https://orcid.org/0000-0003-0037-0303
The COVID-19 pandemic has caused major disruptions to many aspects of healthcare, including the care of patients diagnosed with cancer. Those individuals with cancer must now manage not only the uncertainty surrounding their prognosis, but anxiety associated with COVID-19, possible isolation from friends and family, and interruptions to their routinely scheduled oncologic care (Citation1). In the article that accompanies this editorial, Papautsky and Hamlish attempt to determine the extent of health-related worry as a function of breast cancer survivors’ vulnerability, as well as how their relationship with their care team may be associated with vulnerability and worry (Citation2).
In a cohort of 633 participants with breast cancer who were surveyed via social media platforms, high rates of worry concerning their diagnosis was noted among those classified as vulnerable populations (receiving treatment, immunocompromised and delays in care) (Citation2). Notably, 62% of the individuals surveyed were on active therapy. In addition, trust in the health care team was a significant covariate with vulnerability and worry, emphasizing the importance of communication and trust in promoting effective cancer care (Citation2). In sum, this study provides important insight into the emotional burden associated with COVID-19 and highlights the need for our supportive care teams to rapidly adapt to providing support in these challenging times (Citation2). Whereas these are important results, some caution is warranted in light of the methodology employed by the authors. For example, with respect to characterization of immunocompromised status, it is unclear how reliable self-report is and what parameters patients used to classify themselves as immunocompetent or compromised.
Previous studies have noted that patients with cancer are experiencing increased rates of fear and anxiety associated in the context of COVID-19 (Citation3,Citation4). Specifically, higher rates of fear of cancer recurrence/progression have been noted among cancer survivors since the outbreak of COVID-19 (Citation4). The World Health Organization has made several recommendations to promote health and safety, including self-isolation if symptomatic and the maintenance of social distancing to the degree possible. These recommendations have also led to numerous changes to the delivery of health care, including the cancelation of non-essential medical care, postponed routine follow-ups, and greater utilization of remote telemedicine) (Citation5,Citation6). These changes and disruptions to care have been associated with heightened anxiety among patients with cancer, as well as a fear of requiring treatment in a setting that would further isolate them from their loved ones, including intensive care units and some hospital stays (Citation7). Whereas such cautionary measures have been necessary to control the spread of this virus, another study noted patients’ desire to keep their current plan for treatment and surveillance despite the recommendations, thus generating further stress and anxiety (Citation8).
The increasing rates of emotional distress and anxiety associated with COVID-19 has highlighted the critical role that effective communication and support plays in cancer care. It remains unclear when, or if, oncology care will return to its pre-COVID state, and thus it remains critical that we need to find novel ways to be physically and emotionally connected with our patients while maintaining social distancing, ensuring that all information is conveyed and understood, and engender sufficient trust so that patients feel able to discuss and express their own needs or concerns. As our supportive care models adapt to this new reality, we must continue to promote patient-centered care and shared-decision making, regardless of the physical distance that separates us from our patients.
Disclosure statement
No potential conflict of interest was reported by the author(s).
References
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- Papautsky EL, Hamlish T. Emotional response of US Breast Cancer Survivors During the COVID-19 Pandemic. Cancer Investigation. 2020. doi:10.1080/07357907.2020.1841220.
- Sigorski D, Sobczuk P, Osmola M, Kuć K, Walerzak A, Wilk M, et al. Impact of COVID-19 on anxiety levels among patients with cancer actively treated with systemic therapy. ESMO Open. 2020;5(5):e000970. doi:10.1136/esmoopen-2020-000970
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- Prevention, C. F. D. C. A. Interim guidance for healthcare facilities: preparing for community transmission of COVID-19 in the United States. In: Coronavirus Disease 2019 (COVID-19). Atlanta (GA): Communicable Disease Control; 2020.
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- Staehler M, Battle D, Pal SK, Bergerot CD. Counterbalancing COVID-19 with cancer surveillance and therapy: a survey of patients with renal cell carcinoma. Eur Urol Focus. 2020:S2405-4569(20)30259-5.. doi:10.1016/j.euf.2020.09.002.