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Radiation therapy during COVID-19 – Frequently Asked Questions

Radiation therapy services are essential and still accessible in Australia and New Zealand throughout the COVID-19 pandemic. Radiation oncology teams are making special provisions for patients in the current situation.

If you are uncertain about your current treatment options during the COVID-19 pandemic, please contact your radiation oncologist to receive the best advice for your individual situation.

          • How can I protect myself and others from getting COVID-19?

            In general, to protect yourself and others, you should:

            • Practice good hygiene such as:
              • Wash your hands frequently for at least 20 seconds with warm water and soap, or at least 60% alcohol hand sanitiser
              • Refrain from touching your face (i.e. eyes, mouth, and nose)
              • Sneeze or cough into your elbow, or tissue paper, and discard the tissue paper immediately
              • Cleaning frequently touched objects and surfaces such as kitchen counters, bathroom sinks.
            • Practice physical distancing principles such as:
              • Stay at home as much as possible. Only go out if essential (i.e. for healthcare or weekly groceries)
              • Avoid gatherings
              • Avoid non-essential travel
              • Maintain a physical distance from others. In Australia a 1.5m gap and in New Zealand a 2m gap has been advised.
              • Avoid unnecessary person-to-person contact, such as handshakes.
            • Self-isolate if you need to.
            • Get tested if you have symptoms – refer to your state testing criteria and location.

          • What do cancer patients need to know about COVID-19?

            COVID-19 is a new highly contagious viral infection that can affect your airways and lungs. It can take between 2-10 days from infection to showing symptoms. It spreads from person to person through droplet exposure such as saliva and runny nose discharge when a person sneezes or coughs.

            These symptoms include:

            • Cough
            • Fever
            • Breathlessness
            • Sore throat
            • Sneezing
            • Runny nose
            • Loss of smell.

            These symptoms are like other viral illnesses, but consider COVID-19 infection especially if you have recently been overseas, or in contact with someone with confirmed COVID-19. Symptoms of COVID-19 are treated with supportive medical care. There are no cures or vaccines for COVID-19 infection, but clinical trials are ongoing.

            COVID-19 can become a life-threatening illness in some people especially with certain risk factors. These risk factors for a severe COVID-19 infection include people with:

            • immunocompromised conditions from a number of causes including cancer treatments (chemotherapy, immunotherapy, targeted cancer treatments), bone marrow or organ transplantations, use of corticosteroids (e.g. dexamethasone) amongst others.
            • lung conditions such as asthma and smokers’ lungs
            • heart conditions
            • diabetes
            • severe obesity
            • people on dialysis
            • liver disease
            • older people over 70 years.

            Discuss with your radiation oncologist if the risks of beginning or continuing your radiation therapy treatment could outweigh the benefits. In the event of a severe workforce shortage due to COVID-19 outbreaks, there may be a prioritisation of treatment based on need and capacity. This may affect your radiation therapy treatment. Your radiation oncologist will make a plan regarding your care based specifically on you, your tumour and personal circumstances and within the context of the service circumstances and the community situation.

            Every cancer centre is working hard to take measures that allow this to occur with procedures and policies that safeguard everyone. If this is a stressful time for you, please discuss your concerns with your treating team.

            If you believe you have COVID-19 infection, then contact:

            • In Australia: National Coronavirus Helpline 1800 020 080
            • In New Zealand: Healthline 0800 358 5453 or + 64 9 358 5453

        • What infection prevention measures have been put in place at radiation therapy clinics to prepare for COVID-19?

          Treatment centres across Australia and New Zealand already have strict procedures and guidelines in place to reduce transmission. These measures are evolving and being improved upon as more is learned, both internationally and locally about COVID-19.

          Staff training in the following are occurring including self-screening, infection control related hygiene, and processes to reduce COVID-19 transmission.

          You may also encounter the following at your treatment centre:

          • Having your consultation via phone or telemedicine. You will need to attend in person for your planning scan and radiation therapy treatment
          • Being asked to wait in your car with your mobile phone until the treatment centre staff contact you to come inside
          • Screening at the entrance of the treatment centre: you may be asked your name, your travel history, have your temperature taken, have your clinical symptoms assessed. You may be directed for further medical assessment if COVID-19 is suspected
          • Restriction of visitors accompanying you
          • Increased frequency of disinfection of surfaces in the treatment centre
          • Reduced number of chairs and patients in the waiting rooms to reduce close proximity to others
          • Staff wearing personal protective equipment including masks, gowns, and gloves
          • Increased social distancing between you and health care staff
          • Lack of handshakes for greetings.

        • What should I do if I become unwell during treatment? Will my treatment continue if I’m infected with COVID-19?

          Please call your local treatment centre to notify them if you develop symptoms or become unwell during treatment, or are deemed a close contact of someone else who contracts COVID-19.

          Decisions about your treatment should be made in consultation with your medical team. Every treatment centre has their institutional policies about treating patients who have been tested positive with COVID-19. The decision to break or continue with treatment will be based specifically on your situation.

