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Cancer management for patients with COVID-19

This page was last updated in August 2022 and is no longer being actively maintained. For advice specific to the health sector, please refer to the Department of Health and Aged Care's website.

Links to available national and international guidance regarding considerations for cancer management for cancer patients with COVID-19 are provided below. This guidance is intended to support clinical decision-making for cancer patients with both symptomatic and asymptomatic SARS-CoV-2 infection.

Guidance from national and international organisations consider the following:

  • Shared decision making with individual patients - Reach a shared decision with the patient about their treatment. (NICE 2021)
    • Discuss with all patients the risks and benefits of starting, continuing or deferring systemic anticancer treatment. Include in the discussion:
      • factors that may affect their risk of becoming severely ill with COVID-19, including underlying conditions, male sex, ethnicity, cancer symptoms and vaccination status
      • that there is uncertainty whether patients who have received systemic anticancer treatment are at increased risk of becoming severely ill with COVID-19
      • the possible greater risk of poor outcomes for patients with haematological cancers from COVID-19
      • the possible greater risk of poor outcomes from COVID-19 with increasingly immunosuppressive systemic anticancer treatments. (NICE 2021)
  • Decisions about interrupting anti-cancer treatment in patients with active COVID-19 should be based on a clinical benefit: risk assessment that considers the risk of interrupting cancer treatment versus the still poorly defined risk of adverse COVID-19 outcomes in patients receiving active cancer treatment, while protecting staff from infection. (ASCO 2021, NICE 2021)
  • The heterogeneity of cancers, the complexity and number of different cancer treatment regimens, as well as the uncertainties about COVID-19 clinical course in individual patients preclude definite guidelines about cancer therapy management in those who have a positive SARS-CoV-2 test. (NCCN 2021)

These considerations may also be informed by local jurisdictional and health service policies.

Antiviral COVID-19 treatments

  • If a patient tests positive to COVID-19, it is important for them to let their treating team know as soon as possible, because there are COVID-19 treatments available. These antiviral treatments work best when they are given within 5 days after symptoms begin.
  • Antiviral treatments taken as capsules or tablets may help stop COVID-19 infection from becoming severe.
  • People who test positive for COVID-19 who are at higher risk of severe illness are eligible for antiviral treatments, including:
    • People who are 70 years or older
    • People who are 50 years or older with 2 additional risk factors
    • Aboriginal or Torres Strait Islander people who are 30 years or older with 2 additional risk factors*
    • People who are aged 18 years and older and are moderately to severely immunocompromised, including from blood cancers, chemotherapy or whole-body radiotherapy or high dose corticosteroids or other immunosuppressive treatments in the last 3 months.
  • For more information, visit Updated eligibility for oral COVID-19 treatments on the Australian Government Department of Health website.

* Risk factors for these groups include:

  • living in residential aged care
  • living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
  • neurological conditions like stroke or dementia and demyelinating conditions e.g. multiple sclerosis, Guillain-Barre Syndrome
  • chronic respiratory conditions including COPD, moderate or severe asthma
  • obesity or diabetes (type I or II requiring medication)
  • heart failure, coronary artery disease, cardiomyopathies
  • kidney failure or cirrhosis
  • living remotely with reduced access to higher level healthcare.

Pre-exposure prophylaxis of COVID-19

Therapy is available for pre-exposure prophylaxis in severely immunocompromised individuals not expected to mount an adequate immune response to COVID-19 vaccination or due to underlying medical conditions or treatments that compromise the body’s immune system. For more information, visit Evusheld fact sheet for health professionals on the Australian Government Department of Health website.

Guidance for patients about managing cancer care in the context of COVID-19 infection, including making decisions about their treatment and care if they test positive to COVID-19, is available at Managing your cancer care in the context of COVID-19.

For more information:

This page will be updated as further national or international guidance becomes available.

For information about COVID-19 vaccination, visit Cancer Australia’s Frequently Asked Questions (FAQs) about COVID-19 vaccines for people affected by cancer. These FAQs are updated regularly as new information and evidence emerges.

For FAQs in-language, visit www.canceraustralia.gov.au/CALD.

With the assistance of Aboriginal and Torres Strait Islander people and health experts, Cancer Australia has also developed dedicated Frequently Asked Questions (FAQs) about the COVID-19 vaccines for Aboriginal and Torres Strait Islander people with cancer and complementary FAQs for their healthcare team.