Repository of advisory documents for cancer treatment during the coronavirus (COVID-19) pandemic
This resource is for clinical teams managing cancer patients. It has been made available freely for the benefit of clinical teams across the UK and around the world. As such it may be accessed by anyone be they a healthcare professional, patient or a carer or any other member of the public. The resources in the library have been written by and for clinicians and therefore, the language and context is not patient or public orientated. UK patients and the public should refer to the latest NHS advice on COVID-19 and to patient information produced by UK cancer charities such as CRUK and Macmillan. Please discuss any concerns about your treatment with the team who is treating you.
The aim of this virtual library is to facilitate national discussion and the sharing of expert opinion in order to provide guiding principles for the management of cancer patients in the UK during the COVID-19 pandemic. The documents are the collaborative work of oncologists and their teams. They are not RCR guidelines nor consensus statements. They are intended to be a useful, dynamic resource for the oncology community.
Cancer services will need to consider and adopt changes to their usual protocols and procedures based on local demand and capacity. Before implementing any changes, please discuss and agree them with your department colleagues, your wider site-specific cancer multidisciplinary teams and your commissioners where that applies.
The documents have a clear authorship and initial publication date. Please post via the RCR clinical oncology coronavirus (COVID-19) discussion forum (member login required) or email professionalservices@rcr.ac.uk if you wish to discuss any issues or give constructive feedback. If you would like to contribute new documents or know of weblinks that would be useful to include please contact professionalservices@rcr.ac.uk.
These documents will be updated as new information is available. We will review them at least once a week to make sure they remain current. Please check this webpage regularly.
This resource is a result of the dedication, flexibility and collaboration of oncologists and their teams everywhere. Thank you all.
Acute oncology
- Guidance for the management of acute oncology patients during the coronavirus pandemic (PDF) (Published 7 April 2020)
Breast
- Guidelines on radiation therapy for breast cancer during the COVID-19 pandemic (PDF) (Published 24 March 2020)
- Emergency guidelines for pre-operative breast radiotherapy during the COVID-19 pandemic (PDF) (Published 27 March 2020)
- Emergency guideline for treating patients requiring adjuvant internal mammary chain radiotherapy in 5 fractions during COVID-19 pandemic (PDF) (Published 3 April 2020)
Bladder
- Guidance for management of urothelial cancer during COVID-19 pandemic (PDF) (Published 24 March 2020. Updated October 2020)
CNS
- Neuro-oncology treatment guidance during COVID-19 pandemic (PDF) (Published 27 March 2020)
Gynaecological
- Proposed guidance for radiotherapy for gynaecological cancer and COVID-19 (PDF) (Published 24 March 2020. Updated 5 May 2020)
Head and neck
- Head and neck cancer and COVID-19 (PDF) (Published 24 March 2020. Updated 6 May 2020)
Lung
- Reduced fractionation in lung cancer patients treated with curative-intent radiotherapy during the COVID-19 pandemic (PDF) (Published 2 April 2020. Updated 5 May 2020. A revision was added to page 25 in July 2020)
Managing treatment gaps in radiotherapy of lung cancer during the COVID-19 pandemic (PDF) (Published 6 May 2020)
Lower GI
- Lower GI response to the COVID-19 outbreak (PDF) (Published 24 March 2020. Updated 29 April 2020)
Upper GI
- Considerations for treatment of oesophagogastric cancers within the United Kingdom during the COVID-19 pandemic (PDF) (Published 24 March 2020. Updated 25 March 2020)
- Considerations for the treatment of oesophageal cancer with radiotherapy during the COVID-19 pandemic (Link added 22 April 2020)
- Considerations for treatment of pancreatic cancer within the United Kingdom during the COVID-19 pandemic (PDF) (Published 25 March 2020. Reviewed 3 April 2020)
- Radiotherapy protocol: Radical pancreas 15 fraction (PDF) (Updated 21 May 2020)
- Please check back soon for updated radiotherapy protocols
Lymphoma
- ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic (Link added 16 April 2020)
Melanoma
- Guidelines for follow-up and SACT for melanoma during COVID-19 pandemic (PDF) (Published 24 March 2020)
- Radiotherapy for melanoma in COVID-19 pandemic (PDF) (Published 5 May 2020. Updated 30 November 2020)
Non-melanoma skin cancer
Non-melanoma skin cancer (NMSC) and COVID-19 (PDF) (Published 2 April 2020. Updated 30 November 2020)
Neuroendocrine tumours
- Guidance for the management of neuroendocrine tumours during the COVID-19 pandemic (Link added 2 April 2020)
Paediatric radiotherapy
- Prioritisation of paediatric and TYA patients (with paediatric-type tumours) for radiotherapy during the COVID-19 pandemic (PDF) (Published 2 April 2020. Updated 9 April 2020)
- A Rapid Review of Evidence and Recommendations From the SIOPE Radiation Oncology Working Group to Help Mitigate for Reduced Paediatric Radiotherapy Capacity During the COVID-19 Pandemic or Other Crises (link added 5 May 2020)
Prostate
- Guidance for treatment of uro-oncology patients during COVID-19 pandemic (PDF) (Published 24 March 2020)
Sarcoma
- Updated neoadjuvant/adjuvant/definitive radiotherapy guidelines for the management of newly diagnosed soft-tissue and bone sarcoma (PDF) (Published 24 March 2020)
Stereotactic radiosurgery
- Guidance for stereotactic radiosurgery (SRS) during COVID-19 pandemic (PDF) (Published 6 April 2020)
Thyroid
- Thyroid cancer: radioactive iodine treatment during COVID-19 pandemic (PDF) (Published 24 March 2020. Updated 21 September 2020)
Managing gaps in treatment: extra guidance for COVID-19
- Timely delivery of radical radiotherapy: guidelines for the management of unscheduled treatment interruptions, fourth edition (PDF) (Existing RCR guidance published January 2019)
- Additional guidance on management of unscheduled radiotherapy treatment interruptions in patients during the COVID-19 pandemic (PDF) (Published 6 April 2020)
- Managing treatment gaps in radiotherapy of lung cancer during the COVID-19 pandemic (PDF) (Published 6 May 2020)