We have put together some answers to frequently asked questions from the breast cancer community about what to expect when New Zealand is set at Red on the COVID Protection Framework. Take a look below. Remember, if in doubt, speak to your medical team – they are in the best position to help you.
Breast Cancer Foundation NZ is still here to support you at all levels of the COVID Protection Framework (traffic light system). You can see the support services we have available here, or call our nurses on 0800 226 8773 if you have any questions or concerns.
Looking after yourself once COVID-19 is in the community
- How should I prepare to look after myself and my family if I am diagnosed with COVID-19?
- Who do I contact if I am unwell?
- Should I wear a face mask to protect myself?
How should I prepare to look after myself and my family if I am diagnosed with COVID-19?
There are a number of things you can do to prepare, including planning how you or someone else might isolate at your home if they are diagnosed with COVID-19. It is also a good idea to stock up on the medications and comfort items you will need if you feel unwell. This includes making sure you have a good supply of all of your usual medications in case it is difficult to pick up prescription items at any time in the pandemic. It would also be worthwhile to identify a friend, family member, or neighbour who can help you if you get sick.
BCFNZ recommends that you look at this series of easy to understand topics provided by Health Navigator to learn more about looking after yourself and whānau if you are diagnosed with COVID-19. This information covers how to monitor symptoms, what medication is recommended for different symptoms and who to call if you become unwell or need advice. Other topics include:
- How to isolate at home with the family / whanau
- Caring for adults
- Caring for children
- What to expect if you are admitted to hospital
Who do I contact if I am unwell?
At this phase of the Red setting, your GP or another health professional will call you if you are diagnosed with COVID-19. They will let you know what to expect and discuss with you who to contact if you are unwell or your symptoms deteriorate. Many people will only experience mild flu-like symptoms and can self-care.
If you are receiving current treatment for breast cancer though, particularly chemotherapy or immunotherapy medicines, then a plan will be made for your GP or another heath professional to phone you to monitor your symptoms. They may also send you a pack of support items to help with symptom monitoring.
You should also let your oncologist and breast cancer nurse know if you have been diagnosed with COVID-19. They will advise you and your GP if any additional precautions should be taken or if they recommend specific medicines to reduce any symptoms you may experience
When on chemotherapy, it is also important to remember that a fever can be a sign of an infection other then COVID-19 and require urgent treatment with antibiotics. You should follow the instructions given to you by your cancer treatment team and report this to the hospital.
Healthline can also give you advice, particularly if you have questions about COVID-19 (0800 611 116).
Should I wear a face mask to protect myself?
Wearing a mask helps to prevent the spread of COVID-19 and you are encouraged to wear a mask when you are out in public. The government has now made it mandatory for everyone aged 12 and over to wear a mask when they are visiting any essential services while the COVID Protection Framework is set at Red. This includes at supermarkets, hospitals and clinics, pharmacies and service stations.
There are new rules about the type of masks we wear. Masks should be tightly fitted across the nose and mouth, and secured by loops around the head or ears. Masks known as N95 or P2 are considered the best because they seal tightly to the face and have a highly rated filter. The paper surgical masks worn by many are also recommended if the N95/P2 masks are not available; surgical masks fit well and are able to filter out many airborne particles. These masks are available at many stores including supermarkets pharmacies and online stores. Fabric masks do not filter air to the standard needed during this latest Omicron outbreak, and many of these do not fit tightly to the face and so are no longer recommended. It is ok though to wear a fabric mask over a surgical mask as this can improve the overall fit of the surgical mask.
If you have an appointment with your specialist team at a hospital or clinic, or a GP appointment, and you do not have a mask, just let then know when you arrive and they will supply you with one.
Your health and breast cancer treatment during COVID-19 alert level Red
- Will my breast cancer treatment be affected?
- Can I visit my GP if I find a lump or an unusual change in my breasts?
- Will I still be able to go to my regular screening mammogram?
Will my breast cancer treatment be affected?
Your health and ongoing cancer care remain a priority during the COVID-19 pandemic. If you have routine appointments with your GP or at the hospital, your medical team may contact you to reschedule or arrange a telehealth consultation, via phone or video call. If you’re undergoing essential treatment, like chemotherapy, your appointment should still go ahead but you may notice some changes. Those changes are likely to include wearing a mask during your appointment and limiting the number of support people you can bring with you. You should also plan to arrive early for hospital appointments as there will be screening questions before you enter. Your medical team will let you know about any changes to your appointments.
Can I visit my GP if I find a lump or an unusual change in my breasts?
It's important to get any changes in your breasts checked out, even if you've had a mammogram recently. Give your doctor a call - you may be able to have an appointment with them over the phone or via video. Doctors are still referring patients to breast clinics, so even if you are unable to see your doctor, you should still be able to have any changes checked out.
Will I still be able to go to my regular screening mammogram?
