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How cancer services are fighting to counter covid-19’s impact

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2747 (Published 15 July 2020) Cite this as: BMJ 2020;370:m2747

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Rapid Response:

Re: How cancer services are fighting to counter covid-19’s impact

Dear Editor

As a doctor who was diagnosed with breast cancer at the start of the pandemic, I read the article "How cancer services are fighting to counter covid-19's impact" with great interest. It is clear to me that my own experience has only been the tip of the iceberg, and that the devastating impact of Covid-19 on cancer patients will play out far into the future. Typically, I was not an easy patient, having scattered pleiomorphic calcifications throughout my breast, which defied multiple core and vacuum biopsies to offer up any diagnostic certainty. My initial diagnosis was widespread low grade DCIS, which was revised to grade 1 invasive ductal carcinoma post-op.

Being told that I needed a mastectomy on 3rd April 2020 but would have to wait indefinitely for surgery had a devastating impact on me. I was trying to work in an old age psychiatry service, making difficult decisions whilst not being able to see patients face to face, with the knowledge that there was a tumour growing in my breast, which I could do nothing about. During this time I also had a bout of Covid-19 myself (confirmed several months later by serum antibody testing), though I "did not meet the criteria" to be tested at the time as I had no fever. Imagine having to say to your employer "I have breast cancer and will be going off sick for at least 6 weeks for a mastectomy, but I don't know when it will be. Until then I will continue to work but please forgive me if I am a little anxious and distracted." After nearly three months in limbo, I eventually had to give up doing clinical work as I deemed that I was putting my own health and the safety of my patients at risk.

I have not a bad word to say about the team in Burnley which looked after me. I was their first immediate implant reconstruction after resumption of some semblance of a surgical list on 1st July. I cannot thank the unit enough for fighting to resume surgery, as the effect on my psychological wellbeing has been immense. I am incensed by the Government's claims that the NHS has been open for business as normal throughout the pandemic. That is very far from the truth.

Competing interests: No competing interests

17 July 2020
Marisa D Wray
consultant psychiatrist
Westmorland General Hospital, Burton Road, Kendal LA9 7RG