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When Ruth Cottle and her husband discovered they were expecting their first baby, they were thrilled and knew 2020 would be a very different year for them. They never anticipated how fraught and challenging it would turn out to be.

Weeks after the birth of her baby daughter, Ruth was diagnosed with breast cancer – in the middle of the coronavirus lockdown.

The 32-year-old management consultant told HuffPost UK she went to her GP a week or so before lockdown was imposed to get a lump on her breast checked out – but acknowledged that if lockdown had already been in place, she would have delayed seeking medical advice.

She is now urging others with symptoms or fears about cancer to get checked out. Her message comes as experts voice their fears that people are ignoring symptoms because they are reluctant to seek medical help during the coronavirus crisis.

Latest figures reveal that the number of people seen by a specialist for suspected cancer following an urgent GP referral was around 26,000 lower than would have been expected in March.

Under normal circumstances, experts would have expected around 208,000 people in England to have been seen by a cancer specialist following urgent GP referral – but the figure was 181,873.

There are also concerns that hundreds more cancers may be going undetected at the earliest stage every week as vital screenings have been put on hold.

Ruth told HuffPost UK that she was full of excitement at the prospect of having her first baby and had a smooth pregnancy.

However, towards the end of her pregnancy, she noticed a lump in her left breast. “I had a bit of a google and from what I read, I found it was normal for your boobs to change during pregnancy as the milk production develops,” she said.

“Being 32, I didn’t think it was anything sinister. There is no history of any cancer in my family, let alone breast cancer.”

Ruth, who is married to Mark, gave birth to Madison on February 10 and remembers hearing “murmurings” about coronavirus in China around that time.

But she noticed she was struggling to feed on the left side, while feeding from the right breast was fine. 

In hindsight she knows she was seeing typical symptoms of breast cancer, which also included a difference in her nipple – but being a new mum, struggling with breastfeeding didn’t ring any alarm bells.

She realised the lump on her breast was still there and was getting quite big. “It was about the size of a table tennis ball,” she said. “I started thinking I should go and get it checked out by a doctor,” she said. “But being a busy new mum, thinking it and doing it were very different things.”

Ruth eventually went to see her GP about a week before lockdown and although her doctor did not seem too concerned, she referred Ruth to the breast clinic as a precaution. A week into lockdown she underwent an ultrasound and biopsy.

“I was still not particularly worried about it being cancer,” said Ruth. “I was more worried about going to hospital during lockdown than I was about cancer.

“Neither me or my husband told our families I had found a lump or that I was going to hospital as we did not want to worry them unnecessarily during an already stressful period.

“Madison is the first grandchild on both sides of the family and they were already upset at not being able to see her for however long lockdown lasted.”

Ruth had an appointment to see a consultant on April 1 and to her shock and disbelief, he told her they had found cancer in her breast and lymph nodes.

“It was a huge shock,” she said. “I thought: ‘It can’t be cancer, I’m only 32’.

“I was at the appointment on my own as my husband had taken my daughter for a walk around while I went into the hospital.

“My thoughts immediately turned to Madison and I thought: ‘How could I leave my then seven-week-old daughter without a mum?’

“Your mind goes to the darkest places and I started worrying I wouldn’t be around when Madison turned one or that if my time was limited, we wouldn’t be able to do all the things I might want to do because of the coronavirus lockdown.”

Telling family and friends about her diagnosis also proved difficult for Ruth as the lockdown meant she couldn’t tell them face-to-face and they in turn wanted to help and support her in person, but felt helpless.

“I kept apologising as I felt I was adding to everyone’s worries at a time when they were already upset,” she said.

Ruth was informed she needed more scans and tests and spent the next month undergoing investigations.

Initial results showed the cancer had not spread which was a huge relief, and Ruth is now recovering after a lumpectomy ahead of chemotherapy.

She had to have a Covid-19 test 48 hours before going in for her surgery which made her feel reassured, and she says her dealings with hospitals and “amazing” health workers have put her at ease about the coronavirus risks.

“My worry has now shifted,” she explained. “For my first couple of treatments, I was more worried about coronavirus than any potential cancer diagnosis. I thought the chances of me having cancer were really slim.”

Ruth is urging other people not to delay getting any unusual symptoms checked out, even if it’s just to put their mind at rest.

She added: “I know people will feel uneasy about going to seek medical help, but GPs are still open and they can do phone consultations.

“Going into hospital has been reassuring as they have all the safety measures in place and the staff are all masked up and there’s been hardly anyone else in the waiting rooms.”

