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ESMO Patient Guides COVID19 1000x250

Outpatient visits

High priority

Your outpatient appointment may be a high priority if:

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    You have recently been diagnosed with invasive lung cancer (or your doctor thinks you may have invasive lung cancer) and you are experiencing symptoms that are linked to lung cancer
  • You have recently been diagnosed with invasive lung cancer (or your doctor thinks you may have invasive lung cancer) and you are thought to have stage II–III or metastatic lung cancer
  • You need to attend an outpatient appointment for administration of lung cancer treatment

Medium priority

Your outpatient appointment may be a medium priority if:

  • You have recently been diagnosed with stage I lung cancer, or your doctor thinks you may have stage I lung cancer
  • You have recently undergone surgery for lung cancer and are not experiencing any side effects linked to your surgery
  • You are due to have a follow-up appointment because you are at high risk of your lung cancer returning after treatment
  • You are receiving treatment for lung cancer but are considered stable and are not experiencing any new problems or symptoms

Low priority

Your outpatient appointment may be a low priority if:

  • Your appointment is a routine survivorship visit
  • You are in remission and you are at low or intermediate risk of your lung cancer returning
  • Your appointment is a follow-up visit for psychological support

Imaging

High priority

Your appointment may be a high priority if:

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    You are experiencing symptoms related to your chest, lung cancer or treatment. If you are experiencing new symptoms, you are likely to undergo a computed tomography scan
  • You need additional assessments based on results of previous tests that suggest it is likely that you have stage II–IV lung cancer
  • You need a biopsy to investigate a mass that your doctor thinks might be stage III/IV lung cancer
  • You are in the first 6 months of active treatment for lung cancer and your doctor needs to check if you are responding to treatment
  • You are receiving active treatment for lung cancer and your doctor needs to check if your cancer is progressing
  • You are participating in a clinical trial and imaging assessments are required as part of the study protocol

Medium priority

Your appointment may be a medium priority if:

  • You have completed treatment for lung cancer in the past year and are at high or intermediate risk of your cancer returning
  • You need additional assessments based on results of previous tests that suggest it is likely that you have stage I lung cancer
  • You need a biopsy to investigate a mass that your doctor thinks might be invasive stage I/II lung cancer
  • You are receiving treatment for lung cancer and are experiencing new problems or symptoms
  • You have been receiving active treatment for lung cancer for more than 6 months and your condition is considered stable and controlled
  • You need additional investigations to evaluate high-risk nodules detected on previous tests

Low priority

Your appointment may be a low priority if:

  • You completed treatment for lung cancer more than a year ago and are at high or intermediate risk of your cancer returning
  • You have completed treatment for lung cancer and are at low risk of your cancer returning
  • You are due to have additional investigations to evaluate low-risk nodules detected on previous tests
  • You are due to undergo routine screening for lung cancer

Surgery

High priority

Your appointment may be a high priority if:

  • You need surgery to relieve symptoms of lung cancer-related complications such as pleural effusion, pericardial effusion or empyema
  • You need surgery to remove a large or medium-sized resectable tumour that has not been previously treated, or after induction chemotherapy
  • You need a surgical procedure to help your doctor diagnose or stage your lung cancer

Medium priority

Your appointment may be a medium priority if:

  • You have differing results from two separate biopsies and your doctor thinks it is likely that you have lung cancer
  • You need surgery to remove a small resectable tumour. Radiotherapy may be offered in this case, but surgery is usually preferred
  • You need a surgical procedure to investigate and/or remove high-risk nodules detected on previous tests. Radiotherapy may be offered in this case

Low priority

Your appointment may be a low priority if:

  • You have differing results from two separate biopsies and your doctor thinks it is unlikely that you have lung cancer
  • You are due to have a surgical procedure to investigate and/or remove low-risk nodules detected on previous tests. Radiotherapy may be offered in this case

Medical management of early-stage lung cancer

High priority

Your appointment may be a high priority if:

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    You are scheduled to undergo chemoradiotherapy for stage I/II small-cell lung cancer
  • You have stage II lung cancer and are able to receive neoadjuvant chemotherapy in order to delay surgery by 3 months
  • You have undergone surgery for a large tumour that showed signs of lymph node metastasis, are young (<65 years of age) and generally fit, and are scheduled to receive adjuvant chemotherapy
  • You are at significant risk of febrile neutropenia and need to be treated with prophylactic growth factors to help boost your immune system

Medium priority

Your appointment may be a medium priority if:

  • You have undergone surgery for a medium-sized tumour that showed signs of lymph node metastasis and are scheduled to receive adjuvant chemotherapy. In these cases, your full medical history will be reviewed and your doctor will advise on the best approach for you
  • You are due to have a follow-up appointment between treatment cycles. This will only be performed if necessary and will likely take place via telephone
  • You are due to have a blood test between treatment cycles. This will only be performed if necessary and will take place at home if possible

Low priority

Your appointment may be a low priority if:

