In response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, governments imposed various measures to decrease the rate of disease spread, and health care policy makers prioritized resource allocation to accommodate COVID-19 patients. We conducted a cross-sectional online survey in Germany (July 2020–June 2021) to assess the frequency of changes to cancer care among cancer patients and to explore the psychological impact of the pandemic writ large. Cancer patients who contacted the Cancer Information Service (Krebsinformationsdienst, KID) of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) via email were invited to complete an online questionnaire, capturing demographics, cancer specifics (e.g., type, disease phase, primary place of treatment, etc.), and any changes to their medical, follow-up, psycho-oncological or nursing care. General level of psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) along with face-validated items regarding worries and social isolation specific to the pandemic. In total, 13% of 621 patients reported a change to their treatment or care plan. Of those patients with changes, the majority of changes were made to follow-up care after treatment (56%), to monitoring during treatment (29%) and to psychological counseling (20%). Of the overall sample, more than half of patients (55%) reported symptoms of anxiety and 39% reported symptoms of depression. Patients with a change in cancer care were more likely to report symptoms of depression than those with no change (AOR: 2.18; 95% CI: 1.26–3.76). Concern about the pandemic affecting the quality of health care was a predictor of both anxiety (AOR: 2.76; 95% CI: 1.75–4.35) and depression (AOR: 2.15; 95% CI: 1.43–3.23). Results showed that the majority of cancer patients in our study did not experience a change in their cancer care. However, the level of anxiety and psycho-social burden of cancer patients during the pandemic was high throughout the study period. Our findings underscore the need for health care services and policy makers to assess and to attend cancer patients' medical needs, with added emphasis on patients' psychological and social well-being. This applies particularly in situations where the healthcare system is strained and prioritization is necessary.

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Cancer information services (CISs) can play an important role within the pathway of cancer information seeking, but so far, this role is not well understood. Callers (n = 6,255) who contacted the largest provider of cancer information in Germany participated in a survey in which they reported their information sources, information level, and needs leading to the call. Persons with prior information from a physician (n = 1,507) were compared to people with prior online information (n = 901) and people with prior information from both sources (n = 2,776). Nearly all callers (96.7%) stated prior sources, while physicians and the Internet were the most frequently reported sources. People, who only talked to a doctor before, are more likely to be a patient and in the disease stages during/after the first treatment or with recurrence than prior Internet users. The two groups do not differ in their prior information level but did differ in their information needs. CISs are an important supplement to other sources, while the information repertoire depends on patients’ stages during the cancer journey. Specific characteristics and needs of callers with different prior information sources help to individualize the service of CISs and similar providers.

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Cancer patients have a great need for information. Besides the attending physician as the most valued source of information they use various other sources. The broad avail-ability of information raises the need for "meta-information" for assessment, explanation and integration into the individual context. Here, a telephone information ser-vice meeting high quality standards can of-fer substantial support, combining the advantages of mass media with interpersonal communication. The cancer information ser-vice (KID), established at the German Can-cer Research Center in 1986 with funding by the Federal Ministry of Health, has implemented this concept of health information for the first time on a national basis. The KID provides comprehensive and up-to-date information on all cancer-related issues tailored to individual needs as well as address-es and resources of institutions and organisations of cancer care. Around 40% of KID users are patients. Major concerns are reassurance, assessment and integration of information from other sources, the need for guidance through the health care system and for supportive communication.Tele-phone information can bridge information gaps and deficits and enhance the doctor-patient relationship by building a basis for in-depth discussions. To meet the needs and new information preferences, the KID also publishes brochures and offers information via the Internet and an e-mail service. The KID is integrated in a network of can-cer care resources and, through documentation and evaluation of the calls, contributes to cancer information tailored to the needs of patients.

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