Uncertain times are upon us, around the world, as we globally respond to the coronavirus (COVID-19) that is affecting us all on some level. Many members of our bladder cancer community are directing questions our way about how the this virus might affect their health and treatments. We will be answering many of these questions after consulting with the members of our Medical Advisory Boards. Please keep in mind that circumstances around this issue vary from region to region, and are changing by the hour, so some information may be rather general in nature. You may also wish to check out the Bladder Cancer Advocacy Network’s (BCAN) FAQ page here for further questions and answers.
As always, all of us here at BCC wish to support our community as best we can, but it’s important to emphasize that BCC staff are not medical professionals. It’s important to first turn to your medical team for advice, when possible.
Have a question? Send us an email at info@bladdercancercanada.org and we’ll do our best to answer it.
Does having BCG treatments weaken or compromise one’s immune system, with special concern given to the COVID-19?
Our Medical Advisory Board has received many questions about compromised immune systems with BCG. They do not believe that receiving BCG should put any patient at increased risk of COVID19 other than the fact that they have to travel to the hospital. We encourage any patients scheduled for BCG to contact their health care team prior to your appointment and they can advise you of any precautions you should take.
Will my next round of BCG treatments be delayed beyond the normal 3-4 month interval?
We have been advised by our Medical Advisory Board that at many centres, BCG maintenance treatments have been cancelled for the time being due to the COVID-19 crisis. However, your health care team would really be best able to answer your questions as they are familiar with your case and what care they are planning to provide.
Does receiving treatment for non-muscle invasive bladder cancer increase my risk of getting COVID-19?
The diagnosis of patients and their required treatment can be very different. According to our Medical Advisory Board, it needs to be clear that none of the treatments for non-muscle invasive bladder cancer (NMIBC) affect the risk of getting COVID-19, except through the exposure of being in the health care facility setting. Some doctors think they can safely delay treatments for 3 months and they may consider this as an option to avoid the patient visits required for treatment. Treatment for NMIBC should not make the course of COVID19 more severe.
As always, it’s best to consult your health care team when you have questions and are feeling concerned, anxious or unsure.
Will the treatment of my bladder cancer be affected by COVID-19?
It’s always best to consult your health care team with questions like these.
Your concerns and your wellbeing are a high priority of your attending doctors, nurses and other health care professionals but these times are unprecedented and you will need to heed their recommendations and follow their directives. In many cases, the most critical patients will receive treatments in priority. Some attending urologists have deferred 6 and 12 month bladder cancer cystoscopies as an example and may be cutting back on seeing new patients because their facility’s OR time is being reduced. In other cases (ie. metastatic bladder cancer), doctors will continue with the recommended treatment plan as they have a relatively narrow window of treatability. Since the COVID-19 situation is fluid and changing daily, each hospital and health care system may need to restrict access to therapies further depending on the local level of infection.
Will receiving chemotherapy affect my immune system’s ability to fight COVID-19?
Chemotherapy treatment does affect your body’s immune system and all patients currently receiving treatment (or have received treatment in the past few months) should take care to isolate themselves from the increased risk of becoming affected by all viral and bacterial infections. Read our article Protecting Yourself During the Coronavirus for some helpful tips on how to protect yourself.
What to do if I see blood in my urine during these exceptional circumstances? Is it still urgent to do a follow-up with a doctor?
It’s important to remember that blood in the urine can be a symptom of many conditions, some critical and some not. There are also a number of other important considerations such as if you have previously been diagnosed with bladder cancer or recently had a TURBT or BCG treatment. These are all important criteria in determining the seriousness of blood in the urine.
Diagnosis should be sought in in accordance to current healthcare priorities and protocols at healthcare facilities. If you were previously diagnosed with bladder cancer, it’s important to reach out to your health care team by phone for advice. If this is the first time you are seeing blood in your urine, a reasonable place to start is with a call to your family physician for further instructions.
The medical supply chain is currently under great pressure. Will this impact my ability to order ostomy supplies?
We know that there are many patients that are ordering extra supplies to ensure that they are not stuck without supplies if the global situation does not improve soon. Other patients are ordering their usual quantities, in an effort to not contribute to depleting the supply that is needed for others. This is a personal decision and we do not feel strongly that one option is more appropriate than the other. We do know that some suppliers have indicated that delivery may be delayed due to the higher than normal order volume. You may want to keep this in mind when placing your order.
I do not currently have a family physician to turn to. I am afraid of going to the walk in clinic or emergency, due to the COVID-19 situation and the potential risk to my general health. Where do I go?
Many doctor’s offices have turned to meeting with patients via Telehealth.
There are also a number of public Telehealth options available. Information about provincial services are included below:
British Columbia: https://www.healthlinkbc.ca/services-and-resources/about-8-1-1
Alberta: https://www.albertahealthservices.ca/maz/telehealth.aspx
Saskatchewan: https://www.ehealthsask.ca/services/telehealth
Manitoba: https://mb.211.ca/agencies/mb-telehealth/
Ontario: https://www.ontario.ca/page/get-medical-advice-telehealth-ontario
Quebec: https://www.quebec.ca/en/health/finding-a-resource/info-sante-811/
New Brunswick: https://www2.gnb.ca/content/gnb/en/departments/health/Tele-Care.html
Nova Scotia: http://www.nshealth.ca/virtual-care
Prince Edward Island: https://www.princeedwardisland.ca/en/information/health-and-wellness/811-telehealth
Newfoundland and Labrador: https://www.811healthline.ca/
Nunuvut: https://www.gov.nu.ca/health/information/telehealth
North West Territories: https://www.hss.gov.nt.ca/en/services/nwt-healthnet/telehealth
Yukon: https://ykhealthguide.org/
Canadian Women’s Health Network has a source for telemedicine at this link:
http://www.cwhn.ca/en/yourhealth/provincialhealthlines
