During the COVID-19 pandemic, cancer care needs to be tailored to different phases of the pandemic and the competing priorities driving healthcare. In addition to the increased risk of serious infection or mortality in cancer patients, resource limitations, healthcare system capacity and the risks associated with delayed cancer diagnosis and treatment, require consideration.
Cancer Australia developed Cancer care in the time of COVID-19: A conceptual framework for the management of cancer during a pandemic to promote discussion and guide decision-making on cancer care during a pandemic.
The conceptual framework uses published data and guidance to explore system-wide approaches to cancer management during various epidemiological scenarios of COVID-19, in alignment with the principles of the Optimal Care Pathways for people with cancer. Considerations for cancer management are based on three acute phases of the pandemic (the preparation phase; approaching health system capacity; and health system capacity exceeded), and early and late recovery phases. The framework also accommodates for second and subsequent waves of infection.
Modifications to cancer care during a pandemic must be evidence-based, risk-based and consensus-based, aiming to improve outcomes for people with cancer while minimising their risk of exposure to, and harm from, COVID-19. This pandemic has also driven improvement in quality cancer care, as some modifications to care, including increased use of telehealth and hypofractionated radiotherapy, will be of permanent value.
This conceptual framework is intended as a useful resource for cancer organisations, health professionals, medical colleges, and policy-makers to guide decision-making and inform optimal cancer care during a pandemic. While the framework is designed for the Australian healthcare system and this pandemic, the principles are transferrable to any jurisdiction and any pandemic.