Madison, who is now 14-weeks-old, has been the “most wonderful distraction” from Ruth’s cancer ordeal. She said: “I still had to get up and feed her and look after her and she needs so much of your attention, it helped keep my mind off cancer.

“Madison is lovely and is such a happy, smiling and contented baby.

“I certainly never expected to have a newborn to care for during a pandemic and then get diagnosed with breast cancer on top of that.

“But hopefully, we will be able to look back and think: ‘That was a shit year, but we got through it.’”

Lynda Thomas, CEO at charity Macmillan Cancer Support, which has launched an emergency fundraising appeal during the coronavirus crisis, told HuffPost UK that the decrease in cancer referrals is deeply troubling.

She said the target for 93% of people to be seen by a specialist within two weeks of urgent referral was breached in March for the 13th month in a row.

“The unintended consequence of having such a strong public message telling people to stay at home is that there are a lot less people going to their doctor or turning up at A&E,” she said.

“But for certain types of people, including cancer patients, you cannot afford to wait and some cancers, particularly aggressive ones, need to be treated urgently as time is of the essence.

“There is a real danger that there are patients sitting on cancer symptoms and the fear is that there will be a growth in people dying of cancer and a tremendous backlog when it comes to appointments.

“We don’t want cancer to become the ‘forgotten C’ during the coronavirus pandemic.”

Emma Wright, 41, was diagnosed with Stage 2 breast cancer at the end of February, within six days of going to the doctor.

She had to go for her first treatment and hormone therapy injections on her own without her husband’s support.

“It was really tough because it’s at these times that you really need somebody with you,” she said.

“Even the simple things like being in a waiting room and having to sit at a distance from people and meeting your oncologist who is wearing full protective gear, it just adds another level of stress and emotion to what is already a very stressful situation.” 

Emma is having to deal with having cancer surgery, going through the menopause due to her treatment, home schooling her child, worrying about the financial implications of her self employed husband being off work – and she knows many others living with cancer are going through the same difficult time.

She said: “The most worrying thing I have heard is that people are getting scared to go to the doctors about possible early diagnosis of a lump or a bump they have found.

“That scares me because after this is over, we do not need a nation with a ticking time bomb of people who have missed the boat and have not got diagnosed early enough.”

NHS screening programmes for breast, cervical and bowel cancers can detect the diseases before patients experience any symptoms.

However, experts are concerned as screening has formally been suspended in Scotland, Northern Ireland and Wales. In England, although there has not been a national suspension, specialists say it has effectively been paused.

For some cancers, early diagnosis detected through screening can have a major impact on survival rates.

Around 200,000 people a week are no longer being screened for bowel, breast and cervical cancer across the UK. Cancer Research UK estimates almost 400 people a week are not being diagnosed through screening.

When bowel cancer is diagnosed at its earliest stage, 92% of people will survive the disease for five years or more compared with 10% when the disease is diagnosed at the latest stage.

Bowel cancer is the fourth most common cancer, but the second biggest cancer killer. Genevieve Edwards, chief executive of Bowel Cancer UK, told HuffPost UK she was “extremely worried” about the huge drop in people going to their GP.

“We think as many as three out of four patients with bowel cancer symptoms are not going to the doctors, she said. “The last thing the NHS wants is large numbers of patients presenting with advanced bowel cancer in the months ahead as they will have much worse outcomes.”

Edwards is also worried about delays inscreening as she says not only can it detect cancer before symptoms arise, it can be preventative as well.

Sara Hiom, Cancer Research UK’s director of early diagnosis, told HuffPost UK that for the vast majority of cancers, early diagnosis means a greater chance of successful treatment.

“When cancers have spread all around the body, it is much more difficult to cure them long term,” she said. “For the most part, at this stage, treatment will extend life but there will be less chance of an overall cure beyond 10 years.”

Hiom says pushing the importance of early cancer diagnosis is at the heart of what she has been working on for the last 15 years. She says GPs are keen to allay people’s fears and encourage them to come forward and that there are cancer hubs with Covid-free environments where people can go for diagnostic tests and treatment.

Professor Peter Johnson, the NHS clinical director for cancer, is urging people not to hesitate to get checked if they have symptoms.

“From online consultations to the roll-out of cancer treatment hubs, we are doing all we can to make sure patients receive the life-saving care that they need.” he said. “We know that finding cancer early gives us the best chance to cure it and ignoring potential problems can have serious consequences now or in the future.”