This statement has been archived.
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The coronavirus epidemic represents a significant challenge to providing care for cancer patients. The RCR recognises the pressure that this places on all oncologists and departments. Clinicians may need to depart from established protocols and procedures at this time in line with recent national communications (PDF). Departments already have business continuity plans. These must be reviewed and updated regularly in the light of central and local NHS and public health advice.
Departments should consider the following:
Outpatient and acute oncology services (AOS)
- For patients at risk of neutropenia who meet the current Government case definition for possible COVID-19 infection, ensure there is an appropriate local AOS pathway and assessment area.
- For all outpatient appointments consider telephone/video clinics rather than face-to-face visits.
- For patients who are self-isolating, discuss the risk/benefit of attending for treatment with your local infection control team, considering the latest government guidance.
- When capacity is limited, consider evidence-based shorter fractionation schedules and deferring radiotherapy for some groups.
- For patients with suspected or confirmed COVID-19 infection, consider cohorting on one machine or in one part of the department.
- Where gaps in treatment occur, try to compensate as per the RCR guidelines. We recognise that despite this, gaps in treatment may affect outcomes.
Systemic Anti-Cancer Therapy (SACT)
- For patients who have not yet started SACT, assess the risk/benefit of treatment and discuss this with the patient. This may mean deferring or not recommending treatment. Record all discussions as part of the informed consent process.
- For patients currently having SACT, re-assess the appropriateness of treatment. This may mean stopping treatment.
- For patients continuing on SACT, provide information on what to do if they develop symptoms of possible COVID-19 infection.
This is a rapidly evolving situation. Clinicians should review the latest government advice. We will update this statement as new or modified information becomes available.
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