Assessing patient risk from cancer and COVID-19: Managing patient distress

Klaassen, Zachary; Wallis, Christopher J.D.

doi:10.1016/j.urolonc.2021.01.023

Cited by 15 publications

(23 citation statements)

References 20 publications

(18 reference statements)

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“…Delay in monitoring response to TKI therapy, TKI therapy interruption, or dose reduction in persons with CML was associated with worse mental health in our study, consistent with the recent findings that treatment interruption, delay in cancer care, or reduced therapy intensity was associated with mental health problems and worse HRQoL in persons with cancer or lymphoma ( 12 , 13 , 16 – 18 , 40 – 43 ). Fear of being infected with SARS-CoV-2 in the hospital or during travel as the common reason causing them not to follow the regular monitoring or cannot get TKI drugs in the hospital also reflected that they exaggerated the implementation of containment measures for avoidance of SARS-CoV-2 infection due to their psychological fragility.…”

Section: Discussionsupporting

confidence: 92%

“…The IES-R (range, 0-88) was used to assess subjective distress (excessive panic and anxiety) caused by traumatic events including traumarelated distressing memories and persistent negative emotions resulting from the pandemic, which is composed of three subscales to measure the avoidance, intrusion, and hyper-arousal. The total IES-R score was categorized as follows: subclinical (0-8), mild (9-25), moderate (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43), and severe (44-88) (37). Respondents who had the scores greater than the cutoff threshold of 10 in PHQ-9, 10 in GAD-7, and 26 in IES-R indicate moderate to severe depression, anxiety, and distress, respectively, and IES-R score ≥ 26 is associated with post-traumatic stress disorder (PTSD) symptoms (35,38,39).…”

Section: Assessment Of Mental Healthmentioning

confidence: 99%

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Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

et al. 2021

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Mental health problems in the general population have been reported during the SARS-CoV-2 pandemic; however, there were rare data in persons with chronic myeloid leukemia (CML). Therefore, we performed a cross-sectional study on mental health evaluated using the 9-item Patient Health Questionnaire (PHQ-9; depression), the 7-item Generalized Anxiety Disorder (GAD-7; anxiety), and the 22-item Impact of Event Scale—Revised (IES-R; distress), including subscales of avoidance, intrusion, and hyper-arousal in persons with CML, non-cancer persons, and immediate family members of persons with cancer as controls (≥16 years) by an online survey. Data from 3,197 persons with CML and 7,256 controls were collected. In multivariate analyses, CML was significantly associated with moderate to severe depression (OR = 1.6; 95% Confidence Interval [CI], 1.4, 1.9; p < 0.001), anxiety (OR = 1.4 [1.1, 1.7]; p = 0.001), distress (OR = 1.3 [1.1, 1.5]; p < 0.001), and hyper-arousal (OR = 1.5 [1.3, 1.6]; p < 0.001). Moreover, delay in regular monitoring was significantly associated with depression (OR 1.3 [1.0, 1.7]; p = 0.024), anxiety (OR = 1.3 [1.0, 1.8]; p = 0.044), avoidance (OR = 1.2 [1.0, 1.4]; p = 0.017), and intrusion (OR = 1.2 [1.0, 1.4]; p = 0.057); tyrosine kinase-inhibitor dose reduction or discontinuation, depression (OR = 1.9 [1.3, 2.8]; p = 0.001), distress (OR = 2.0 [1.4, 2.8]; p < 0.001), avoidance (OR = 1.6 [1.2, 2.1]; p = 0.004), intrusion (OR = 1.6 [1.1, 2.1]; p = 0.006), and hyper-arousal (OR = 1.3 [1.0, 1.8]; p = 0.088). We concluded that persons with CML during the SARS-CoV-2 pandemic have worse mental health including depression, anxiety, and distress symptoms. Decreasing or stopping monitoring or dose resulted in adverse mental health consequences.

