Depression and anxiety in cancer patients before and during the SARS-CoV-2 pandemic: association with treatment delays

Abstract

Purpose Pandemics can be associated with anxiety and depression in cancer patients who are undergoing treatment. In the present study, we aimed to perform a comparative evaluation of the conditions of cancer patients before and during the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) pandemic using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) to detect the impact of the pandemic on treatment delays that are associated with anxiety and depression in cancer patients. In addition, the effect of public transport use on treatment delays was examined. Methods BDI and BAI were administered to 595 breast, ovarian, colon and gastric cancer patients before and during the pandemic. The questionnaires were administered by the physician blindly, who was unaware of the delay of the patients. The number of days by which the patients delayed their treatment due to the fear of contamination were recorded retrospectively. Correlation analyses were performed between the obtained scores and treatment delays. Results The depression and anxiety levels in cancer patients were found to increase during the pandemic (p = 0.000), and this increase was positively correlated with the disruption of their treatment (p = 0.000, r = 0.81). Depression and anxiety levels and treatment delays were higher in elderly patients (p = 0.021). Depression and anxiety were more pronounced in female patients (p = 0.000). Moreover, treatment delays were more common in patients who had to use public transportation (p = 0.038). Conclusion SARS-CoV-2 pandemic may increase anxiety and depression in cancer patients. This can cause patients to experience treatment delays due to concerns about becoming infected. At this point, if necessary, assistance should be obtained from psychiatric and public health experts.

Psychological Distress Among Cancer Patients During COVID-19 Pandemic in the World: A Systematic Review

“…In a study, Bargon et al concluded that, among 1,051 patients with breast cancer, there was a significant decline in psychological well-being, which could be due to having less contact with physicians (Bargon et al, 2020 ). Other studies have confirmed the results of previous studies by stating that high levels of depression, changes in treatment plans, and concerns about not seeing the physicians are the most important reasons for oncology patients' high level of anxiety during the COVID-19 pandemic (Chen et al, 2020 , 2021a ; Swainston et al, 2020 ; Gultekin et al, 2021 ; Hamlish and Papautsky, 2021 ; Nardone et al, 2021 ; Yildirim et al, 2021 ). In a study, Chapman et al, examined the effect of COVID-19 on job security and emotional functioning of breast cancer patients, and concluded that the existence of threat against job security was associated with depression in individuals.…”

Sleep Disorders Before and During the COVID-19 Pandemic in Patients Assigned to Adjuvant Radiotherapy for Breast Cancer

“…In a study from the United Kingdom including 144 participants (cancer patients and their supporting networks), the COVID-19 pandemic had no detrimental effect on the patients' psychological well-being (14). On the contrary, the authors of a study from Turkey including 595 patients with cancer under active treatment stated that the pandemic may have increased anxiety and depression in their group (15). Moreover, in two larger studies from China focusing on patients with breast cancer, a high prevalence of depression, anxiety, distress and insomnia was observed (16,17).…”

“…The majority of patients with cancer belong to the high-risk group because of immuno-suppression due to malignant disease or anticancer treatment (9-12). The studies reported so far have provided conflicting results regarding the impact of the COVID-19 pandemic on distress and sleep disorders in patients with cancer (13)(14)(15)(16)(17). No study has particularly focused on the impact of the COVID-19 pandemic on the prevalence of sleep disorders before a course of radiotherapy.…”

Cancer Treatment During COVID-19: A Qualitative Analysis of Patient-Perceived Risks and Experiences with Virtual Care

“…With the amount of epidemiologic information about COVID-19 circulating broadly, there is considerable risk for vulnerable patients to develop false beliefs about the threat of infection, potentially contributing to poor physical and mental health ( 29 – 31 ), and anxiety-driven treatment delays ( 32 , 33 ). However, we have found that although cancer patients experience some COVID-19 anxiety, this is not a barrier to continuing their in-person cancer care ( 34 ).…”