Hospitals are scrambling to return cancer care to pre-pandemic levels amid warnings about missed diagnosis and longer waits for treatment.
Amy Parkins knew it would be cancer.
The single lump, found on her breast two weeks ago, had grown into three, and doctors had allowed her partner to be in the room with her to hear the news.
On August 19, the 33-year-old executive assistant from Blofield sat on a bed in the Norfolk and Norwich University Hospital (NNUH) and listened numbly as a consultant hidden behind full PPE and a face mask changed her life.
She is one of more than 300 cancer patients referred to the NNUH over the summer.
But as the NHS picks itself up from the first wave of coronavirus – and prepares for a second - doctors and charities are sounding alarm bells.
Figures suggest patients with cancer symptoms are staying away from hospitals and GP surgeries, while the number of those waiting longer for treatment is also on the rise.
In Norfolk, the latest numbers show cancer referrals are down by a third compared to March, from 228 to 173, and numbers are still below what they were this time last year.
“When the doctors told me it was cancer my first thought was about my four-year-old daughter,” said Ms Parkins.
“She was starting school in September, and I just kept thinking about how I might not be around to take her on her first day.”
She said coronavirus precautions have made the last few months even more difficult.
“I still haven’t seen the faces of my consultants and other staff,” she said. “Even though I know why it has to be like that, it makes an already surreal and terrifying experience feel very impersonal.”
Ms Parkins waited six weeks to start her treatment, meaning she was seen within the target of 62 days.
But while the NHS has battled to bring waiting times for cancer treatment down, around a quarter of patients at Norfolk’s three emergency hospitals are waiting more than the target two months.
Figures also reveal 28 cases in the county’s hospitals where cancer patients have seen 104 days pass without their treatment starting. This figure fluctuates each month but the trend has been on the rise since August 2019.
“The waiting is a whole new level of anxiety,” said Ms Parkins.
“There’s this thing inside you and you’re terrified it’s going to get worse.”
Laura Middleton-Hughes, 33, from Eaton, is also being treated at the NNUH for breast cancer.
The former hairdresser was first diagnosed in 2014, but developed incurable secondary tumours two years later. On Friday, just 10 minutes after receiving treatment, she said: “The moment you’re told is so hard to describe.
“It’s like your whole world, your plans and your future just get taken away from you.
“I wanted to have children, but the treatment means that I’m unable to.
“Now I live for every day and make sure I do at least one thing a day that makes me smile.”
Oa Hackett, 34, from Bawburgh, founded charity Littlelifts, which gives out comfort boxes to women with breast cancer.
She was diagnosed with breast cancer herself in 2014. “I can’t imagine what it’s like getting the news now,” she said. “The thought of people going through this alone is heartbreaking.”
Healthwatch Norfolk chief executive Alex Stewart said untimely deaths would be an inevitable impact of the coronavirus crisis on cancer care.
“Covid has had a huge impact,” he said. “GP surgeries were not seeing the volume of patients that they would have usually seen. There’s a whole host of missed referrals, and this will also be across a whole host of other conditions too.”
Norfolk’s three hospitals said getting cancer treatment services back to pre-Covid levels was a priority.
Dr Matthew Lawes, NNUH cancer clinical lead, said the “small proportion” of patients whose treatment had been delayed by the virus were being closely supported.
He said projects to expand cancer services in Norfolk were continuing, including the development of the North Norfolk Macmillan Centre at Cromer Hospital.
At the James Paget University Hospital in Gorleston, chief operating officer Joanne Segasby said their capacity had been increased by re-commissioning an operating theatre. She said there were plans to increase diagnostic capabilities in the months ahead.
Denise Smith, chief operating officer at the Queen Elizabeth Hospital in King’s Lynn, said waiting lists were being reviewed to prioritise the most urgent cases.
She added that the recent purchase of the BMI Sandringham Hospital would support their ability to complete more surgery.
•How quickly should patients be seen?
The NHS has a target that 85pc of patients start a first treatment for cancer within two months of an urgent GP referral.
Patients who are referred from an NHS cancer screening service should also start treatment within 62 days.
In Norfolk the figure was around 70pc in July, the month which the most recent figures are available for.
Across the UK there were 11,742 people referred to start cancer treatment in July.
This is down 24pc from 15,363 in March and there has been a similar trend in the east of England.
In the same month, a fifth of patients were found to have been waiting for more than two months for treatment to start, and one in 10 had waited more than 104 days.
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