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Section: Discussionsupporting

confidence: 92%

Section: Assessment Of Mental Healthmentioning

confidence: 99%

Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

et al. 2021

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“…While numerous psychosocial factors are associated with distress and adherence, 8 , 9 , 10 research focused on evaluating measures that can offer a general understanding of recurrent and potentially pathological modes of adjustment. A context such as the pandemic associated with a significant risk 2 , 3 , 5 , 7 of high distress and low adherence can be informative in testing such measures in cancer care. Our results seemingly suggest that the more severe are specific maladaptive traits or HiTOP domains, the greater the relationship between risk perception and psychosocial suffering.…”

Section: Discussionmentioning

confidence: 99%

“… 2 Several studies describe a detrimental effect of the pandemic in terms of delay, reduction or cancellation of scheduled treatment, diagnosis, or general health service. 3 , 4 This unexpected disruption of cancer care is one of the factors that influence the level of distress of patients, 5 and collective concerns and risk perception that recurs in the general population. 6…”

Section: Introductionmentioning

confidence: 99%

Risk perception, treatment adherence, and personality during COVID‐19 pandemic: An international study on cancer patients

Cheli

Lam

Estapé³

et al. 2021

Psycho-Oncology

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Objective To explore the role of personality traits in moderating the relation between COVID‐19 risk perception and treatment adherence, and between risk perception and psychosocial distress in patients diagnosed with cancer. Methods An online survey ( n = 1281) was conducted worldwide in seven countries (Austria, Germany, Hong Kong, Italy, Spain, Sweden, and Turkey). Inclusion criteria were to be 18 years of age or older, have received a cancer diagnosis, and be in treatment or follow‐up. A few moderated regression models were performed with both personality traits and Hierarchical Taxonomy of Psychopathology super‐spectra as moderators. Results Detachment, negative affectivity, psychoticism and all the super‐spectra significantly moderated the relation between coronavirus risk perception and psychosocial distress, after the adjusting effect of confidence in safeguards. Only negative affectivity moderated the association between coronavirus risk perception and treatment adherence. Conclusions Personality traits may foster the understanding of how a patient might adjust to cancer treatment and, more generically, to highly stressful events such as the COVID‐19 pandemic. Further research is needed to confirm the results in different cancer stages and types.

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“…et al, 2020;Onder et al, 2020;Williamson et al, 2020;Xia et al, 2020;Fung and Babik, 2021). Early studies from the COVID-19 pandemic indicated that 1 in 3 cancer patients suffered from psychological distress, suggesting a higher number in comparison to prepandemic studies (Klaassen and Wallis, 2021). This review looks at how the COVID-19 pandemic has amplified stress in cancer patients and how stress, cancer and COVID-19 may interplay, mechanistically, via the Renin Angiotensin System (RAS).…”

Section: Introductionmentioning

confidence: 99%

Is RAS the Link Between COVID-19 and Increased Stress in Head and Neck Cancer Patients?

Iftikhar

Islam

Shepherd

et al. 2021

Front. Cell Dev. Biol.

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The COVID-19 pandemic emerged as a largely unexplained outbreak of pneumonia cases, in Wuhan City, China and rapidly spread across the world. By 11th March 2020, WHO declared it as a global pandemic. The resulting restrictions, to contain its spread, demanded a momentous change in the lifestyle of the general population as well as cancer patients. This augmented negative effects on the mental health of patients with head and neck cancer (HNC), who already battle with the stress of cancer diagnosis and treatment. The causative agent of COVID-19, SARS-CoV2, gains entry through the Angiotensin converting enzyme 2 (ACE2) receptor, which is a component of the Renin Angiotensin System (RAS). RAS has been shown to influence cancer and stress such that it can have progressive and suppressive effects on both. This review provides an overview of SARS-CoV2, looks at how the RAS provides a mechanistic link between stress, cancer and COVID-19 and the probable activation of the RAS axis that increase stress (anxiogenic) and tumor progression (tumorigenic), when ACE2 is hijacked by SARS-CoV2. The mental health crises brought about by this pandemic have been highlighted in many studies. The emerging links between cancer and stress make it more important than ever before to assess the stress burden of cancer patients and expand the strategies for its management.

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Assessing patient risk from cancer and COVID-19: Managing patient distress

Cited by 15 publications

References 20 publications

Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

Risk perception, treatment adherence, and personality during COVID‐19 pandemic: An international study on cancer patients

Is RAS the Link Between COVID-19 and Increased Stress in Head and Neck Cancer Patients?

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