Let’s be upfront about the coronavirus and people undergoing cancer treatment. This special episode of Upfront is in response to unprecedented enquiries to BCNA about the coronavirus. We’re joined by BCNA’s Director of Program and Policy, Vicki Durston and one of our Helpline cancer nurses, Riki Long to provide some practical tips for minimising risk and answer some of the common questions we are receiving.

RESOURCES: My Journey 

Upfront About Breast Cancer is a production of Breast Cancer Network Australia. Our theme music is by the late Tara Simmons. This episode is proudly empowered by Red Energy, who have partnered with BCNA to provide empowering information and support to help get our community through COVID-19.

Want to get in touch? Visit our website at bcna.org.au, email us at helpline@bcna.org.au, or call our Helpline on 1800 500 258.

Transcript:

Kellie Curtain [00:00:07] Let's be upfront about the coronavirus and people undergoing breast cancer treatment. This special episode of Upfront is in response to unprecedented enquiries to the BCNA Helpline about the virus. The coronaviruses are a family of viruses that can cause common colds as well as more serious respiratory illnesses that can affect your lungs and airways. Also known as COVID-19, most people who contract the virus won't suffer serious problems. But for those whose health is already compromised, there can be a higher risk of complications. A vaccine for this virus is now being tested in the USA, but will not be available for at least a year. Reducing your risk of infection is the key to staying healthy, and that's what we're going to talk about today. Joining us is director of Program and Policy, Vicki Durston, and one of BCNA's Helpline cancer nurses, Riki Long. Welcome to you both.

 Vicki Durston [00:01:03] Thanks, Kelly. Thank you.

 Kellie Curtain [00:01:05] So, Vicki, it's uncertain times, isn't it?

 Vicki Durston [00:01:09] It certainly is. And there's lots of questions and certainly from a BCNA's perspective is that we're looking and identifying what some of those questions might be that we're receiving from our members and those people diagnosed with breast cancer and trying to address and alleviate some of those concerns.

 Kellie Curtain [00:01:32] And I think it's also worth pointing out that because it's an ever changing landscape, BCNA will be constantly updating our online resources and doing more podcasts if necessary to address the increasing concern or changes.

 Riki Long [00:01:46] Yes, absolutely. We're updating our information on the My Journey online tool every day and addressing questions as they come through the tool and through the help line to make sure that we reduce any anxiety that might be existing out there.

 Kellie Curtain [00:02:03] Okay. So what is the actual risk for those in current breast cancer treatment?

 Riki Long [00:02:12] So people having active treatment for cancer. Older people, those with chronic health conditions such as rheumatoid arthritis, people have heart disease, diabetes, for example, they're at higher risk of becoming seriously ill if they contract the coronavirus. This is because their immune system might be compromised by their treatment and their bodies aren't able to fight infection as well as a healthy immune system. So while anyone having treatment for breast cancer will most likely be at increased risk of getting viruses, including coronoavirus, some particular breast cancer treatments that are known to reduce the immune system and so increase the risk. People with increased risk are those who include those having chemotherapy or have had chemotherapy in the last three months. Women and men with metastatic breast cancer who might be taking a CDK 4/6 inhibitor such as Ribociclib, Palbociclib or Abemaciclib are also at increased risk and other people having treatments such as radiotherapy and surgery.

 Kellie Curtain [00:03:21] Okay. So should they continue with their treatments?

 Vicki Durston [00:03:26] Absolutely. So we have been reassured by the health services that the number one priority is to ensure that treatment goes ahead. So we encourage all those that are currently undergoing treatment that they touch base with their treating team. But also the number one priority is to ensure that treatment is not interrupted. But as we've said, it's unprecedented times and things are changing day to day. So what we encourage people to do is to really engage with us at BCNA and look at our information that's updated daily. We're certainly engaging with our health services as well as government and through the Department of Health to ensure that though that information that changes on a daily basis is addressed through our Helpline and through the information on the My Journey online tool. So the priority for health services is to ensure that those people at risk and those people within our network are actually having treatment. So we encourage you to attend your appointments that are scheduled for, if you're uncertain, to call your treating team. But if there are things, practical things that BCNA you know, can help with to alleviate the pressure of the health services, that's what our Helpline team is here for. So we can offer those practical tips that can help you and answer some of those unanswered questions that that we're finding people have at the moment.

 Kellie Curtain [00:04:52] So for the general public, it everyone's saying wash your hands, wash them for 20 seconds with soap and water. And that's the best thing you can do. Is that the same for those undergoing treatment or are there extra precautions that they can take?

 Vicki Durston [00:05:04] There certainly is extra precautions while they're being treated and undergoing treatment. So obviously washing hands for 20 seconds. Also, cleaning down surfaces at home can be some practical tips that you can use. We're also talking about social distancing for those people at risk. So not attending cinemas, movies where there's lots of people. Also places like shopping centres, which we're starting to see that happening anyway. So again, it's all about reducing risk to exposure. So those people that are having treatment, you know, there's some of the things that we want to think about. And Riki, you might like to talk about some of the questions that you're receiving on the Helpline and some of the practical tips that our Helpline nurses are providing. 

