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There’s been a lot of very understandable concern about the impact of COVID on cancer treatments. In our @TheLancetOncol study, we looked at how radiotherapy delivery changed across England during the first lockdown. #radonc #COVID #RTDS @PHE_uk 1/n https://authors.elsevier.com/a/1cSeV5EIIgBXhl
Key messages:
- 20% ↓ in courses April 2020
- Biggest ↓ prostate and skin cancers, likely safe delays
- ↑ in oesophageal and bladder cancer courses
- Switch to shorter RT
- Persistent smaller reduction in June, likely due to reduced diagnoses
- RT continued throughout
2/n
- 20% ↓ in courses April 2020
- Biggest ↓ prostate and skin cancers, likely safe delays
- ↑ in oesophageal and bladder cancer courses
- Switch to shorter RT
- Persistent smaller reduction in June, likely due to reduced diagnoses
- RT continued throughout
2/n
If you’re worried about new symptoms that could be due to cancer, visit your GP. An early diagnosis is much more likely to be a curable diagnosis. We’re still here to treat the old ‘Big C’ despite the new one. @CR_UK @PWMJohnson More info about changes in RT below. 3/n
Using data from #RTDS @PHE_uk #NCRAS we see that in April 2020 the average number of courses started each week fell by 19.9% compared to April 2019. 4/n
The fall in courses was particularly marked in prostate cancer (77%) and non-melanoma skin cancers (72%) where short delay is unlikely to be detrimental. The age profile of these diagnoses underpins a wider pattern of reduced courses delivered for older patients. 5/n
New courses for patients over 70 reduced more than for under 70’s (34.4% vs 7.3%). Likely doctors and patients balancing the risks of #COVID against benefits of immediate RT, or indeed any RT where benefit is marginal. Age differences greatest in breast and skin cancer 6/n
IMPORTANTLY in April/May no reduction seen in e.g. head and neck, cervical and lung cancer where delay damaging to outcomes. Big increases in courses for oesophageal, bladder and rectal cancers reflecting aim to mitigate risks of delayed surgery through use of radiotherapy. 7/n
The fall in attendances (fractions) was greater than fall in episodes, 29.1% in April 2020 cf 2019. Differential between courses and fractions reflects increase in hypofractionated regimens. 39.9% of courses delivered using ≥5Gy per fraction cf 9.4% the previous year. 8/n
Smaller, but still marked changes in fractionation in other diagnoses, including lymphoma and rectal cancer amongst others. Changes align with updated guidelines and aim to keep patients safe and services running. @RCRadiologists @ILROGTeam @ESTRO_RT @ASTRO_org 9/n
Huge team effort from radiotherapy services across the country to continue delivering care for patients with cancer during #COVID, keep patients safe and help mitigate consequences of reduced surgical activity. @SCoRMembers @ipemnews @RCradiologists 10/n
Worryingly, in June, despite lockdown easing and RT waiting time targets being met, course numbers were still lower than in 2019. Likely reflecting known persistent reductions in cancer referrals and diagnoses. If you're worried about new symptoms, get checked out. 11/n
This work uses data provided by patients and collected by the NHS @PHE_uk #RTDS #NCRAS as part of their care and support. n/n
@DrCMJones @MontefioreD @BCI_UK @KatRoe_PHE @mereride @pippajanelewis @tomroques @JeanetteRCR @RachaelBrannan @useMYdata
@DrCMJones @MontefioreD @BCI_UK @KatRoe_PHE @mereride @pippajanelewis @tomroques @JeanetteRCR @RachaelBrannan @useMYdata
