We have put together some answers to frequently asked questions from the breast cancer community about what to expect when Covid Alert Levels change. 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 throughout all alert levels. 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.
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.
The Covid-19 vaccine is recommended for people with breast cancer who are currently having treatment. This vaccine 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. 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.
We recommend that whanāu and your support network have a vaccine. This is the best way others can protect you from Covid-19 during treatment.
Yes, it is recommended that you have a Covid-19 vaccine. 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 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 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 health and breast cancer treatment during Covid-19
- Will my breast cancer treatment be affected?
- What should I do if I become unwell or think I have been exposed to Covid-19?
- Can I visit my GP if I find a lump or an unusual change in my breasts?
- Should I wear a face mask to protect myself?
Your health and ongoing cancer care remain a priority during Alert Level 4. 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 not being able to have a support person 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.
If you are currently on treatment your medical team will give you information about infection, what to do if you feel unwell, and the steps to take if you do get sick. If you get a fever while on chemotherapy, you should follow these instructions carefully.
If you have completed treatment, your GP will be your first port of call. It’s best to ring them first, and they can then assess you over the phone. If needed, they may be able to still see you in person.
Healthline can also give you advice, particularly if you have questions about Covid-19 (0800 358 5453 for information and advice about Covid-19 or 0800 611 116 for general health concerns).
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.
The government has now made it mandatory for everyone aged 12 and over to wear a mask when they are visiting any essential services during Alert Level 4. This includes at supermarkets, pharmacies and service stations. Pharmacies and online stores are selling reusable or simple paper masks, but you can also use face coverings like a scarf or bandanna. There are also many free patterns to make your own mask at home, like this one. If you don’t already have masks, you could call your breast nurse at the hospital for their advice. Masks for family and close contacts are also important when they are out in the community.
It is also recommended you keep a two-metre distance from people not in your bubble when you are out. Depending on your living situation, it may be best to nominate someone else in the family to be the person visiting essential services such as supermarkets
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?
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.
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.
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 email@example.com. Our nurses are here to help at all alert levels, and we will still be offering all our support services.