COVID-19 Pandemic Stressors and Psychological Symptoms in Breast Cancer Patients

Abstract

Background. The current Coronavirus disease 2019 (COVID-19) pandemic is a highly stressful event that may lead to significant psychological symptoms, particularly in cancer patients who are at a greater risk of contracting viruses. This study examined the frequency of stressors experienced in relation to the ongoing coronavirus pandemic and its relationship with psychological symptoms (i.e., anxiety, depression, insomnia, fear of cancer recurrence) in breast cancer patients. Methods. Thirty-six women diagnosed with a non-metastatic breast cancer completed the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the COVID-19 Stressors Questionnaire developed by our research team. Participants either completed the questionnaires during (30.6%) or after (69.4%) their chemotherapy treatment. Results. Results revealed that most of the participants (63.9%) have experienced at least one stressor related to the COVID-19 pandemic (one: 27.8%, two: 22.2%, three: 11.1%). The most frequently reported stressor was increased responsibilities at home (33.3%). Higher levels of concerns related to the experienced stressors were significantly correlated with higher levels of anxiety, depressive symptoms, insomnia, and fear of cancer recurrence, rs(32) = 0.36 to 0.59, all ps < 0.05. Conclusions. Cancer patients experience a significant number of stressors related to the COVID-19 pandemic, which are associated with increased psychological symptoms. These results contribute to a better understanding of the psychological consequences of a global pandemic in the context of cancer and they highlight the need to better support patients during such a challenging time.

Psychosocial Impact of Cancer Care Disruptions in Women With Breast Cancer During the COVID-19 Pandemic

“…Results indicated that about a quarter of this sample experienced clinically elevated FCP, as defined by the most recent psychometric evidence ( Fardell et al, 2017 ). A recent study of non-metastatic breast cancer survivors during the COVID-19 pandemic found that 53% had FCP scores in the clinical range ( Massicotte et al, 2021 ), but used a lower cutoff score recommended in earlier work ( Simard and Savard, 2009 ). Using this same lower cutoff, 60% of the current sample had clinical levels of FCP, yielding findings consistent with those reported by Massicotte et al (2021) .…”

“…The current recommended cutoff score to establish clinical levels on the FCRI-SF is a sum score > 22 ( Fardell et al, 2017 ), equivalent to a mean score > 2.44, which we used here as an approximate indicator of FCP severity on our adapted measure. To facilitate comparison to other recently published findings on FCP during the COVID-19 pandemic ( Massicotte et al, 2021 ), we also reported the percentage of scores exceeding the lower cutoff of > 13 (equivalent to a mean score > 1.44), which is often still used as recommended by original measure developers ( Simard and Savard, 2009 ).…”

“…Indeed, among breast cancer survivors, approximately 54% reported concerns regarding the efficacy of anti-cancer therapies that were delayed and/or changed due to the pandemic ( Juanjuan et al, 2020 ). We are aware of two published studies examining FCP among cancer survivors during the COVID-19 pandemic ( Chen et al, 2020 ; Massicotte et al, 2021 ). Among cancer survivors in the pandemic epicenter in China, 86.5% reported some degree of FCP, and importantly, the study found that having had disruptions in cancer care was significantly predictive of FCP ( Chen et al, 2020 ).…”

“…Among cancer survivors in the pandemic epicenter in China, 86.5% reported some degree of FCP, and importantly, the study found that having had disruptions in cancer care was significantly predictive of FCP ( Chen et al, 2020 ). Another study conducted in Canada similarly found that among women with non-metastatic breast cancer receiving chemotherapy, 52.8% had clinically significant levels of FCP, but whether or not participants experienced treatment delays and/or changes due to the COVID-19 pandemic was not reported ( Massicotte et al, 2021 ).…”

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

“…Romito et al (2020) from Italy, reported 36% patients of lymphoma with anxiety, 31% with depression and 36% with post-traumatic stress disorder (PTSD), as analyzed through Hospital Anxiety and Depression Scale (HADS-A) and (HADS-D). Increased anxiety, insomnia and depression in breast cancer patients was observed using the HADS, Insomnia Severity Index, Generalized Anxiety Disorder Questionnaire (GAD-7) and Impact of Events Scale Revised (IES-R) (Juanjuan et al, 2020;Massicotte et al, 2021). Another study from China, including 834 patients with breast cancer, showed a prevalence of depression, anxiety and insomnia in 21.6, 15.5 and 14.7% of the cohort, respectively.…”