Practical advice for those waiting for cancer screening or who are on a cancer journey on what they can do while services are interrupted

During this challenging time where so much is outside of our control, it has never been more important to focus on what we can control in relation to our health. It is no secret that the COVID-19 pandemic has placed our health system under unprecedented pressure and as a result has meant that other areas of health have had to be deprioritised. Cancer services have unfortunately been impacted with screening for breast, cervical and bowel cancer, disrupted to varying degrees for the second time in the last 11 months. Diagnostic delays and surgery being cancelled has also been reported. Many of us may feel that the right thing to do is to avoid adding undue pressure to an already struggling health system and remain at home to keep ourselves safe. 

But what is the right thing to do if you are worried about changes to your body and how can we ensure we are best protecting our own health while in lockdown? 

We spoke to the Marie Keating Foundation’s Director of Nursing Services, Helen Forristal, to find out: 

Helen, it is an unbelievably challenging time for our health system and those working in it, how are cancer services affected and how are people feeling out there? 

Without a doubt our frontline workers are under pressure and they have done an amazing job over the last 11 months coping with something none of us could have predicted. We applaud and respect  them for that. But cancer hasn’t gone away and doesn’t realise or care that we are in the middle of a pandemic. We are working hard at the Marie Keating Foundation in collaboration with other patient groups and stakeholders, to ensure that cancer does not become the forgotten ‘C’ in all of this. 

With our health system under so much pressure, the focus on COVID-19 and with so much fear and anxiety around it, its unsurprising that we have seen a trend in people feeling like they should stay out of the health system at all costs. We have received an increase in the number of calls and enquiries we are getting from the public. The calls themselves are taking longer and are more challenging and complex as levels of anxiety and fear increases – people are asking us questions around screening, diagnosis, treatments and access to the vaccine. 

You mentioned screening, can you give us an update on these important services? 

Ireland has three screening programmes; BreastCheck for women aged 50-69, CervicalCheck for women aged 25-65 and BowelScreen for men and women aged 60-69. Regrettably due to the rising COVID-19 numbers and the pressure this is putting on our health system, at the minute all three programmes are affected by COVID-19 to varying degrees. For BreastCheck routine screens are paused; however, if you had been recently screened and have either been called back for further diagnostic tests or for initial treatment, these services are going ahead. For CervicalCheck routine screening is continuing, however some GPs are operating a reduced service at this time. It is important that women book their appointment when invited, and note that they do not need to book with their own GP but can go to any screener registered with CervicalCheck. BowelScreen is also operating but at a reduced capacity. It is important to understand that although a key cancer prevention tool, screening is designed to detect pre-cancer or early cancer in people who do not have symptoms and by in large most people who attend a screening appointment will have a normal result. We are speaking to the National Screening Service to ensure that as early as it is safe to do so, screening services are resumed. In the meantime, if you are in an eligible age category you should check to ensure you are on the register so that when services do resume you will be sent an invite or a kit. You can check by phoning 1800 45 45 55.

So, what should people be aware when they are at home? 

The most important thing we can all do is to be aware of our own bodies. Know and understand what is normal for you. If you notice or experience symptoms or changes to your body, it is important that you don’t delay and call your GP. GPs are under pressure but they do want to hear from you if you are worried about a non-COVID health matter, it is far better that your doctor knows about it. It may be that they can only do an initial consultation over the phone but letting them know you are concerned and what symptoms you are experiencing is vital. Your GP will and should refer you on if needed. Symptomatic services are running and although there may be some delays, it is vital that no one sits at home worried about a change to their body. 

More information on the early signs and symptoms of the common cancers can all be found on our website www.mariekeating.ie . One of the very practical ways women can be body aware is to self-check their breasts once a month so if they do experience any changes it is picked up quickly.  We have a simple video on our website to take you through how to do a breast self-examination so do check this out. 

Is there anything we can all be doing to improve our health and reduce our risk of cancer while at home?

There is plenty we can be doing to keep fitter and healthier while in lockdown! Making changes to seven key areas of our lives can actually reduce our risk of cancer in the future by between 30-50%. Our Your Health Your Choice campaign encourages us all to make better choices by; not smoking, reducing our alcohol intake, being safe in the sun, increasing exercise levels, improving our diet, taking up screening opportunities when they are back and ensuring our children get the HPV vaccine. You can learn more about the campaign on our website. If anyone wants to get started with healthier habits, we are running a Your Health Your Choice challenge, encouraging participants to hit their 10,000 recommended daily steps for 20 days. You can sign up at www.yourhealthyourchoicechallenge.ie and all the money raised will go towards supporting our cancer support and survivorship services. 

It must be a particularly anxious time for people on a cancer journey right now, what supports are available to them? 

There is a huge level of anxiety out there for those on a cancer journey or who have recently finished treatment. It is important for them to know that there are support services available to them. For free counselling, a great resource is Together 4 Cancer Concern at 1800 200 700 

The Marie Keating Foundation also runs a Positive Living Group which supports women with metastatic breast cancer and currently meets twice a month virtually. This amazing group of ladies support each other through shared experience but we also bring in experts on topics the women need. I facilitate the group and it is a safe space for anyone living with advanced breast cancer to come and share their experiences. Another free online resource is our virtual Survive & Thrive programme which is a six-week programme delivered by one of our nurses and a survivor and is for men and women who have come out the other side of treatment and are adjusting to life after cancer. Both of these programmes are available to register for free on our website www.mariekeating.ie/events 

The Virtual Support Hub on our website also hosts plenty of video resources and a recording of our full Cancer & COVID wellness webinar series too. 

The main thing for people reading this is to know that they are not alone and the Marie Keating Foundation is with them every step of the way.  

Linda Keating, Director of Fundraising – pull quote:

“I have been overwhelmed at how our nurses at the Marie Keating Foundation have adapted to the challenge of delivering our services throughout the pandemic. They have worked tirelessly to ensure that we have remained there for people and their families at every step of a cancer journey.  When I look back over the last 23 years since we set up the Foundation, after losing my wonderful Mam to breast cancer, I have to say the last 11 months have without a doubt been our most challenging.  Cancer patients, survivors have been seriously impacted by COVID-19 and I am so proud that our nurses and our services, with great support from the people of Ireland, are keeping it all going.”