Substantial Impairment of Quality of Life during COVID-19 Pandemic in Patients with Advanced Rectal Cancer

Abstract

The aim of this study was to analyze the quality of life of patients with advanced rectal cancer before and during the COVID-19 pandemic and to determine whether the pandemic affected patients’ quality of life. The study included 389 patients and was performed from May 2010 to June 2021. The fifteen months from March 2020 to June 2021 were categorized as the COVID-19 period. Patients were surveyed using the QLQ-C30 and QLQ-CR38 questionnaires. The questionnaires were used at different phases of radiochemotherapy: prior to RCT (day 1), during RCT (day 14), at the end of RCT (day 35), and prior to mesorectal surgery (day 70). Scores were formed from the questions. In addition, scores were analyzed for different age groups (<64 and >64) and sexes (female and male). Overall, patients reported lower functional scores and higher symptom scores during the pandemic than before the pandemic. Although it had been expected that older and younger patients would differ clearly, there were only minor differences. The comparison between the two sexes showed very different scores, with female patients having lower functional scores and higher symptom scores than male patients before and especially during COVID-19. In conclusion, age does not play a major role in quality of life, but sex does play an important role in perception of functioning and symptoms. COVID-19 also had a major impact on patients’ lives, as it was a very isolating and stressful time for everyone, especially cancer patients, which was reflected in worsening scores.

Impact of COVID-19-related experiences on health-related quality of life in cancer survivors in the United States

“…The COVID-19 pandemic has disproportionately affected cancer survivors. Health care systems have delayed non-urgent procedures, including post-treatment cancer screenings [ 13 , 32 ], with about half of survivors experiencing a COVID-19-related health care delay [ 33 ]. Many survivors have been transitioned to telehealth; while this may facilitate care in some circumstances (e.g., improved coordination) [ 27 ], <5% of survivors used telemedicine prior to the pandemic [ 34 ].…”

“…The COVID-19 pandemic has disproportionately affected cancer survivors. Health care systems have delayed non-urgent procedures, including post-treatment cancer screenings [13,32], with about half of survivors experiencing a COVID-19-related health care delay [33].…”

Influence of the COVID-19 Pandemic on Patients with Rectal Cancer

“…The control group consisted of all patients diagnosed during a comparable period preceding the COVID-19 pandemic (01 March 2018-29 February 2020). Of these, 65 patients were assigned to the control group (pre-COVID- 19), and 55 patients to the study group (during the COVID-19 pandemic). Medical history and anthropometric parameters were recorded (Table 1).…”

“…Early detection is crucial, especially for rectal cancer, particularly in the middle and lower thirds of the rectum. As a low-lying rectal cancer advances, preserving the sphincter becomes increasingly challenging, impacting quality of life [ 19 ].…”

Impact of COVID-19 on Quality of Life in Long-Term Advanced Rectal Cancer Survivors

“…The aim of this study was to assess the patients' QOL during treatment and up to four years after surgery, both prior to and after the beginning of the COVID-19 pandemic, and to compare the results. It is especially focusing on the time after surgery and the development throughout all stages, and can be seen as a follow-up to a similar study conducted with an overlapping patient sample for the time before surgery [13].…”