In my clinical life, I am an oesophogogastric cancer surgeon, which means I operate on people who have cancer of the oesophagus (gullet) or stomach. Whilst these cancers are relatively rare when compared to breast cancer or prostate cancer, they are unfortunately associated with much worse survival. For the type of oesophageal cancer most commonly seen in the UK, adenocarcinoma (we have the highest incidence in the world), five-year survival is only 15% and has not really improved in the last 20 years. These cancers tend to present late and have often spread at the time of diagnosis. For the third of patients with potentially “curable” disease the treatment process of chemotherapy + radiotherapy followed by surgery and recovery takes out a year of their lives. The risks are high and the benefits uncertain.

Now imagine going through this in a pandemic. Not only are you vulnerable because of the cancer diagnosis and treatment, but you don’t know whether or not your hospital will be able to do your operation because it might be overwhelmed with COVID-19 patients. This is the “other side” of the pandemic.

Here in Southampton, we have been relatively fortunate. The hospital has fared well, partly via good fortune in terms of absolute number of local COVID patients, but mostly through excellent planning and team work. We have taken more than our fair share of patients who required ITU care from other parts of the country, this was right and proper. We have made use of the wonderful team at UHS and the pandemic has deepened the already special relationship between the University and UHS.

But what of our cancer patients? For some, the pathway has changed and we have extended chemotherapy or used other suitable treatments. However, for the vast majority we have managed to operate safely and securely with excellent outcomes. We have also supported neighbouring hospitals by providing operating lists for their patients who couldn’t have surgery in their local hospital. This has meant performing operations with surgeons with whom we are not familiar and taking ownership of these patients as if they were our own. This was and is the right thing to do. I am proud of our response and the clinical team that I am lucky enough to work in for making this happen. We all agree that it’s the patient who counts, no matter where they come from.

We have learnt that collaboration is the new competition, this is the “other side” of COVID-19.

The “other side” of COVID-19 by Professor Tim Underwood

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