‘Watch for cancer signs and contact your doctor’
PEOPLE need to be alert to the more vague symptoms of cancer and must not be afraid to seek advice from their GPs during the coronavirus pandemic, medical researchers say.
They also warn new ways of remote working could make it harder for GPs to pick up on worrying symptoms, in a comment article published today in Lancet Oncology.
The experts, from four universities including Cardiff, write: “It is likely that patients with well recognised ‘red flag’ symptoms such as a new lump or rectal bleeding will continue to present to primary care.
“However, with Covid-19 at the forefront, vague cancer symptoms such as fatigue, change in bowel habit and weight loss may be dismissed by the patient as trivial. Respiratory symptoms including persistent cough may be attributed to Covid-19 and not acted on.”
The researchers say cancer in primary care – from diagnosis to management of those living with the disease – is “evolving rapidly” in the face of the pandemic.
“In a climate of fear and mandated avoidance of all but essential clinical services, delays in patient, population and healthcare system responses to cancer symptoms seem inevitable,” they say.
Professor Kate Brain, a researcher from Cardiff University’s School of Medicine who is looking at the impact of delayed diagnoses of cancer, says: “UK national cancer screening programmes, which account for 5% of all cancer diagnoses each year, have been suspended.
“As such, early diagnosis through spotting – and acting upon – the early signs of cancer becomes extremely important.
“Cancer cannot wait – even in the midst of a pandemic. We would urge anyone with symptoms that are causing concern to contact their GP.”
The group of experts also urge GPs to recognise that telephone and video consultations will work for some patients but will disadvantage others, particularly those who do not have access to a computer.
The researchers argue that new ways of working across primary care may also “blindside” some GPs. Remote consultations make it harder for doctors to pick up on the other cues that may help in a face-toface consultation, such as the patient’s demeanour, they say.
Some GPs may not be able to access timely routine tests because hospitals are focused on Covid-19, which adds to the importance of picking up on symptoms.
SO far more than 200 people have died with coronavirus in care homes in Wales, and the total is growing all the time, despite the best efforts of carers and health care staff who are giving their all around the clock.
From the start of the year to April 17, the number of care home Covid-19related deaths has reached 227, ONS figures released on Tuesday state.
The figure has been questioned by some who have lost loved ones who do not know if their death is being counted as part of the final toll.
And it comes at a time when care home residents and staff in England will be tested regardless of whether they have coronavirus symptoms, but this is not the case in Wales.
This is the situation being faced in our care homes.
On Thursday, April 23, 83-year-old Evelyn Davies passed away at a care home in South Wales.
A grandmother-of-six, and greatgrandmother to eight, she tested positive for Covid-19 and sadly died two days later.
Her daughter Lesley Wilson said she did not wish to name the care home her mother was in, but thanked staff for all their efforts.
Lesley said: “The staff were amazing from start to finish. They thought she had a chest infection, but it got worse, so they tested her for the virus and it came back positive.”
Born in Abercwmboi, Evelyn moved to Penywaun in 1965 where she lived with her husband and four children.
She has been described as the “perfect grandmother”.
Lesley said: “She was there for us all whenever we needed her, whether it was big or small. She’d drop everything to help. She was so kind, loving and extremely funny. We all love her so much and will miss her forever.”
Moelona Myfanwy Flower was 94 years old when she died at Pantanas Care Centre in Treharris on April 12. On her death certificate, the motherof-two’s cause of death was given as “pneumonia in an environment of coronavirus”.
But her son David Flower said that while he believed his mother might have contracted Covid-19, he was worried her death would not be included in the number of people in Wales to die with the virus.
David, 65, said: “Her body was past its best so if she had coronavirus she didn’t have the strength to fight it off.
“They said she had the flu. I think we are talking about five days before [her death] but it’s hard to know as we couldn’t see her.
“The Welsh Government can’t be counting people in care homes if their death certificates have that kind of non-statement on it.”
Public Health Wales said whether a death was counted in the Welsh total would depend on “how the person certifying the death completes the death certificate”.
According to the British Medical Association, guidance has been given on the completion of death certificates under the Coronavirus Act 2020.
In both England and Wales the cause of a death recorded in the community is a matter of clinical judgement, determined by weighing up the patient’s recent and past medical history and the circumstances of their death.
It states: “In those cases where the doctor is confident on medical grounds that a particular cause of death is likely then that should be entered on the MCCD (Medical Certificate Cause of Death).
“Covid-19 is an acceptable direct or underlying cause of death for the purposes of completing the MCCD, even without the results of a positive test, and it is important that likely Covid-19 deaths are reported as such via the registrar.”
In Pantanas Care Home in Treharris where Moelona died, four patients were accepted from hospital after “being assured verbally that they did not have Covid-19”.
A spokesman for the care home said all four residents were isolated in individual rooms but three developed symptoms of coronavirus and passed away.
He said: “Our staff were all wearing PPE but we were at that time unable to obtain visors from any source.
“A number of other residents have since passed away but the cause is unclear because they already had complex underlying health problems.
“Our thoughts are with the families and friends of all of those who have passed away and we would also like to pay tribute to our wonderful staff for their skill and dedication.”
Over in Greenhill Manor Care Home in Pentrebach, Merthyr Tydfil, eight residents have also died, with their funerals being listed between April 20 and May 11.
A spokeswoman for the 120-bedroom care home described four deaths as “possible cases” of Covid-19 but said they were unable to confirm this.
They said no tests were able to be carried out as they were told Public Health Wales were “not testing anyone in the area”.
Both care homes come under the Merthyr Tydfil local authority where 12 coronavirus-related deaths have been recorded in care homes up to April 17, according to the ONS.
As well as a lack of testing, the devastation caused by deaths in care home across Wales weighs heavily on care home staff.
In Tregwilym Lodge in Rogerstone, general manager Karen Healey described the pandemic as “catastrophic” after losing 15 residents in the space of a month.
Tests weren’t carried out but 14 of the elderly residents reportedly had coronavirus symptoms.
Speaking to the BBC, Ms Healey said: “From a staffing and care point of view it’s been catastrophic.
“But more importantly the profound loss and the numbers we’ve been dealing with - and the families has been absolutely unbelievable.
“We’ve never seen anything like it