Your medical team will tell you if the way you have your treatment is going to change. Any changes they discuss with you are to keep you as safe as possible and reduce your risk of being exposed to coronavirus.
- Check with your GP or hospital team before you attend any appointments. If your appointment is not essential, it might be cancelled or postponed to reduce your risk of being exposed to coronavirus. You might have some appointments by phone or video instead of face-to-face.
- If your treatment includes medicines you take at home, you might be able to get repeat prescriptions without needing a hospital appointment first. The medicines might be able to be delivered to your home, or a friend or family member might be able to collect them at a drive-through pick-up point.
- You might have a longer gap than usual between your hospital appointments or check-ups. This lowers your risk of being exposed to coronavirus.
- If you are having treatment and your symptoms are improving, you are unlikely to have a scan unless it is needed to guide what treatment you have next. This helps keep the number of hospital appointments you have to a minimum.
If there are changes to your schedule of appointments, you might find our know your nodes video helpful. This is designed for people who are self-monitoring for symptoms such as swollen lymph nodes, whether you have had treatment or you are on active monitoring (‘watch and wait’).
If you are having lymphoma treatment and you have a fever or any other signs of infection, including a cough, contact your key worker or chemotherapy helpline, not NHS 111. They will assess your symptoms and advise you on what you need to do.
If you have your treatment in a hospital outpatient or day case unit, there might be some changes to how this works. Your medical team will explain these to you. Any changes they discuss with you are to keep you as safe as possible and reduce your risk of being exposed to coronavirus. There are also some precautions you should take to reduce the risk to you and your family and friends.
- In England, you must wear a face mask when you attend hospital appointments. This can be home-made. If you don't have a face mask, the hospital should be able to provide one for you. In Northern Ireland, Scotland and Wales, face masks are recommended in enclosed spaces where it is difficult to maintain social distancing.
- Your appointment might be in a different place from usual to help keep you away from other people as much as possible. Some regions are developing cancer hubs, where people who have cancer can be treated separately from people with other conditions.
- Your medical team might ask you to arrive for your treatment at a different time than usual. Medical teams are trying to rearrange their appointment schedules to have as few people as possible in each department at any one time.
- Don’t arrive early for your appointment. It is important to spend as short a time as possible at the hospital. Your medical team might ask you to wait in the car until they call you in for your appointment (for example, via text message).
- If possible, you should not have a friend or family member with you while you have your treatment. This will help reduce the risk of developing or spreading coronavirus infection. If a friend or family member usually takes you to and from your appointment, you could ask them to drop you off and collect you when you have finished, rather than waiting with you. Alternatively, they could wait for you in the car.
- Wash your hands or use hand sanitiser before you set off for your appointment, as soon as you arrive at the hospital, and at frequent intervals while you are at the hospital. Wash your hands or use hand sanitiser again before you leave the hospital and as soon as you arrive home.
- During your appointment, try to stay at least 2 metres (6 feet) away from other people (apart from essential interactions with medical staff).
All essential or urgent treatment for cancer will continue. However, there might be some changes to the treatment you have, or how you have it. Many lymphoma treatments lower your immune system so these changes aim to reduce your risk of being exposed to coronavirus while you might be more vulnerable to infection. If your medical team suggests any changes to your treatment, they will talk to you about why the changes are necessary. Your medical team is aiming to give you the best chance of avoiding coronavirus infection while still treating your lymphoma.
- You might have the same medicines as usual, but given in a different way. For example, you might have rituximab as an injection under your skin (a subcutaneous injection) instead of through a drip into a vein (an intravenous infusion). This way of having ritixumab is just as effective at treating lymphoma but it is quicker to have, so you don’t have to be at the hospital for as long. Subcutaneous rituximab is not usually available for lymphoma treatment on the NHS (except for maintenance therapy), but this might change temporarily during the coronavirus pandemic.
- You might have your treatment less frequently than usual – for example, every 4 weeks instead of every 3 weeks – so you don’t have to attend hospital as often.
- Your medical team might suggest a shorter treatment regimen so you need fewer hospital appointments.
- Your medical team might consider using a different treatment regimen – for example, one that doesn’t lower your immune system as much as standard treatment.
- If you are having treatment that is likely to make your white blood cell count very low, you might have growth factor treatment to help reduce your risk of getting a serious infection. This might be a short-acting injection that you have every day for a few days (usually at home), or a long-acting injection that you have once in every chemotherapy cycle.
- Your medical team might suggest treatment with a targeted drug instead of chemotherapy, to reduce the time you need to spend in hospital to have your treatment or to treat side effects. The targeted drugs available depend on the type of lymphoma you have and how many courses of treatment you’ve already had. They might include drugs that are approved to treat lymphoma but that might not normally be available to you on the NHS.
- If you are having a long-term treatment regimen, your medical team might suggest that you have a break from treatment for a while. Your treatment will carry on when it is safe to do so.
- If you were due to have a stem cell transplant, it might have been postponed until it was safer for you to have it. In some cases, it may now be appropriate for it to be rescheduled. Before having a stem cell transplant, you must self-isolate for at least 2 weeks. You will be tested for COVID-19 before you start your treatment. If you test positive, your stem cell transplant is likely to be postponed for at least 3 months if it is not urgent. If you've been in close contact with somebody who developed COVID-19 within the week before your stem cell transplant, your transplant might be postponed for 3 weeks if possible.
- If you were receiving rituximab or obinutuzumab maintenance therapy, this might have been stopped recently so you didn’t have to attend hospital when the risk of being exposed to coronavirus was high. Lymphoma specialists feel it may now be appropriate to consider restarting this treatment in certain cases. Your medical team will tell you if this applies to you and discuss if there are any new safety measures you need to take if you restart maintenance therapy.
Hear people talk about their experiences of cancer treatment during the pandemic in this video by Cancer52, an alliance of patient support cancer charities that includes Lymphoma Action
Due to the coronavirus pandemic, many clinical trials in the UK temporarily stopped accepting new participants. Some of these are now open to new participants again, although some are not. If you are interested in taking part in a clinical trial, your consultant may be able to advise you whether it is currently open and if you might be eligible based on your individual circumstances.
If you are already receiving treatment as part of a clinical trial, you are likely to have fewer hospital appointments, tests and scans than stated in your clinical trial information sheet. This is to keep you as safe as possible at this time. Check with your research nurse or trial centre before you attend any clinical trial appointments.
Many clinical trials are testing treatments for COVID-19. Some of these might be open to people with lymphoma who develop COVID-19. If there is a trial that is suitable for you, your medical team might ask you if you would like to take part. Visit Lymphoma TrialsLink to find out what is involved in clinical trials. Please note that our database does not include COVID-19 trials.
At present there are no medicine shortages in the UK linked to coronavirus, and no drug manufacturers have said they expect problems with supply due to coronavirus. The government is monitoring the situation and is taking precautionary measures to help make sure the supply of medicines to patients in the UK is not affected.