Coronavirus (COVID-19) and cancer

People with cancer and their families might feel especially worried about the virus. Cancer and its treatment can lower your ability to fight infection.

What is coronavirus?

COVID-19 is an infectious illness caused by a new type of coronavirus. There are several types of coronaviruses. Some cause mild illnesses such as a cold, while others can be more serious and affect your breathing or respiratory system. For most people, the virus won't cause serious problems. But for some people, the virus can have severe complications.

Coronavirus mainly spreads from person to person. This happens when someone who has the virus coughs, sneezes, talks, or sings, which releases tiny droplets into the air. These droplets can reach anyone who is nearby, and they can get the virus.

Research shows that coronavirus can live up to a few days on stainless steel and plastic surfaces. But the risk of getting the virus from contaminated surfaces is very low.

Am I at more risk of becoming unwell because I have cancer?

You are at a higher risk of complications if you have cancer. This is because cancer and its treatment can weaken your immune system Open a glossary item and reduce your ability to fight infections. The immune system protects your body against illness and infection caused by viruses like coronavirus.

Some types of cancer can also lower your ability to fight infection. This is usually cancer that affects your immune system, such as leukaemia Open a glossary item or lymphoma Open a glossary item.

I have cancer and have symptoms of coronavirus

The symptoms of coronavirus include:

  • a high temperature of above 37.8C and, or
  • a new continuous cough - this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
  • a loss of, or change in, your normal sense of taste or smell (you can't smell or taste anything, or things smell or taste different to normal)

If you have symptoms of coronavirus or you feel unwell, and you are having cancer treatment or a cancer that affects your immune system, you should first contact:

  • your chemotherapy helpline
  • the Acute Oncology Service at your hospital

Your healthcare team will assess you over the phone and might ask you to stay at home.  

Call 999 immediately if you are feeling very ill.

If you have symptoms but you are not having cancer treatment, you can look at the NHS 111 online coronavirus service or call NHS 111.   

How do I protect myself from coronavirus if I have cancer ?

Some people with cancer are more at risk of being seriously ill if they develop the COVID-19 infection. This is because they have a weakened immune system Open a glossary item. They are called clinically extremely vulnerable.

Current advice

The current advice for people who are clinically extremely vulnerable is to follow the same advice as the rest of the population. But to take extra care to protect themselves and follow the advice of their healthcare team.

Shielding

At the start of the pandemic, clinically extremely vulnerable people had to follow particular measures called shielding. Your GP or healthcare team might ask you to shield again depending on your individual risk and circumstances. 

COVID-19 Population Risk Assessment

Some people might be asked to shield because they have been identified through the COVID-19 Population Risk Assessment. This assessment might show that they are at high risk of serious illness if they catch the virus.

If you are unsure what treatment you're having and whether you are clinically extremely vulnerable, speak to the team caring for you.

I have cancer but I’m not in one of the vulnerable groups

If you are not in one of the above vulnerable groups, you should follow guidance for the rest of the population. This can help to reduce your risk of catching and spreading the coronavirus.

You can read the government guidance for each UK country if you follow the links at the bottom of this page, in the 'More information' section.

I’ve had cancer and finished treatment, am I at risk from coronavirus?

After treatment for cancer, your immune system usually recovers over time. So if you've had cancer in the past, it is unlikely that you're in the extremely vulnerable group if:

  • it's some time since you finished treatment 
  • you don't have one of the other specific conditions listed on the government website 
  • you haven't received a letter or been contacted by your local authority 

Contact your health care team if you are uncertain or you're still concerned that you might be in the extremely vulnerable group.

I have symptoms that could be cancer, what should I do? 

You should still contact your doctor if you notice a change that isn't normal for you or if you have any possible signs and symptoms of cancer.

One of the symptoms of coronavirus is a new continuous cough. It is important that you tell your GP everything about your cough. And whether you have any other symptoms such as unexpected weight loss, fatigue or loss of appetite. In some people, a continuous cough can also be a symptom of cancer and not coronavirus.

Even if you're worried about what the symptom might be, or about getting coronavirus, don't delay contacting them. Your worry is unlikely to go away if you don't make an appointment. The symptom might not be due to cancer. But if it is, the earlier it's picked up the higher the chance of successful treatment. You won't be wasting your doctor's time.

Contacting your GP

The coronavirus outbreak means that GPs are doing more appointments on the phone or online instead of face to face. This is to reduce the risk of coronavirus to them and their patients. When you speak to them, they will ask about your symptoms and tell you if you need to go into the surgery to see a GP.

They may suggest that you keep an eye on your symptoms and arrange another appointment to check in with them after a certain amount of time. Make sure you know when and how to contact them. And contact them again if your symptoms get worse or don’t get better.