 Riki Long [00:05:51] And some of the questions coming through have been with people with low immune systems already and family members who might be coming in and out of the house going about their normal business and their level of risk. And the important message is there is the same for the rest of us in terms of our hand-washing. As soon as they come in the house having that kind of safe social distance. So reduce hugging, handshaking, kissing, any of those kind of things that are going to put you at increased risk. People have been coming back from trips, of course, self-isolation for two weeks. Anyone that has a cold in a family who might be visiting, for example, are asked to stay away at that time until they're well. Those kind of practical tips.

 Kellie Curtain [00:06:47] What about those that are trying to stay healthy, going to the gym? Is that advised or not, is that one of the questions that you've had?

 Riki Long [00:06:55] For people with low immune systems, we're encouraging people to not go to places where they're going to be at risk with other people. So reducing those activities, perhaps taking a walk instead where they've got a bit more ability to distance themselves from other people and still keep up their exercise, because we know that's important, too, for people's general health and well-being.

 Ad [00:07:24] BCNA is my journey online tool is a new resource that gives instant access to trusted and up to date information which is relevant to your breast cancer journey. For more information, visit my journey.org. au

 Kellie Curtain [00:07:40] So what about prescription medicines? Is there a need to start stockpiling?

 [00:07:44] So health professionals, Kelly, here are asking patients to actually fill their scripts and certainly scripts that potentially could get them through for a few weeks to avoid those unnecessary appointments. Our health professionals are prioritising their appointments and putting in place things like teleconferencing, Skype appointments. So we're starting to see a shift in the health services of how our medical oncologists, radiation oncologists and surgeons will be consulting with patients. So if you do have a script we don't want to stockpile and we certainly don't want people to feel as if they need to panic and go and fill  unnecessary scripts. However, we do encourage people to certainly think about what they might need should they be self distancing for a period of time.

 Kellie Curtain [00:08:36] Riki, what are some of the other questions that you're getting on the Helpline and some of the other questions in terms of even if people with a lower immune systems in terms of what they can and can't do.

 Riki Long [00:08:52] So in terms of leaving the house, visiting people, even travelling interstate were some questions that we've had recently. So in terms of those things, again, it's just sensible precautions if they are going to visit a relative to make sure people in the house are all well and there's not too many people. Avoiding large gatherings and certainly for interstate travel or any kind of trouble, cruise travel or any holidays that have been planned, they are strongly discouraged at the moment because of the high risk of infection.

 Kellie Curtain [00:09:38] People undergoing breast cancer treatment, sometimes some of the side effects can be a little bit similar to those of a cold or a virus being a high temperature. How does someone know the difference or when to call a doctor?

 Riki Long [00:09:58] I think when people are certainly having treatment for breast cancer and having chemotherapy, for example, that they are all fairly well educated on the symptoms that they should report because their immune system is low. So having a temperature that is increasing over 37.5C or if they start to feel unwell, develop shortness of breath, cough they are the kind of symptoms that they should be reporting to the doctor. And certainly if their white cell count is quite low, that can become quite an emergency so if they can't get on to their doctor, then they need to contact the emergency department, and if that's difficult to ring 000.

 Kellie Curtain [00:10:47] Vicky, people must be feeling a little bit anxious. Is that normal?

 Vicki Durston [00:10:53] That is normal. With a diagnosis of breast cancer comes that uncertainty. And certainly with the addition of the coronavirus and lots of information coming through, there is that level of even more increased uncertainty and level of distress and anxiety. And so we're here at BCNA, you know, we're here to help and reassure those people that have a diagnosis of breast cancer, that there are some practical things and certainly some resources and tools that we can assist our members with around self-care, putting things like plans in place should you become unwell or family members become unwell. We ask you to keep talking to your village, your family, your friends, practical things that you could do to plan in the event that you do become unwell. But also be reassured that the health services and health professionals are working extremely hard to ensure that your treatment and your care is their priority. And things like our public health system is creating updated information on their website with fact sheets and regular information, regular hotlines. We know our private health care sector is working towards telehealth. The health services are looking at reducing the number of people coming in at any one time, things like the day oncology units are looking at having you have your treatment but not bringing unnecessary people. So they are looking at ways to reduce risk. So please be reassured that our health professionals have our breast cancer patients treatment as their number one priority.

 Kellie Curtain [00:12:39] And I think it's probably a good piece of advice that if you do have a temperature or you do want to go and see your doctor, that you should phone ahead and tell them that you have a temperature and remind them that you are a breast cancer patient.

