Table 1

Practical suggestions on how to implement cancer care during the COVID-19 outbreak

Patients currently receiving or who need to start active treatmentsPatients in follow-up (currently out of active treatment)Admission of patients and caregivers to the hospitalOther occasions of regular face-to-face interaction
  • Case-by-case evaluation of the risk/benefit ratio of delaying anticancer treatment*

  • Start or continue all adjuvant/neoadjuvant treatments (or any other potentially curative therapy), as well as first-line therapies for metastatic disease

  • Delay all treatments beyond first-line therapy with modest efficacy expected (unless there are urgent clinical reasons), maintenance therapies and treatments in patients with low disease burden and slow progression

  • Delay imaging procedures to monitor treatment response (unless there are urgent clinical reasons)

  • Shipment of oral drugs or dispensing of multiple treatment cycles, if feasible, based on supply availability and patients’ characteristics

  • Replace scheduled visits not associated with therapy prescription/administration with email or phone contact (unless there are urgent clinical reasons)

  • Phone call by the clinician in order to perform a quick triage of the clinical condition, and allow the examination of lab and/or imaging exams*

  • To allow access to the hospital for regular consultations in the following cases:

  1. Suspected disease progression

  2. Need for a new prescription of active treatments (eg, adjuvant endocrine therapy for breast cancer)

  3. Strong desire of the patients to perform a regular physical examination

  • No caregiver allowed for all outpatients scheduled for treatment except in the case of documented need of a continuous assistance*

  • Maximum one caregiver allowed (after triage) for every inpatient

  • Quick triage of clinical condition before entering the hospital; no access allowed in the case of fever and/or respiratory symptoms (COVID-19 path to be followed in these cases)*

  • Surgical masks and handwashing with hydrohalcoholic gel provided to all patients at the entrance

  • Limiting points of entry to the hospital with separated paths for accessing the hospital for patients and hospital personnel

  • To avoid all face-to-face meetings (including multidisciplinary tumour boards that can be virtually organised), congresses, seminars and lectures intended for residents and PhD fellows, visits from pharmaceutical companies

  • Cancellation of any group activity (eg, group therapy, recreational activities, etc)

  • *Corresponding to the recommendations published by the Italian Association of Medical Oncology (AIOM) in partnership with the boards of Academic Oncologists (COMU) and of Oncology Unit Directors (CIPOMO).

  • COVID-19, coronavirus disease 2019.