Patients with lung cancer show ‘incredible toughness’ during COVID-19 pandemic
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Patients with non-small cell lung cancer exhibited less depression and anxiety when receiving treatment during the COVID-19 pandemic than healthy individuals, according to a study in Journal of National Comprehensive Cancer Network.
“It is a message of strength and resilience, of being able to persevere despite all the challenges. These patients with lung cancer showed incredible toughness during COVID and went about what they had to do and continued their treatment, despite their very difficult disease,” Barbara L. Andersen, PhD, distinguished university professor in the department of psychology at The Ohio State University, told Healio.
Background
Patients with NSCLC experience the most distress among all patients with cancer, according to Andersen and colleagues; however, it remained unknown whether receiving immunotherapy during the COVID-19 pandemic increased the psychological vulnerability of these patients.
“To meet clinical needs,” researchers wrote, “knowledge of patients’ COVID-19 perceptions and safety behaviors is essential.”
Methodology
The analysis included 76 patients with advanced NSCLC (mean age, 62.6 years; standard deviation, 11.08; 59.2% men; 80.3% white) who enrolled at diagnosis at The Ohio State University Comprehensive Cancer Center and 67 community controls (mean age, 58.6 years; standard deviation, 9.31; 56.7% women; 95.5% white) with similar sociodemographics and smoking histories.
Through questionnaires, researchers assessed COVID-19 perceptions, social distancing, and depressive and anxiety symptoms. Andersen and colleagues evaluated differences in the psychological responses of patients with NSCLC at diagnosis and during COVID-19 (April 28, 2020, to July 14, 2020). They then evaluated differences between patients and controls in COVID-19 perceptions, social distancing practices and psychological symptoms.
Key findings
Results showed the control cohort anticipated the COVID threat would last longer, practiced more social distancing, had more concerns about family (P < .04) and reported worse psychological symptoms (P < .023). Patients with NSCLC, meanwhile, demonstrated greater depressive and anxious symptoms at diagnosis (P < .02) than during COVID-19 approximately 1 year later.
“Despite the many difficulties of travel, risks for COVID exposure and others, all patients returned to the hospital for treatment and clinical evaluations to adhere to immunotherapy or targeted therapies prescribed; they did not falter,” Andersen told Healio.
Additionally, researchers reported the two groups did not differ regarding their concern, understanding or perceived control over COVID-19.
Implications
Although patients with cancer had greater risk during the pandemic, they may also “be more resilient to COVID-19 stressors than has been assumed or suggested,” researchers wrote.
“The present data show that, in the face of multiple health stressors and COVID-19, patients with NSCLC demonstrated resilience,” Andersen and colleagues wrote.
With regard to further research, Andersen pointed to a separate study published in Psychosomatic Medicine in which she and colleagues reported that although immunotherapy and targeted therapies have dramatically improved survival for patients with advanced NSCLC, their benefit may be constrained by depressive symptoms.
Results of that study, which assessed psychological symptom trajectories from diagnosis to 24 months among 157 patients with stage IV NSCLC, showed the continuation of depressive and anxiety symptoms through treatment and thereafter.
References:
Andersen BL, et al. Psychosom Med. 2022;doi:10.1097/PSY.0000000000001027.
Arrato NA, et al. J Natl Compr Canc Netw. 2022;doi:10.6004/jnccn.2021.7076.
For more information:
Barbara L. Andersen, PhD, can be reached at Department of Psychology, The Ohio State University, 1835 Neil Ave., Columbus, OH 43210-1222; email: andersen.1@osu.edu.
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