  • You have undergone surgery for a small tumour with no signs of lymph node metastasis and are scheduled to receive adjuvant chemotherapy, but you have shown features that indicate a poor prognosis. 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
  • You have undergone surgery and are scheduled to receive adjuvant chemotherapy but have significant additional health conditions or are aged >70 years. 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 locally advanced lung cancer

High priority

Your appointment may be a high priority if:

  • You are due to receive neoadjuvant chemotherapy for stage III lung cancer
  • You are scheduled to undergo chemoradiotherapy for stage III small-cell lung cancer
  • You are scheduled to undergo chemoradiotherapy for inoperable stage III non-small cell lung cancer
  • You are due to begin consolidation treatment with durvalumab within 6 weeks
  • You are at significant risk of febrile neutropenia and need to be treated with prophylactic growth factors to help boost your immune system

Medium priority

Your appointment may be a medium priority if:

  • You are due to have a follow-up appointment between treatment cycles. This will only be performed if necessary and will likely take place via telephone
  • You are due to have a blood test between treatment cycles. This will only be performed if necessary and will take place at home if possible

Medical management of metastatic lung cancer

High priority

Your appointment may be a high priority if:

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    You need first-line systemic treatment to improve your prognosis, cancer-related symptoms and quality of life. These treatments may include chemotherapy, chemotherapy with immunotherapy, immunotherapy alone or targeted therapies. Immunotherapy schedules may be modified to reduce clinic visits, e.g. 4- or 6-weekly dosing may be considered rather than 2- or 3-weekly dosing
  • You need second-line chemotherapy or immunotherapy to treat cancer symptoms or progressive disease. Immunotherapy schedules may be modified to reduce clinic visits, e.g. 4- or 6-weekly dosing may be considered rather than 2- or 3-weekly dosing
  • You need second-line targeted therapy to treat progressive disease
  • You are at significant risk of febrile neutropenia and need to be treated with prophylactic growth factors to help boost your immune system

Medium priority

Your appointment may be a medium priority if:

  • You are scheduled to receive second-line or later-line chemotherapy or immunotherapy but are not currently experiencing cancer symptoms
  • Your doctor thinks it is possible for you to be treated with oral chemotherapy rather than intravenous chemotherapy in order to reduce hospital visits
  • You are due to have a follow-up appointment between treatment cycles. This will only be performed if necessary and will likely take place via telephone
  • You are due to have a blood test between treatment cycles. This will only be performed if necessary and will take place at home if possible
  • You have received ongoing treatment with immunotherapy for more than 12–18 months. In these cases, your doctor may consider delaying/missing certain treatment cycles or may increase the time interval between cycles

Low priority

Your appointment may be a low priority if:

  • You have received ongoing treatment with immunotherapy for more than 2 years. There is no clear evidence of the effectiveness of immunotherapy for lung cancer after 2 years; therefore, your doctor will discuss the potential benefit of ongoing immunotherapy versus the risk of COVID‑19 infection and will advise on the best approach for you
  • You have been receiving immunotherapy but stopped temporarily due to side effects. In these cases, restarting immunotherapy may be delayed if there is no sign of disease progression
  • You are receiving bone modifying drugs. These may be stopped or delayed if they are not urgently needed

Radiotherapy

High priority

Your appointment may be a high priority if:

  • You need radiotherapy for inoperable stage II–III lung cancer and are not suitable for chemotherapy
  • You need chemoradiotherapy for inoperable stage II–III non-small cell lung cancer or limited small-cell lung cancer
  • You need palliative radiotherapy to relieve severe cancer-related symptoms such as spinal cord compression or significant bone pain

Medium priority

Your appointment may be a medium priority if:

  • You are scheduled to undergo stereotactic radiotherapy for stage I lung cancer
  • You are scheduled to receive adjuvant radiotherapy after undergoing surgery for non-small cell lung cancer and cancer cells were found at the margin of the resected tissue. Your radiotherapy may be delayed for up to 3 months after surgery, or your doctor may consider rescheduling your radiotherapy to come after adjuvant chemotherapy
  • You have received chemotherapy for limited small-cell lung cancer and are scheduled to undergo preventative radiotherapy to the brain

Low priority

Your appointment may be a low priority if:

  • You are scheduled to receive adjuvant radiotherapy after undergoing surgery for non-small cell lung cancer and no cancer cells were found at the margin of the resected tissue. Your radiotherapy may be delayed for up to 3 months after surgery, or your doctor may consider rescheduling your radiotherapy to come after adjuvant chemotherapy
  • You have received chemotherapy for extensive small-cell lung cancer and are scheduled to undergo preventative radiotherapy to the brain. This may be replaced by surveillance of the brain with magnetic resonance imaging
  • You are scheduled to undergo palliative radiotherapy for a non-life-threatening condition such as mild bone or chest pain. In these cases, you may be treated with strong pain killers rather than radiotherapy

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