One third of cancer patients received different care in first corona weeks
One in three patients experienced changes in cancer care in the first four to six weeks of the COVID-19 crisis. For instance, treatments and follow-ups were postponed or canceled or in-person visits were replaced by telephone or video calls. This is shown by research conducted by Lonneke van de Poll-Franse (Netherlands Comprehensive Cancer Organisation IKNL, Netherlands Cancer Institute NKI, Tilburg University) and colleagues. As far as mental wellbeing is concerned, the crisis seems to have more of an impact on the population at large than on cancer patients.
The researchers carried out an evaluation among patients in the Netherlands Cancer Registry (NCR) who had participated earlier in a study via PROFILES, the patient monitoring registry that IKNL has developed in collaboration with Tilburg University. This selection of patients was supplemented with a random sample from the population at large from CentERdata. In April and May 2020, all respondents were invited to complete a questionnaire.
Telephone and video calls
Of the 4,094 cancer patients who participated, 886 patients were receiving treatment at the time and 2,725 were in follow-up care. Appointments for treatment or follow-up were canceled for 11% of patients while, for 18% of treatments and 9% of follow-ups, appointments were replaced by telephone and video calls.
Patients who received immunotherapy or targeted therapy and patients with more other conditions or metastases more frequently reported changes in cancer care. This is in line with the expert advice to protect vulnerable patients by temporary preventing in-person hospital appointments as much as possible.
Less contact with health professionals
Both the patients and the other respondents indicated that the COVID-19 crisis meant that, if they had physical complaints or worries, they were less likely to contact their GP (21% and 22%, respectively) or a medical specialist or nurse (14% and 15%, respectively). Most patients who had had a telephone or video call would have preferred face-to-face consultation, but 39% was prepared to have another telephone or video appointment.
Cancer patients did worry more about getting infected with COVID-19 (23%) compared to the 977 matched-norm respondents (18%). However, quality of life and feelings of anxiety and depression were largely similar. Matched-norm respondents experienced more loneliness (12%) than cancer patients (7%).
The researchers concluded that, at the moment, there are no indications that additional support should be offered to cancer patients. However, supplementary monitoring is necessary to gain insight into the long-term effects of the changes in cancer care.
In relative terms, however, the corona crisis may have more impact on the mental wellbeing of the general population than on that of cancer patients. A possible explanation may be that the social distancing and more limited freedom of movement has less of an impact on cancer patients because they are already more likely to experience reduced social contact after the diagnosis of cancer.