The COVID-19 pandemic caused anxiety in cancer patients in 2020, according to study results published in JCO Oncology Practice.
Cancer patients reported concerns about the risks that COVID-19 poses to themselves and their family members, worries about how delayed cancer care might affect their outcomes, and concerns about the social and economic impacts of the pandemic.
These findings come from 1-on-1 interviews with 57 cancer patients conducted from August to October 2020. Most participants were women (78.9%), and most were White (57.9%).
Cancer types included breast (35.1%), lung (15.8%), thyroid (10.5%), colon (8.8%), prostate (7.0%), uterine (3.5%), and ovarian (3.5%) cancers, as well as leukemia (8.8%) and lymphoma (7.0%).
Four themes emerged from the interviews. First, patients expressed concern about the risk of SARS-CoV-2 infection, including fears about their own immunocompromised state and the health of family members. Crowded conditions at medical facilities caused some patients to delay care so they could avoid infection.
Second, disruptions in care increased patients’ anxiety about poor cancer outcomes and cancer-related death. Patients expressed worries about cancer treatments being delayed or canceled and the possible impact this would have on their health and recovery. Changes in clinic processes (such as not allowing a caregiver to accompany a patient to their visit) also had an effect on some patients’ mental health.
Third, patients experienced significant social and economic impacts, including losing employment or experiencing fear and stress at the possibility of losing their job or health insurance. For some patients, pandemic-related changes in public transportation schedules also introduced obstacles to obtaining care.
Finally, patients reported increased social isolation and anxiety about the future. Patients isolated themselves to protect their health and reported confusion about the reliability of public health information.
The researchers acknowledged that these interviews were conducted early in the pandemic, at a time when cancer care disruptions were more pronounced and government policies were more restrictive.
Still, they maintained that this study “highlights critical lessons learned from patients at the height of a devastating global public health crisis, and these lessons are important to understand the impact of such a crisis on patients with cancer.”
Using observations from the interviews, the researchers developed 3 suggestions for improving current clinical practice for cancer patients. The researchers recommend that oncology care teams:
- Deliver clear messaging regarding patients’ health risks and expected changes in their care
- Increase attention to mental health needs through proactive mental health screenings and referrals to appropriate care
- Implement routine use of telemedicine as frequently as possible when clinically appropriate, including for clinical trials and support groups.
“These findings can help inform current cancer care delivery and prepare health systems for responses they may take in the future should other crises occur, such as more virulent SARS-CoV-2 variants, waning effectiveness of treatments, and environmental or public health crises that may pose a unique health risk for patients with cancer or disrupt their care,” the researchers concluded.
Rodriguez GM, Kumar D, Patel MI. “I have constant fear”: A national qualitative study on the impact of COVID-19 on cancer care and potential solutions to improve the cancer care experience during the COVID-19 pandemic. JCO Oncol Pract. Published online May 8, 2023. doi:10.1200/OP.22.00550