Cancer care in the time of COVID-19: a conceptual framework for the management of cancer during a pandemic

COVID-19 Cancer End of life care Pandemics Disease management Patients Medicine
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When the COVID-19 pandemic began early in 2020, it was clear that it would have a huge impact on healthcare around the world. However, the exact size and scope of that impact in Australia was unknown. Planning for cancer treatment in a pandemic had not been considered, and how much treatment would have to be changed was not defined. Decisions had to be made quickly, using the best available information gained from experiences around the world. Over time, it became clear that, largely as a result of a number of Government and community responses including quarantine, isolation and social distancing measures, Australia was experiencing a different trajectory to other countries, so modifications to cancer care and patient management decisions would need to be different.

The development of a conceptual framework for the management of cancer during a pandemic was undertaken to provide a basis for preparing for, and implementing, optimal management of cancer during the COVID-19 pandemic, and potentially any other pandemic. The framework explores system-wide approaches to cancer management in the context of various epidemiological scenarios of COVID-19 cases, across the cancer pathway from prevention and early detection through to survivorship and end-of-life care, and in accordance with the principles of the Optimal Care Pathways for people with cancer.

This conceptual framework is intended as a useful resource for cancer organisations, health professionals, medical colleges and policy-makers. It is based on evolving evidence and will be updated over time, as data emerge to inform best practice. While it is clearly designed with the Australian healthcare system and the current COVID-19 pandemic in mind, the principles are transferrable to any jurisdiction and for any pandemic.

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