 Riki Long [00:12:55] Yes, absolutely. Because to ensure that the health system can provide the care it needs to provide, this needs to be managed well. So if you can. call ahead. If you have milder symptoms, it is always advised to call your GP first. If you are quite ill, then try and call the emergency department first and get some advice about what to do and when to come in.

 Kellie Curtain [00:13:24] What about those that are not currently under active treatment? Are they at the same level of risk?

 Vicki Durston [00:13:34] We would be suggesting that those that are not actively having treatment are generally at the same risk as the general population, but we understand that there's lots of unanswered questions. So we'll do our very best to update our My Journey online to have relevant and current information. And the Helpline team will be out to answer those questions. But it is something that is on people's mind. I've had breast cancer before. I'm not in active treatment. Am I at risk at this point? What we do know is that the same risk as the general population. So we would be asking you to adhere to those areas of washing your hands and the same messaging that the government is providing for the general population.

 Kellie Curtain [00:14:23] So there's no doubt that the key here is hygiene and where possible self distancing. What about masks? Everyone's wearing them. There's a lot of opinion as to whether they're of any use at all.

 Riki Long [00:14:37] The thing with masks is there's no guarantee that you'll be safe from the virus by wearing a mask. And the thing with masks is it often gives people a false sense of security that they might be protected and put themselves in more high-risk situations that they would normally. So the best advice is to try and practise self distancing, maintain your self protection measures with hand-washing, etc. and try and reduce your risk.

 Kellie Curtain [00:15:10] Vicki, as we know, this is uncharted waters and call centres across the board, regardless of what type of cancer you have, are experiencing lengthy delays. If people can't get through, what's the best advice?

 Vicki Durston [00:15:27] We certainly would be encouraging people to utilise the technology and source our websites. So there's there's lots of reliable information. So we'd be suggesting to use a reliable source of information. The Department of Health have the up to date source of information that we are utilising as well as our colleagues around the country. There are other help lines that can be utilised for those people that might be listening to our podcast today with another type of cancer. So we would encourage utilising Cancer Council. There are lengthy delays that we're hearing. We're certainly able to meet the demand at this stage at BCNA's Helpline. But we would be encouraging you to source those websites. We have a list of those websites on our My Journey online tool and also our Helpline staff can direct people accordingly. But utilising those websites and also like I mentioned before, the health service that you currently will be having treatment are updating their websites as well with regular information, fact sheets and the way that they're managing their patients. So, again, it's about making sure that you utilise the resources that are accurate because there's a lot of information coming through, all different sources at the moment.

 Ad [00:17:05] BCNA's Helpline is a free, condifential phone service for people diagnosed with breast cancer, their family and friends. Staffed by experienced cancer nurses, the team can help you with your questions, concerns and refer you to appropriate support. Call 1800 500 258.

 Kellie Curtain [00:17:05] The key symptoms and we've been spoken about a lot right across the scale. But if we just pinpoint the really important signs to watch for?

 Riki Long [00:17:16] The most common symptoms of coronavirus are fever, cough, sore throat, fatigue and shortness of breath. And for many patients with cancer, with breast cancer that are having treatment, these will be symptoms that they already are experiencing. But it's important to know if there's any exacerbation in symptoms, if they feel more unwell, they develop a temperature over 37.5C., they have increasing difficulty breathing, that they contact the doctor straightaway. If unable to get onto their doctor to call 000 for an ambulance.

 Kellie Curtain [00:18:01] And Vicki so we want people to exercise some common sense, but don't be too overcautious. They are breast cancer patients.

 Vicki Durston [00:18:08] That's right. So if you are concerned, it's really important that you take action.

 Kellie Curtain [00:18:13] Okay. So with all this proactive hygiene and self distancing, that can be lonely, can't it? If you're reducing your contact because you're vulnerable. How do you get around that?

 Riki Long [00:18:25] Yes. And for many people having active treatment or who have metastatic breast cancer, they're having ongoing treatment. Their immune systems may be compromised as well and this can increase their sense of isolation. So it's really important to keep connected with others. And there's a number of ways that you can do that by many people already setting up more WhatsApp groups, face  timing friends rather than meeting face to face, connecting with BCNA's Online Network, which is a peer support online program that's available 24 hours a day where they can come on board and talk to other women that are feeling the same. So think of all the creative ways that you can connect with others. And there are many with today's technology so that you feel supported and you don't feel so alone.

Kellie Curtain [00:19:22] Thank you, Vicki and Riki, for joining us in what is a really challenging time for all communities. Remember, BCNA's online tool is constantly being updated with the latest information about the effects of the coronavirus. It's easily downloaded on any computer or mobile device. You'll find it on my journey. org. au. Our BCNA Helpline is also operating on extended hours to assist you with any of your concerns. It's 1800 500 258. This special episode does not replace medical advice. For any individual concerns please contact your health professional. I'm Kelly Curtin. Thanks for being upfront with us.