Hughes et al. (2020) 'I feel cancer patients have been neglected'.

Abstract

Purpose This study aimed to explore the experience of the COVID-19 pandemic including Government-enforced restrictions, on women diagnosed with oestrogen receptor positive breast cancer in the UK using a mixed-methods approach. MethodsDepression (PHQ-2), anxiety (GAD-7), optimism (LOT-R) and perceived risk of recurrence (IPQ-BCS) were measured pre-COVID-19 outbreak and perceived vulnerability, severity and impact of COVID-19 were measured during the UK lockdown period of 23rd March-13th May 2020. Free text responses provided qualitative data. Descriptive statistics regarding COVID-19-specific behaviours and correlations between pre-COVID-19 psychosocial factors and COVID-19 outcomes were conducted. Thematic analysis was conducted on qualitative responses. Quantitative and qualitative data are presented together.Results253 responses were received during the UK lockdown period. Twenty-six percent of the sample were shielding and 15% felt at higher risk of contracting COVID-19. Higher pre-COVID-19 depression and anxiety and lower optimism were associated with higher perceived vulnerability to and severity of COVID-19 and lower confidence in protecting oneself. There were positive and negative effects of lockdown on exercise and relationships and 42% reported negative impacts on anxiety. Participants reported fear of COVID-19, difficulties with adapting to isolation and using technology, and anxiety about the impact of delayed cancer treatment on their cancer recovery and recurrence. ConclusionsNegative effects of lockdown, particularly for delayed cancer treatment should be considered to manage ongoing anxiety. Screening of state depression and anxiety is suggested for intervention prioritisation, but more longitudinal research is needed to understand the long-term effects of the COVID-19 pandemic on breast cancer survivors.

‘It feels it’s wasting whatever time I’ve got left’: A qualitative study of living with treatable but not curable cancer during the COVID-19 pandemic

“…For around 150,000 people this included delayed, rescheduled or cancelled treatment, with over half worried this could affect their chance of survival. 16 Similarly other UK surveys of people with cancer found a high level of reported disruption to cancer care and a negative impact on emotional well-being [17][18][19] and a large survey in Singapore found over half of people with cancer and nearly three quarters of their carers feared COVID-19 may affect their cancer treatment. 20 However, the full psychosocial impact of COVID-19 and risk-reducing measures including social restrictions, on those living with incurable, life-threatening conditions and their carers, who often live in the same household, is little understood.…”

“…3 People with treatable but not curable cancer have complex needs, mainly managing their health and wellbeing at home, supported by those close to them, and often wish to maintain independence, normality and control over their lives. [5][6][7][8] These challenges are likely to be exacerbated during the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of coronavirus disease (COVID- 19), identified in December 2019. People contracting COVID-19 may be at risk of severe events requiring admission to intensive care and invasive ventilation, with people with cancer at greater risk.…”