Getting the most out of your telephone appointment

When you speak to the doctor, it can be difficult to remember everything you want to say. And it can be difficult to remember everything they say, especially on the phone.

There are things you can do before and during your appointment with your doctor to make it easier. The video below has tips on what to do to get the most out of your appointment.

  • Let your medical team know if you prefer a telephone or video call, or would like a face to face appointment.
  • Let your team know in advance if you're hard of hearing or need an interpreter.
  • Ask for a timeslot when your doctor will call you.
  • Find a quiet part of the house to take the call.
  • Start with a phone call if you’re not confident with a video call.
  • Ask for help if you need it and, if possible, practise a video call with a friend.
  • Write down a list of questions before the call, and think about what you want to find out from the doctor (see ‘Questions you might want to ask your GP’)
  • Ask someone to listen in for support.
  • Do make sure you are close to your phone or computer around the time of your appointment as people often miss telephone calls from their doctor. Your doctor's call might not always be at the exact time of your appointment due to delays in their clinic.
  • If you have someone listening in for support, put your phone on loudspeaker to do this. They could also ask questions and help you remember what the doctor says.
  • Tell your doctor if you are worried about anything in particular.
  • Ask the doctor who you can call if you have any further questions after your phone appointment.
  • Ask them to explain anything you don't understand.
  • Ask your doctor to summarise what the next steps are.
  • Do I need to see a specialist? Is it urgent?
  • When will I see them?
  • Where will I see them?
  • Will I find out about my appointments by post or telephone?
  • Do I need tests? What will they involve?
  • How long should I expect to wait?
  • Where can I find out more about tests?
  • Do I have to do anything to prepare for this test?
  • When will I get the results and who will tell me?

Your GP might not be able to answer all of your questions. They will tell you what they can at this point. Not knowing is difficult to cope with and might make you feel anxious.

Seeing a specialist and having cancer tests

GPs will make urgent referrals to specialists or for tests if they’re worried you might have cancer. The hospital should contact you to tell you more about your appointment. Your first appointment might be a telephone appointment with a specialist doctor.

Hospital teams might need to prioritise tests and appointments so they can see those most in need. They will base any decisions on the symptoms people have and the risk of them being cancer.

You might have to wait longer to have tests. This might make you worry more. But your team will have you on a list and make sure you do have the test as soon as possible.

Let your GP or the specialist team know if your symptoms get worse or don’t get better.

If you need to see your GP or specialist, they will follow strict guidance on infection control to protect themselves and other patients. This might include wearing personal protective equipment (PPE).

Before you have tests or scans 

Follow the advice from your hospital. Some hospitals might ask you to isolate before your appointment

It is important to attend any appointments for tests. The only reason not to attend is if you have symptoms of coronavirus. In this case, you should contact the hospital tell them about your symptoms. They will cancel your appointment and you should self isolate. The medical team will talk to you about when you can attend an appointment safely.

If you don't need any tests or a referral or they want to delay it

  • Questions you might want to ask:
  • Can you explain why I don’t need to have tests or see a specialist?
  • Is there anything I can do to help myself?
  • Do I need to see you again?
  • Who do I contact if my symptoms continue or get worse, especially during the night or at weekends?

Coping

Coping with a diagnosis of cancer is difficult. For many people, the coronavirus is an extra concern and worry. It is understandable that you might be anxious during this time. So it is important to take good care of yourself.

There are help and support available and things you can do to help you cope if you’re waiting to start treatment.

Does vitamin D protect against Covid-19?

We need vitamin D for healthy bones and muscles. Not getting enough vitamin D can cause a bone problem called rickets in children. In adults, not having enough vitamin D can lead to bone pain and muscle weakness. Low levels may also increase the risk of falls in older people.

The UK Government advises that we should all take a vitamin D supplement during the autumn and winter. This is because between October and early March we can’t make enough.

Vitamin D and COVID-19

There have been reports about vitamin D reducing the risk of getting COVID-19. Some research says that having enough vitamin D can protect against common colds and flu.

The National Institute for Health and Care Excellence (NICE) does not recommend taking vitamin D supplements to prevent or treat COVID‑19. NICE recommends better quality studies to look at how well vitamin D works in preventing and treating COVID-19.

Coronavirus trials

Since the outbreak of the coronavirus pandemic, many trials looking at the coronavirus have been started:

  • National COVID Cancer Survey
  • Coronavirus (COVID-19) SPIKE-1 trial
  • A study looking at COVID-19 and people who have cancer (SOAP)

The NHS has launched a National COVID Cancer Survey. The survey will help to find out how well people with cancer who had the COVID-19 vaccines have formed antibodies Open a glossary item. The survey is looking for cancer patients to sign up now.

