Liang et al.¹ first reported a nationwide analysis of cancer patients with SARS-CoV-2 infection in China. They found COVID-19 cases with a history of cancer was higher than the incidence of cancer in the overall Chinese population, suggesting that cancer patients were more susceptible to infection, and were observed to have a higher risk of severe events. They suggested an intentional postponing of adjuvant chemotherapy or elective surgery for stable cancer in endemic areas. However, the specific clinical strategies for patients with cancer remain unclear; it is urgent to put forward the strategies of cancer management during the pandemic .

For surgery consideration, no matter benign or malignant tumor, if rapid progress, severe organ function impairment or life-threatening situation exists, emergency operation should be conducted. The need for and type of operation should be comprehensively assessed and arranged according to the local epidemic and hospital situation. Where appropriate, neoadjuvant chemotherapy is recommended after the initial diagnosis, and upfront radical surgery is not recommended during the pandemic period. Blood shortage may exist during the pandemic; availability of blood products must be ensured before operation.

Chemotherapy in a local hospital is recommended in order to reduce population migration. High-dose chemotherapy and regimens with severe myelotoxicity should be avoided, or G-CSF should be given. Reducing the dose of chemotherapy to ensure the safety of patients is an option if necessary. Oral chemotherapy drugs to achieve home-based treatment is recommended, especially for palliative treatment.

Radiotherapy may aggravate myelosuppression and increases the risk of COVID-19 infection due to greater exposure. However, there are many options for radiotherapy timing in the comprehensive treatment plan, so it is recommended to postpone the radiotherapy plan if it is not necessary during the pandemic. Where appropriate, single fraction or short courses of radiation are advised.

Ward and outpatient management is crucial for the safety of patients with cancer. Triple pre-examination consisted of “entering hospital,” “general area” and “cancer clinic area” can be adopted. It is recommended to establish and follow a uniform hospital admission process for cancer patients (Figure 1).

All infection prevention and control measures for COVID-19 must be strictly implemented.^{2, 3} The number of healthcare workers in the ward should be limited. Risk-based protection measures should be taken to minimize nosocomial infection according to the exposure risk of staff in different positions. We recommend to set up three areas (clean area, potentially contaminated area and contaminated area) and two people movement pathways (medical staff channel and patient's channel) as well as isolation rooms in the ward. Adequate disinfection should meet the corresponding guidance requirements.