Cancer, coronavirus and what happens next… How one pandemic impacted another

At the start of 2020, as coronavirus began to bubble across the globe, Connie Johncock had just stopped trialling a cancer drug.

Until then, it had been successful in keeping the disease that had already robbed her of a breast and invaded her liver from spreading.

First diagnosed with breast cancer in 2011 when she was just 22, Connie had signed up for new treatment trials in 2018. After two years doing them, the side-effects were massively impacting her mobility and energy levels, so her medical team suggested she take a break from treatment. 

It was a chance for her to recover, they said, and then she could come back six weeks later for blood tests.

‘Naively, we thought Covid would have been done by the time I was done having a break,’ remembers Connie, with a wry laugh. 

As coronavirus began to tear through hospitals up and down the UK, it threw everything and everyone into upheaval, none more so than those impacted by cancer. 

With nearly 50,000 fewer cancer diagnoses made in the UK during the pandemic, up to 740,000 potential cancer cases ‘missed’ and over 30,000 patients having treatments delayed, it’s no exaggeration that the NHS has two pandemic on its hands. 

However, although lockdown exacerbated the issue, the truth is that the UK’s battle against cancer was already at breaking point.

Since 2015 the NHS has been consistently failing to meet the 62-day Cancer Waiting Time target for patients to begin treatment following an urgent GP cancer referral. Not only has the target been missed, but it has been in continual decline since 2017. 

In a bid to combat this crisis, earlier this month – on 4 February, World Cancer Day – Health Secretary Sajid Javid declared a ‘war on cancer’, and spoke of a 10-year plan to improve the dismal rates, which is expected to launch this summer.

‘At the start of the pandemic, many cancer patients saw their treatment paused, disrupted or changed while doctors worked out how to give treatment safely,’ explains Martin Ledwick, Head Information Nurse at Cancer Research UK, who carried out a survey of cancer patients in 2021.

He explains that their report findings revealed that one in three had seen some disruption to treatment and that the majority felt more anxious and frustrated. 

‘We had an increase in calls to our helpline from people who were understandably frightened,’ adds Martin.

He also tells Metro.co.uk that not only did patients struggle with longer wait times, cancellations, and appointment changes, but they also felt increasingly lonely, having to isolate due to their compromised immune systems.

‘Patients also raised concerns about shielding – with some people having to limit contact with others in their households who needed to continue to go out to work,’ says Martin. ‘And once vaccinations were rolled out, many told us they were frightened that with restrictions easing, other people around them might act in a way that could put them at risk.’

For Connie, who is living with secondary cancer, the chaos caused by the pandemic had a huge impact on her treatment options. 

After taking the break in her trial drug, a scan revealed that her tumours had grown significantly. ‘But due to Covid, there were no clinical trials open because all the research had been moved to manage the pandemic,’ she explains. 

‘I had two choices. Wait until the summer to see what was happening with trials – but then there was a risk that the tumours could have progressed more – or I could start the NHS’s standard of care treatment, combining a type of chemotherapy with a targeted drug called Netatinib.’ 

Connie went for the latter, clinging onto the hope that the coronavirus crisis would have passed by the time her treatment finished and she could get back to using the clinical trial drug that had stemmed her cancer from progressing.

However, sadly her drug combination didn’t work and a scan revealed that her breast cancer had now spread to her liver, bones, lungs, lymph nodes, and lungs. 

‘I was heartbroken and frustrated,’ recalls Connie. ‘I felt fearful for the future and betrayed by the whole system.’ 

Such a massive spread of cancer meant Connie was unfortunately no longer eligible to meet the criterion for clinical trials and had to start mainstream chemotherapy immediately. ‘It was exhausting, I had no quality of life,’ she says. ‘I couldn’t even walk up the stairs. I was touch and go and I didn’t think I’d see my 30th birthday. The year just felt like a slap in the face.’

Not only did her physical health decline, but Connie’s mental health also took a knock from the forced shielding. 

‘I was faced with two evils – cancer or coronavirus, both with cruel, undignified ends – so which one should I pick?’ 

‘In hospitals, we have seen significant staff redeployment during peaks of the virus. Along with important infection control measures to reduce the spread of coronavirus in hospitals, this has limited capacity to provide certain aspects of cancer care at points through the pandemic.’

‘We quickly responded by improving our support line and our website, developing new services such as our telephone buddies and setting up a £12.5m NHS fund to help meet the immediate needs arising from the pandemic,’ explains Minesh Patel, Head of Policy at Macmillan Cancer Support. ‘We also set up a Covid hub on our website; the site was visited by 4.2m people in 2020.

Yet, Minesh admits that despite the ‘fantastic efforts’ of the charity’s fundraising teams and generosity of the public, it saw a decrease to income in 2020. 

Although Heidi, who tweets under @storminatitcup, received several letters advising her to shield, she weighed up the risks and chose to go outside for walks with her children and horse when she was allowed. ‘I didn’t really have Covid fear,’ she remembers. ‘Otherwise, I would have just sat in the house for a year and I know my emotional wellbeing would have been hugely compromised with that. Having good mental health throughout cancer is super important so I took measured, minimised risks.’

Finally, in July 2021, Heidi had her breast reconstruction. ‘In so many ways, cancer has taken a lot from me, but it’s given me an awful lot back as well,’ says the 39-year-old. ‘It’s given me the ability to see what really is important in life, but also to give positivity to loads of other people newly diagnosed. I felt amazing with just one boob, but I’m even further away from my diagnosis now, one more step to normal.’

With the UK also taking steps to get back to ‘normal’ with all coronavirus restrictions being lifted this week, cancer patients will continue to face a life-threatening battle in more ways than one way. 

‘Recent NHS England data confirms the huge challenge still facing the NHS, with performance against cancer waiting times going from bad to worse over the last year,’ says Macmillan Cancer Support’s Minesh Patel. 

‘By 2030, we anticipate around 3.3million people will be living with cancer in England. It will have a devastating impact on many people with cancer who are experiencing agonising delays and risk a worse prognosis. 

‘We have been sounding the alarm for a long time now about the desperate need for additional cancer professionals to care for the growing numbers of people living with cancer, and the importance of good care and support,’ he adds. 

‘‘Improving the experience of patients must be at the heart of the Government’s upcoming 10-year Cancer Plan.’

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