor or nurse about this and about the best time to have the vaccine.

What are the symptoms of COVID-19?

  • a cough
  • a high temperature (at least 38°C)
  • shortness of breath.

If you have Covid-19 symptoms please telephone Healthline (for free) on 0800 358 5453 or your doctor immediately.

These symptoms do not necessarily mean you have COVID-19. The symptoms are similar to other illnesses that are much more common, such as cold and flu. Shortness of breath is a sign of possible pneumonia and requires immediate medical attention.

How does the virus spread?

According to health experts, the virus spreads mainly from person-to-person:

  • When somebody who is infected and coughs or sneezes, the virus can be spread in respiratory droplets.
  • These droplets might reach the mouths or noses of people who are in close contact, which could lead to an infection.

The droplets can also land on surfaces, which people might then touch. This could potentially lead to an infection if a person then touches their mouth or nose.

That’s why it’s really important to use good hygiene, regularly wash and thoroughly dry your hands, and use good cough etiquette.

How to manage your mental wellbeing

The MoH says media coverage or public discussion of COVID-19 may affect people. It’s normal to feel distressed and experience symptoms of stress in this time. Below are some tips that may help.

  1. Spend time in places that feel safe and comfortable as much as possible.
  2. Tell yourself that how you are feeling is a normal reaction and will pass – it is nothing to be afraid of.
  3. Reach out to your usual supports – family and whānau, friends and workmates. Sharing how we feel and offering support to others is important.
  4. Keep to usual routines – mealtimes, bedtime, exercise and so on.
  5. Keep active – going to work, doing usual leisure activities and seeing friends can improve general wellbeing and help distract from distressing feelings.