Quality of Life in Patients with Pancreatic Cancer before and during the COVID-19 Pandemic

Abstract

Background: Coronavirus disease 19 (COVID-19) substantially affects cancer patients due to adverse outcomes and disruptions in cancer care. Recent studies have indicated the additional stress and anxiety burden arising from the pandemic and impairing quality of life in this vulnerable group of patients. However, patients with cancer represent a heterogenous group. Therefore, we conducted a study on patients with pancreatic cancer, requiring demanding surgical interventions and chemotherapy regimens due to its aggressive tumor biology, to explore the pandemic’s impact on quality of life within this homogenous cohort. Methods: In a descriptive observational study, the quality of life of patients who had undergone pancreatic surgery for tumor resection at our institution between 2014 and the beginning of the pandemic in March 2020 was assessed. For HRQoL measurement, we used the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), comparing their situation before the pandemic and since its beginning. An additional self-developed questionnaire was applied to assess the life circumstances during the pandemic. Results: Our cohort included 26 patients. Scores from the survey in HRQoL revealed no significant changes over time between before and during the pandemic. A medium deterioration in HRQoL was apparent in social functioning, as well as a small deterioration in role functioning and emotional functioning. Worries concerning a potential impact of COVID-19 on personal health were expressed. Psychological limitations in QoL were mainly attributed to the pandemic, whereas physical limitations in QoL were rather associated with the underlying disease of pancreatic cancer. Conclusion: The COVID-19 pandemic is causing considerable social and emotional distress among pancreatic cancer patients. These patients will benefit from psychological support during the pandemic and beyond. Long-time survivors of pancreatic cancer, such as those included in our cohort, appear to have improved resilience facing the psychosocial challenges of the pandemic. For pancreatic cancer, surgical care is considered the cornerstone of treatment. Prolonged delays in healthcare cause serious damage to mental and physical health. To date, the longer-term clinical consequences are not known and can only be estimated. The potential tragic outcome for the vulnerable group of pancreatic cancer patients highlights the urgency of timely healthcare decisions to be addressed in the future.

Impact of Geriatric Assessment and Management on Quality of Life, Unplanned Hospitalizations, Toxicity, and Survival for Older Adults With Cancer: The Randomized 5C Trial

“…Our sensitivity analyses showed contradictory findings in that those who completed the study during the COVID-19 pandemic reported the highest QOL while also being at higher risk for death. Other studies have reported negative impact of the COVID-19 pandemic on psychosocial QOL, 37 - 39 no impact on QOL, 40 , 41 or, similar to our study, a positive impact on QOL. 42 , 43 It can be hypothesized that the switch to virtual visits and reduced visits in hospital led to less treatment burden and higher QOL.…”

A Preliminary Study on Cancer Patients’ Quality of Life during the COVID-19 Pandemic

“…Differences in physical and psychological well-being were not significantly lower than before the pandemic time, while social well-being was significantly lower. Similarly, the results of research conducted by Alexander et al [27] showed that there is no significant difference in the physical condition of cancer patients before and during Covid-19 that is unlike the case with a decrease in social functions, roles, and emotions which differ before and during COVID-19 pandemic.…”

The impact of Omicron pandemic and COVID‐19 vaccination on the pancreatic adenocarcinoma patients

“…However, continuous follow-ups should be processed to further observe in a long term. Some studies proposed that the COVID-19 could impair the prognoses of pancreatic cancer patients, 21,22 which probably resulted from the impaired cancer screening, diagnosis, and care. 23 The vaccination was not discovered associated with the OS of PAC patients.…”