There is some research that shows that a small number of people with cancer may have formed lower levels of antibodies than the general population. Lower levels of antibodies may mean some people with cancer are not protected well from COVID-19, but doctors are not sure yet.

What is the National COVID Cancer Survey?

The National COVID Cancer Survey is one of the first surveys that will help doctors to understand what protection people with cancer have following COVID-19 infection and/or vaccination.

It will also help them to understand:

  • whether different cancer types affect how well antibodies are formed
  • how different cancer types affect antibodies from being formed
  • if certain treatments affect how well the vaccines work in forming antibodies

Who can take part?

To take part in the survey, you should be:

  • aged 18 or over
  • living in England
  • diagnosed with cancer in the last year or receiving cancer treatment currently

How does it work?

  • visit https://covidcancersurvey.uk/ to sign up to the survey
  • fill in the short form with your details
  • you will then be redirected through to the NHS Test and Trace antibody test booking page
  • book your free test and order your antibody test

You will be sent a finger prick blood test. This test looks for antibodies against COVID-19 in the blood. It will come in the post and with everything needed to complete and return the test.

There are 10,000 places on this survey. The NHS will be asking people to join for the next 2 to 3 months.

How will the survey help people with cancer?

By signing up for this survey, you can help doctors to understand what antibody levels mean for people with cancer. It will also help doctors to provide the best treatment, care and support for people with cancer. And you will find out about your own antibody levels.  

The SOAP study has been looking at COVID-19 in people with and without cancer. It has also been looking at how their immune systems Open a glossary item deal with it.

Early (interim) results for the SOAP trial were published in January 2021. Those results showed that:

  • most people with a solid cancer Open a glossary item will be able to fight COVID-19 in the same way as people without cancer. This is because they develop antibodies to COVID-19
  • people with certain types of blood cancer Open a glossary item varied in how well they were able to respond to the virus. Many of these people took much longer to get rid of it

The SOAP study has also been looking at how having a COVID-19 vaccination affects the immune system. In particular, they were looking at people with cancer. It looked at people having the Pfizer-BioNTech vaccine.

The SOAP study involved 205 volunteers – 54 without cancer and 151 with cancer who were having treatment that causes a weakened immune system (95 with solid cancers, such as breast or lung cancer, and 56 with blood cancers). 

On 10th March 2021, the researchers released some further information. These results have not been peer reviewed. Peer review means that other experts look at the research. These experts are looking for any errors as well as any limitations in the research. This helps to make sure the conclusions from it are accurate.

The results showed that after 3 weeks of having the first dose, antibodies Open a glossary item were found in:

  • 38 out of every 100 (38%) of people with solid cancers
  • 18 out of every 100 (18%) of people with blood cancers

This is compared to 94 out of every 100 (94%) of people without cancer. 

The study also showed that having the second dose of the vaccine 3 weeks after the first dose helps the vaccine work better. The number of people having antibodies 2 weeks later (5 weeks after the first dose) was 95 out of every 100 (95%) for people with solid cancers. Not enough people with blood cancer received a second dose to know if this improved their response.

In people who did not get a vaccine boost at 3 weeks, and who researchers tested after 5 weeks, antibodies were found in:

  • 30 out of every 100 (30%) of people with solid cancers
  • 11 out of every 100 (11%) of people with blood cancers
  • 86 out of every 100 (86%) of people without cancer

While some cancer trials have been paused during the pandemic, some of Cancer Research UK's scientists joined the national and global effort against COVID-19. 

Cancer Research UK has been supporting a trial which is funded by LifeArc, a charity which helps to fund and develop academic research. This research is only about COVID-19 and it is not a cancer trial. 

The aim of the trial is to find out if a drug called camostat helps to stop the symptoms of coronavirus (COVID-19) from getting worse. The trial is for people who:

  • are 50 years or older
  • who have tested positive for coronavirus (COVID-19)
  • are well enough to stay at home

The trial is supported by Cancer Research UK’s Centre for Drug Development (CDD).

More information

More information and support is available for people living in different parts of the UK.

Scotland

NHS inform has further information about the coronavirus for people living in Scotland.

The Scottish government website has the latest guidance for people living in Scotland.

Wales

Public Health Wales has information and guidance for people living in Wales. Information is also available in Welsh.

The Welsh government website also has the latest guidance for people living in Wales.

Northern Ireland

The Public Health Agency has information for people living in Northern Ireland.

The government in Northern Ireland has the latest guidance on its website for people living in Northern Ireland.

England

The NHS website has all the latest information about the coronavirus and how to protect yourself.

The government website has the latest guidance for people living in England.

Last reviewed: 
02 Aug 2021
Next review due: 
23 Feb 2022

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