Quality of life deteriorates for patients with late-stage cancer amid COVID-19 pandemic
Quality of life declined significantly for patients with stage III and stage IV cancer during the COVID-19 pandemic compared with before the coronavirus outbreak, according to results of a survey-based study published in Psycho-Oncology.
Researchers observed declines primarily in social and cognitive functioning.
“During this extraordinary time, [patients with cancer] are facing a war on two fronts —having to struggle with the increased risk [for] COVID-19 morbidity and the risk [for] cancer progression with possible delays of diagnosis or treatment,” Magdalena Ciyska, PhD, clinical researcher at Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology in Poland, said in a press release. “Living with cancer at the time of pandemic does not mean that oncological care must be compromised. The oncology community, despite having to deal with unprecedented challenges in treating patients, at the same time identifies risk factors that deteriorate patients’ quality of life to ensure that their safety and well-being are not affected.”
The COVID-19 pandemic has raised concerns among physicians, governments and patients about the impact on health care delivery. These include the risk for cancer treatment delays as patients are forced to choose whether they should stay at home and skip treatments or visit the hospital and risk being exposed to the virus.
Ciyska and colleagues administered surveys to 260 patients with stage III or stage IV cancer undergoing chemotherapy. The surveys asked patients about their cognitive and preventive behaviors regarding COVID-19 and the accessibility of medical support.
The researchers used the EORTC QLQ-C30 to assess cognitive, emotional, physical, role and social functioning, as well as global health status, quality of life, symptoms and perceived financial impact. They compared the results with those of 8,066 patients with stage III or stage IV cancer who completed quality of life surveys before the pandemic.
Results showed significantly lower global quality of life for patients with cancer during the COVID-19 pandemic compared with before the pandemic (P < .0001). Cognitive and social functioning appeared significantly lower among patients during vs. before the pandemic (P < .0001 for both); however, physical, emotional and role functioning were unchanged.
Difficulties in social functioning included the inability to perform work and a reduction in its efficiency.
Researchers observed no significant effect of COVID-19 restrictions on hobbies and other pastimes. Common symptoms that worsened during the pandemic included insomnia (P < .0001) and fatigue (P = .003).
Researchers conducted the study in the early days of the pandemic, which served as a limitation.
Results also showed 20% of survey respondents considered delaying chemotherapy because of the pandemic, and 5% considered halting further cancer treatment despite fears of disease progression.
“Most patients also worried about their income due to the economic conditions in their country of residence, which can be significantly affected by the COVID-19 pandemic and could indirectly influence their treatment options,” Ciyska and colleagues wrote. “Furthermore, long-term escalation in the need for health services caused by the COVID-19 pandemic will put pressure on health care workers and could at some point compromise the clinical management of people with cancer.”
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