BreastScreen Aotearoa and private mammogram clinics will remain open during at the red setting of the COVID Protection Framework. There may be some changes to appointments as clinics will be doing their best to manage social distancing and other safety measures. If your appointment has been changed someone will call you to explain this, otherwise you should attend your appointment as planned.
Breast cancer treatment and the COVID-19 vaccine
- I am currently having treatment for breast cancer; can I have a COVID-19 vaccine?
- I had treatment for breast cancer just over a year ago, should I have a COVID-19 vaccine?
- I’m worried about having the vaccine because I had lymph nodes removed during surgery and am risk of lymphoedema.
I am currently having treatment for breast cancer; can I have a COVID-19 vaccine?
The COVID-19 vaccine and booster are recommended for people with breast cancer who are currently having treatment. The vaccine or booster shot can be given up to a few days before surgery or a few days after surgery. Check with your GP, surgeon or breast nurse for advice on the timing.
If you are currently having chemotherapy, your oncologist will ask about your vaccination status and discuss with you the best time in the chemo cycle to have a vaccine and/or booster vaccine. This is so that any side effects from the vaccine aren’t confused with complications of chemotherapy, and so that you can mount the best possible immune response to the vaccine.
If you are having radiotherapy or taking hormone therapy for breast cancer it is also recommended that you have the COVID-19 vaccine and any recommended booster vaccines.
We recommend that whānau and your support network have a vaccine and booster. This is the best way others can protect you from COVID-19 during treatment.
I had treatment for breast cancer a while ago, should I have a COVID-19 vaccine and booster?
Yes, it is recommended that you have a COVID-19 vaccine and any recommended booster vaccines. Once you finish cancer treatments like chemotherapy your immune system slowly recovers and your response to the vaccine should be the same as it was before treatment for breast cancer.
We also recommended that you have a COVID-19 vaccine and any recommended boosters if you are taking hormone therapy or having bisphosphonates (medicine to strengthen your bones) in the years following surgery. If you have any concerns or questions you can discuss any risks and benefits and the timing of a vaccine and/or booster with your oncology team or GP and they can advise you on your individual plan.
There is no evidence that the COVID-19 vaccine increases the risk of lymphoedema, but you may prefer to ask that the vaccine is injected into the arm that was not affected by surgery or into another muscle if both arms were affected. Have a chat with your vaccinator about your concerns and they will let you know what is possible.
Your immunity and COVID-19
- Am I at higher risk from COVID-19 because I've had breast cancer?
- Will my immunity be affected by treatment?
- How long will my immune system be suppressed after I finish chemotherapy?
- I’ve had lymph nodes removed as part of my surgery for breast cancer treatment. Will this affect my immunity?
Am I at higher risk from Covid-19 because I’ve had breast cancer?
Everyone carries the same risk of getting COVID-19, but it will impact everyone differently. People who currently have breast cancer, including those who’ve recently been diagnosed or who have advanced breast cancer, may have lowered immunity because of the cancer itself. Some breast cancer treatments can also lower your immunity.
It also seems that people who have had cancer in the past may be at higher risk of complications from the virus. Most people who develop cancer – in New Zealand and around the world – are older, and are likely to have other medical conditions too. These factors may raise your risk of getting sick.
Will my immunity be affected by treatment?
Certain cancer treatments can affect your immune system, making you more vulnerable to infection. Those having chemotherapy or targeted treatment (like Herceptin) at the moment, or who have who have recently completed treatment, are likely to be immune-compromised in some way.
While on chemotherapy there is, of course, the very real risk of developing severe bacterial infections and your team of doctors and nurses will have spent time explaining this risk to you – describing the signs and symptoms of infection and how to report concerns immediately to hospital staff. This situation doesn’t change with COVID-19 and you should continue to have regular blood tests to check your white blood cell count if you have been asked to. It’s important to keep taking any medicine you’re been prescribed, as this will help support your body’s ability to fight infection. Please continue to keep your appointments with your treatment team, and contact them directly if you have symptoms and follow their advice.
Radiotherapy is less likely to affect your immune response, but you may find that your medical consultant will look at new ways of scheduling treatments to limit your exposure to others.
Taking hormone therapies, like tamoxifen, won’t increase your risk of getting sick, as there is no evidence that hormone therapies affect the immune system.
How long will my immune system be suppressed after I finish chemotherapy?
If you’ve finished treatment recently, your immunity should recover within the next few months. If you finished cancer treatment months or years ago, your immunity should have recovered by now.
There is no definitive way to test how good your overall immunity is, but how fast you recover from colds, etc might give you a clue about this. This will be different for everyone, as everyone’s immune system and treatment is different. If you’re still unsure, the best person to ask is your breast nurse or oncologist.
While lymph nodes are part of the immune system, having lymph nodes removed doesn’t affect your body’s ability to fight infections like COVID-19.
If you're worried or have any questions, call our nurses for free on 0800 226 8773 or email them at breastnurse@bcf.org.nz. Our nurses are here to help at all alert levels, and we will still be offering all our support services.