Key recommendations include the following:
- Communicate with patients and support their mental well-being.
- Minimise face-to-face contact.
- Advise patients to contact their cancer team rather than NHS 111 if they feel unwell, to ensure symptoms are appropriately assessed.
- For patients not known to have COVID-19, ask them to attend appointments alone if possible.
- Minimise time in the waiting area.
- COVID‑19 alone is not a reason to cancel radiotherapy.
- Be aware that immunosuppressed patients may have atypical presentations.
- For immunosuppressed patients having radiotherapy who have a fever with/without respiratory symptoms, suspect neutropenic sepsis and treat appropriately.
- Ensure treatment schedules accommodate cleaning needs.
- Prioritise treatment as follows:
- Radical radiotherapy or chemoradiotherapy with curative intent, if: the patient has a category 1 tumour and treatment has already started and there is little or no possibility of compensating for treatment gaps.
- External beam radiotherapy with subsequent brachytherapy, if: the patient has a category 1 tumour and external beam radiotherapy has already started.
- Radiotherapy that has not started yet, if: the patient has a category 1 tumour and they would normally start treatment, based on clinical need or current cancer treatment waiting times.
- Urgent palliative radiotherapy for patients with malignant spinal cord compression who have salvageable neurological function.
- Radical radiotherapy for a category 2 tumour, if radiotherapy is the first treatment with curative intent.
- Post-operative radiotherapy, if the patient has a tumour with aggressive biology or have had surgery, but there is known residual disease.
- Palliative radiotherapy, where improving symptoms would reduce the need for other interventions.
- Adjuvant radiotherapy if the disease has been completely resected and there is
- Radical radiotherapy for prostate cancer, in patients having neoadjuvant hormone therapy.