To wonder why medical procedures have been cancelled?

[malificent7]

Apparently the fairly big hospital where i finished my last placement is quiet.
A and e is dead apparently according to colleagues. So why are operations and cancer treatment cancelled?
I dont think icu is overrun with corona victims but i may be wrong.

Ah, thanks mumof1, so The decision’s been taken that there’s no point in identifying symptoms If you then can’t do anything about it? Well i think there is something in that - it would certainly cause huge stress to know that you were in that position.

What/when is the endgame there, i wonder? - is colonoscopy/endoscopy awaiting enough ppe for those carrying it out, or enough tests that patients can be tested to check they’re not infected before the procedure? Or is it just postponed until further notice - and what’s the estimate of avoidable deaths as a result?

If anaesthetists are running intensive care units, often bigger than normal as they've expanded into theatres, how can they also anaesthetise for routine surgery? I would think that's a major hurdle.

Good point middlewood - though if less mechanical ventilation is needed than initially predicted, might that mean some can return to Doing anaesthesia for cancer surgery now? (Sorry about random caps)

Yes, I would think so.

@fromlittleacorns Bowel Cancer UK is looking for people whose screening it treatment has been impacted by coronavirus www.bowelcanceruk.org.uk/news-and-blogs/coronavirus-faqs/has-your-bowel-cancer-screening-been-impacted-by-coronavirus/

Many cancer charities, I think 19 of them, have kind of joined forces to look at the impact of coronavirus on patients.

DH has already had bowel cancer, he and many others have a genetic predisposition to bowel cancer, known as Lynch Syndrome, and need regular colonoscopy and endoscopy screening. He isn't due screening soon but many others must be and it's a worrying position to be in.
If someone is diagnosed with bowel cancer quite young (below 40) it's advisable that they are tested for Lynch Syndrome, and if they have it then their family members should also have the option.
Sorry to hijack but bowel cancer is the second biggest cancer killer in the UK.

Back to the OP, I think hospitals didn't take the decision to cancel lightly, the scale of the coronavirus outbreak was a huge unknown and still is to a degree, but I hope that elective procedures can recommence soon for people who need them.

Thanks hitthefloor, and yes I agree Tainted Love is a very good dance record.

That must be so worrying for people with Lynch syndrome and other genetic predispositions - I hope that they can get back into the routine asap.

I clicked on the link out of interest, but I think the requirement that you have to be willing to speak to media may reduce takeup by those affected - many people may not be prepared to take the risk of twitterism and general opprobrium! or indeed may not want to talk about health stuff in public. So concern may be 'underplayed' in the media.

Interesting thing is that I've seen one of the letters and it says being aware of symptoms of bowel cancer is still very important and plse contact your gp if you have them - which suggests some NHS colonoscopy and endoscopy is still happening - or is that just naieve optimism?

Does anyone know the position on mammography - is it just routine screening thats suspended, or is it being postponed for those with suspicious lumps/other symptoms as well? Or does it vary from place to place?

Anaesthetists being deployed to ICU means surgery “can’t” happen. Even minor procedures involve the need for an anaesthetist to monitor oxygen/heart rate etc and administer anaesthetic if any complications arise.

all surgery carries the risk of complication so there needs to be a contingency for when that happens. And with ICU’s being potentially overrun with COVID patients that contingency couldn’t be guaranteed.

Remember one of the reasons why we went into lockdown and the nightingale hospitals were built was because it was estimated that the main hospitals would be overrun. This in fact has happened in most other countries but as much as people like to slag off the government it didn’t happen here, to the point I read yesterday that the London nightingale is being shut down.

Also a lot of people would have cancelled their own surgeries for fear of contracting COVID in the same way many haven’t been going to a&e. So with all minor procedures being cancelled it didn’t put people in a position where they felt they had to choose.

Thanks alternative, thats interesting. Presumably emergency surgery is still happening? Have to admit i havent read anything about that.

Does anyone know the mammography position - is that still being done for those with symptoms eg lumps (as opposed to Routine screening Which i know is suspended) or has it come to a halt completely?

fromlittleacorns People with breast symptoms are being investigated

@fromlittleacorns I understand what you mean about very many people not being keen on sharing their story publicly or not having the energy when they are feeling so unwell. I would hope that by contacting the support charities directly they can still receive the support they need first and foremost, and perhaps the charities can use their stories as case studies if that's something the person wants.

I'm not sure if colonoscopy or endoscopy procedures have stopped completely but I expect they're only carried out if absolutely no alternative.
For example, by the time DH's bowel cancer was diagnosed it was also clearly visible on a CT scan. Usually a colonoscopy / endoscopy would be done first as these are considered the best diagnostic tests, and if there are polyps they might be able to remove for testing.
But if the cancer is advanced enough to be seen on a CT scan they might be able to do that first as less invasive. If it can be clearly seen they might be able to confirm diagnosis then. It shouldn't be used to rule out bowel cancer though as could miss some changes. I don't know how cost-effective or feasible that would be as an option.
I hope screening can start up soon, the UK already lags behind many European nations when it comes to cancer screening and recovery rates.
We'll need staff available working in the labs to process samples though.

I work in a&e and since last week it has tripled in minors and walk ins. Most of our wards were being used as covid wards at one point so couldn't accommodate other patients. While this has dropped at the moment it could easily surge again and would be extremely difficult to start cancelling stuff. Much easier to keep the capacity there is needed

My hospital in New York never stopped doing IV infusions for cancer patients or others getting biologic meds, but that area is on it's own floor in a separate building. We've also set aside some surgical spaces for emergencies but they've been used very, very sparingly.

Hitthefloor i agree, but i suppose it would be good if people could report anonymously to cancer charities so that cancer charities could publicise the issue more. I dont think there is that much public awareness of the impact on future death rates of discontinuing treatment and screening.