Cancer has become a prevalent disease, affecting millions of new patients globally each year. The COVID-19 pandemic is having far-reaching impacts around the world, causing substantial disruptions to health and health care systems that are likely to last for a prolonged period. Early data have suggested that having cancer is a significant risk factor for mortality from severe COVID-19. A diverse group of medical oncologists met to formulate detailed practical advice on systemic anticancer treatments during this crisis. In the context of broad principles, issues including risks of treatment, principles of prioritizing resources, treatment of elderly patients, and psychosocial impact are discussed. Detailed treatment advice and options are given at a tumor stream level. We must maintain care for patients with cancer as best we can and recognize that COVID-19 poses a significant competing risk for death that changes conventional treatment paradigms.

The results of this study shed new light on providing timely information and palliative care to support carers. We call for health services to reconsider the current medical model for this patient group, where patients are the centre of care, information and support, towards a more collaborative model which places carers and patients into a partnership.

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This study used qualitative methods to elicit the thoughts and attitudes of patients with advanced cancer. Our two interrelated aims were to explore how participants experience and apply meaning; and to consider whether this experience can be understood within an integrated framework of assumptive world (AW), sense of coherence (SOC) and meaning-based coping (MBC). Using semi-structured interviews, 26 conversations were held overall with 10 participants. Transcriptions were analysed for themes of lived-experience and for evidence of the principal elements of AW, SOC, and MBC. Findings suggest three interrelated domains that form an adaptive pathway towards coherence and sense of self. While this pathway is essentially linear it is also responsive to the ongoing stressful nature of advanced cancer.