Last updated 13 May 2020
Author:
Dr Tony Williams, Consultant Occupational Physician, Working Fit Ltd
|
Cancer type
|
Vulnerability
|
References
|
| Cancer, general
Diagnosed <1 year ago |
Add 5 years | Provisional guidance |
| Cancer, general
Diagnosed 1-4.9 years ago |
Add 2 years | Provisional guidance |
| Brain tumour
on radiotherapy and/or chemotherapy or within three months of chemotherapy |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer
https://www.medrxiv.org/content/10.1101/2020.03.18.20038067v1.full.pdf |
| Brain tumour
surgery only or more than three months after chemotherapy or radiotherapy in remission |
Low | |
| Breast cancer
biologic or immunotherapy |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer |
| Breast cancer
on chemotherapy and/or radiotherapy |
Very high or High | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer
https://www.medrxiv.org/content/10.1101/2020.03.18.20038067v1.full.pdf |
| Breast cancer
currently on hormone therapy (Tamoxifen, Letrozole) |
Low | |
| Breast cancer
surgery only including axillary node clearance, no adjuvant chemo- or radiotherapy |
Low | |
| Bowel cancer
on chemotherapy, biologic or immunotherapy |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer
https://www.medrxiv.org/content/10.1101/2020.03.18.20038067v1.full.pdf |
| Bowel cancer
surgery only |
Low | |
| Cervical or vulval cancer
on chemotherapy |
Very high | https://www.bgcs.org.uk/professionals/guidelines-for-recent-publications/ |
| Cervical or vulval cancer
surgery only or three months after radiotherapy only |
Low | |
| Kidney cancer
on radiotherapy or biologic therapy |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer |
| Kidney cancer
after surgery or ablation only |
Low | |
| Liver cancer
current chemotherapy or radiotherapy |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer
https://www.medrxiv.org/content/10.1101/2020.03.18.20038067v1.full.pdf |
| Liver cancer
no current therapy or three months since therapy |
May be increased | DOI: https://doi.org/10.1016/S2468-1253(20)30057-1 |
| Lung cancer
current chemotherapy, docetaxel therapy, TKI therapy or radical radiotherapy |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer
https://www.medrxiv.org/content/10.1101/2020.03.18.20038067v1.full.pdf DU, Q. et al. 2018. Docetaxel increases the risk of severe infections in the treatment of non-small cell lung cancer: a meta-analysis. Oncoscience, 5, 220-238. WANG, Y., et al. 2017. Incidence and risk of infections associated with EGFR-TKIs in advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized controlled trials. Oncotarget, 8, 29406-29415. |
| Lung cancer
post surgery |
May be increased | |
| Ovarian cancer
on chemotherapy |
Very high, specialist should consider stopping chemotherapy earlier than planned | https://www.bgcs.org.uk/professionals/guidelines-for-recent-publications/ |
| Ovarian cancer
three months or more after cessation of chemotherapy |
May be increased or low | |
| Ovarian cancer
surgery only |
Low | |
| Pancreatic cancer
current chemotherapy or immunotherapy |
Very high | https://www.pancreaticcancer.org.uk/information-and-support/coronavirus-covid-19-and-pancreatic-cancer/
https://www.medrxiv.org/content/10.1101/2020.03.18.20038067v1.full.pdf |
| Pancreatic cancer
three months or more after chemotherapy or immunotherapy |
May be increased | https://www.pancreaticcancer.org.uk/information-and-support/coronavirus-covid-19-and-pancreatic-cancer/ |
| Pituitary adenoma
ACTH-secreting |
May be very high, high or increased depending on effect on immune system | https://www.pituitary.org.uk/news/2020/03/coronavirus-faqs/ |
| Pituitary prolactinoma or growth hormone-secreting | Low | https://www.pituitary.org.uk/news/2020/03/coronavirus-faqs/ |
| Prostate cancer
with radiotherapy for bone metastases or Radium-223 therapy or Enzalutamide |
Very high or high
May affect bone marrow and therefore immunity |
https://prostatecanceruk.org/prostate-information/coronavirus-covid-19-and-prostate-cancer |
| Prostate cancer
with steroids only |
increased only as generally low dose | https://prostatecanceruk.org/prostate-information/coronavirus-covid-19-and-prostate-cancer |
| Prostate cancer
with external beam radiotherapy to prostate only, hormone therapy or no therapy |
Low | https://prostatecanceruk.org/prostate-information/coronavirus-covid-19-and-prostate-cancer |
| Skin cancer
on chemotherapy, immunotherapy or targeted therapy |
very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer |
| Skin cancer
up to six months after chemotherapy or radiotherapy |
High or increased | |
| Skin cancer
surgical therapy only |
Low | |
| Stem cell transplant
Within six months, or still taking immunosuppressive drugs |
Very high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer |
| Stem cell transplant
At any stage after treatment for leukaemia, lymphoma, myeloma |
Very high or high | https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer |
| Stem cell transplant Age >20, within six months, unrelated donor transplant, male sex, chronic GVHD plus immunosuppression, history of recurrent respiratory infections | Very high, high or increased depending on age
(HR = 3.87) |
NORKIN, M. et al. 2019. Characteristics of Late Fatal Infections after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant, 25, 362-368.
https://www.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer |
| Stem cell transplant
No history of GVHD, not on immunosuppressants |
May be increased (long term increased risk of infections, may be related to impaired recovery of CD4+ T cells) | DU, Q. et al. 2018. Docetaxel increases the risk of severe infections in the treatment of non-small cell lung cancer: a meta-analysis. Oncoscience, 5, 220-238. |
| Uterine cancer
on chemotherapy |
Very high, benefit of chemotherapy may not outweigh risks of Covid-19 infection | https://www.bgcs.org.uk/professionals/guidelines-for-recent-publications/ |
| Uterine cancer
three months or more after chemotherapy |
May be increased | |
| Uterine cancer
surgery only |
Low |
Risk of severe illness or death if contracts COVID-19. Read more
Likely to need hospitalisation if contracts COVID-19, with protracted illness and heavy NHS burden. Read more
Increased risk compared with healthy individual but should recover.
No greater risk than healthy individual.