          If you are sick and you suspect you have symptoms of COVID-19, seek medical advice as soon as possible. All people who develop symptoms related to COVID-19 should get tested for COVID-19. In Australia you can call the National Coronavirus Helpline for advice. This line operates 24 hours a day, seven days a week on 1800 020 080. In New Zealand, you can call Healthline on 0800 358 5453.

          If you are tested for COVID-19, you will need to isolate yourself until the results return, as per government recommendations. If you are a close contact of a person who tests positive for COVID-19, you will also be asked to isolate.

        • What precautions should I undertake during my treatment? Should I wear a mask when I come for an appointment?

          Your treatment centre will be implementing hygiene and physical distancing measures to protect you, other patients and our healthcare workers.

          You can help prevent spread by practicing good hand hygiene and physical distancing measures in the treatment centre and by following the government restrictions that have been put in place in response to increased COVID-19 numbers.

          Masks are mandatory in some states, and many other governments/hospitals are strongly encouraging the widespread use of masks, particularly in health settings. If unsure, it is best to check with your medical team.

        • Can any of my medical consultations be undertaken by teleconference or other technology to minimise my contact with other people?

          Given that the COVID-19 virus is easily transmitted from person to person, social distancing behaviour should be attempted in the hospital setting where possible, as it has been in the community. It would be of benefit for all involved if patients limit their attendances to hospital and reduce their risk of being exposed to infected individuals.Your radiation oncologist will want to continue to monitor you at regular intervals throughout your treatment. This may be done over the phone safely and accurately. Radiation therapists and nursing staff can send your clinician photographs of various acute reactions (i.e. skin reactions) for assessment and advice on management. Your clinician will always be available for discussion of any concerns you may have throughout your treatment, and this does not change because of the pandemic.

          Teleconference or telephone clinics may be utilised during this time, to allow assessment of new cases and for follow-up of patients after treatment. In the absence of symptoms, these consultations may be all that is required; however, patients should be reassured that if there are issues that arise during or at any time after these consults, they will be addressed as usual with assessment in person and investigations performed as would have been the case prior to the crisis.

        • Should my treatment be delayed until after the pandemic?

          Your radiation oncologist will discuss this very important question with you and the multidisciplinary members of your treatment team, including your surgeon, medical oncologist and general practitioner. If radiation therapy is being used as the primary curative treatment, all attempts will be made to start and continue the treatment, ensuring that all infectious disease precautions are adhered to. Where appropriate, shorter treatment courses will be used, maintaining effectiveness and safety. During this difficult time the risks and benefits of radiation therapy also has to consider the additional potential risk of acquiring COVID-19 or the social cost to you of maintaining your social distancing. For some this might mean radiation therapy benefits are too small to make radiation therapy an appropriate recommendation.

          Radiation therapy can also be used to palliate cancer-related symptoms such as bleeding, pain, shortness of breath and cough. In this setting, your radiation oncologist would aim to continue, given the benefit to your quality or life. Your radiation oncologist can again reduce the number of visits of your radiation therapy, if this is safe and as effective as a longer course.

        • Will there be any difference to my cancer control or outcomes if I delay my treatment?

          Please be reassured that this decision is not one you will ever have to make alone. The use of radiation therapy in the curative setting can be as the primary treatment modality or as an adjuvant treatment after surgery to help reduce the risk of cancer recurrence. Your radiation oncologist will discuss the treatment options in this uncertain time with you and the relevant members of your multidisciplinary team to address the role of radiation and the impact should it be deferred or even omitted.

          If the benefits of radiation therapy are deemed higher than the relatively small risks associated with contracting infection with COVID-19, your radiation oncologist will advise you to continue with radiation treatment.

        • Who should I contact if I have any questions or concerns regarding my treatment during the pandemic?

          Please contact your treating radiation oncologist to discuss any issues associated with your radiation therapy treatment. Your local hospital will also have an infectious disease team who will be guiding COVID-19 related decisions and will be happy to provide you information related to the COVID-19 outbreak.

          Your GP is a valuable resource for all your usual medical problems and is an important link during this uncertain time. In Australia, the National Coronavirus hotline (1800 020 080) and the Australian Government COVID-19 information website remain the most up to date information for COVID-19 specific advice. For New Zealand patients, Healthline (0800 358 5453) and the Ministry of Health Coronavirus website have the most current information.

          As we are all aware, this is an incredibly difficult and uncertain time, and many people will feel increased levels of anxiety or depression, which may be especially prominent with physical isolation. If anyone is struggling to cope, please contact your GP, Beyond Blue (Australia), Mental Health Foundation (New Zealand) or other similar avenues.

        • How will my routine follow-up visits be organised if a physical examination is required?

          Most routine follow-up visits that can be safely deferred will be deferred and where possible, phone call reviews or telemedicine will be used. If a physical exam is important, you will be given a regular follow up appointment. This will incorporate measures to minimise COVID-19 transmission. See “What infection prevention measures have been put in place at radiation therapy clinics to prepare for COVID-19?”.

        • Resources

          Page last updated: 09/09/2020