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ESMO Patient Guides COVID19 1000x250

Outpatient visits

High priority

Your outpatient appointment may be a high priority if:

  • shutterstock_1250216740
    You have gastro-oesophageal cancer and are experiencing symptoms such as severe difficulty in swallowing, weight loss or bleeding
  • You have recently been diagnosed with gastro-oesophageal cancer
  • You are receiving neoadjuvant or adjuvant chemotherapy or chemoradiotherapy
  • You have metastatic gastro-oesophageal cancer and are currently receiving treatment with intravenous chemotherapy or immunotherapy

Medium priority

Your outpatient appointment may be a medium priority if:

  • You have recently had surgery or definitive chemoradiotherapy and have not experienced any complications
  • You are receiving palliative care but no active treatment for your cancer, and you are not experiencing any distressing symptoms. In these cases, your follow-up appointments may be conducted via telephone
  • You are receiving oral treatment for your cancer (e.g. maintenance therapy with capecitabine), but are not experiencing any troublesome side effects from this treatment
  • The purpose of your appointment is for psycho-social support rather than an urgent medical need

Low priority

Your outpatient appointment may be a low priority if:

  • You have lived with gastro-oesophageal cancer for some time and are not experiencing any new symptoms or side effects
  • Your appointment is a routine survivorship visit
  • You are in remission and you are at low or moderate risk of your cancer returning

Imaging

High priority

Your appointment may be a high priority if:

  • You are experiencing acute symptoms such as severe difficulty in swallowing or an intestinal occlusion
  • You need imaging for initial staging of your cancer
  • You need imaging to assess your cancer before undergoing surgery, or following neoadjuvant therapy
  • You need imaging to check if your cancer is responding to active treatment
  • You have cancer-related symptoms and you need imaging to check if the symptoms are due to disease progression

Medium priority

Your appointment may be a medium priority if:

  • You are receiving active treatment for metastatic disease and you are due to have an imaging appointment to check if your cancer has progressed

Low priority

Your appointment may be a low priority if:

  • Your appointment is a routine follow-up visit

Surgery

High priority

Your appointment may be a high priority if:

  • You are currently receiving neoadjuvant chemotherapy or chemoradiotherapy
  • You were recently diagnosed with gastro-oesophageal cancer and you need surgery to treat an intestinal occlusion
  • You need surgery to relieve symptoms of cancer-related complications such as bowel perforation or peritonitis
  • You need surgery to treat complications arising from a previous surgical procedure, such as bowel perforation or anastomotic leak
  • You were recently diagnosed with localised gastro-oesophageal cancer, you have no additional health conditions and you need surgery to treat bleeding

Medium priority

Your appointment may be a medium priority if:

  • You are due to undergo a laparoscopy to stage your cancer
  • You have inoperable or recurrent cancer and need palliative surgery (e.g. bypass surgery or feeding tube insertion) to treat symptoms

Low priority

Your appointment may be a low priority if:

  • You are receiving active treatment for metastatic gastro-oesophageal cancer, your doctor thinks your cancer may be progressing, and you are due to have surgery to treat an intestinal occlusion

Endoscopic procedures

High priority

Your appointment may be a high priority if:

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    You are experiencing symptoms such as bleeding, severe difficulty in swallowing and weight loss, and your doctor wants you to have an endoscopic examination to find out if you have gastro-oesophageal cancer
  • You have localised gastro-oesophageal cancer and are scheduled to have an endoscopic resection to remove the tumour
  • You have gastro-oesophageal cancer and need an endoscopic examination to investigate active bleeding
  • Your doctor thinks you will benefit from an endoscopic procedure to insert a stent or feeding tube

Medium priority

Your appointment may be a medium priority if:

  • You are due to undergo endoscopic ultrasound to stage your cancer

Low priority

Your appointment may be a low priority if:

  • Your appointment is a routine follow-up visit

Radiotherapy

High priority

Your appointment may be a high priority if:

  • You are receiving radiotherapy as part of a clinical trial
  • You are receiving ongoing neoadjuvant or chemoradiotherapy, are not experiencing troublesome side effects and do not have additional health conditions. It is unlikely that chemoradiotherapy will be initiated for newly diagnosed patients who are frail or who have additional health conditions

Medium priority

Your appointment may be a medium priority if:

  • You need palliative radiotherapy to treat pain or bleeding

Medical management of early-stage gastro-oesophageal cancer

High priority

Your appointment may be a high priority if:

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    You are receiving treatment as part of a clinical trial
  • You are receiving ongoing neoadjuvant chemotherapy or chemoradiotherapy

Medium priority

Your appointment may be a medium priority if:

  • You are scheduled to receive adjuvant chemotherapy. In these cases, your doctor will discuss the potential benefit of adjuvant chemotherapy versus the risk of COVID‑19 infection and will advise on the best approach for you

Medical management of advanced gastro-oesophageal cancer

High priority

Your appointment may be a high priority if:

  • You are receiving first-line chemotherapy or maintenance therapy and are experiencing clinical benefit. If you are receiving treatment with an oxaliplatin-based regimen, your doctor may decide that you should receive oral capecitabine rather than intravenous fluorouracil. Your doctor may also consider reducing your chemotherapy dose to lower the risk of side effects 
  • You are receiving treatment as part of a clinical trial
  • You have cancer with high microsatellite instability and are receiving treatment with immunotherapy. Your doctor may consider increasing the interval between your treatment visits to 6 weeks to reduce the number of hospital visits, with appointments between visits conducted via telephone

Medium priority

Your appointment may be a medium priority if:

  • You are receiving second-line or later-line treatment

Low priority

Your appointment may be a low priority if:

  • You have intestinal occlusion due to peritoneal carcinomatosis and are receiving best supportive care 

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