In the unprecedented times of Corona Pandemic (CP), each individual is facing uncertainty and stress. Presence of cancer during these times compounds the troubles. The changing scenario of consultation and treatment during pandemic, logistic issues, dwindling finances and fear are making a negative impact on the mental health of cancer patients. In a qualitative analysis conducted in a tertiary oncology hospital from 1st June to 6th July on the recently diagnosed or under treatment cancer patients. The face to face interview was conducted using a semi structured questionnaire specific to Cancer amid CP, General Anxiety Disorder Item Scale 7 and Physical Health Questionnaire 9 (PHQ-9). There were total 294 patients, mean age around 51 years with a male female ratio of 3:2, 40% were suffering from head and neck malignancy. There was a delay initiating cancer treatment in 22.4% of patients and three fourths of them attributed it to CP. Almost 80% of patients perceived that pandemic has adversely affected their treatment and 50% thought they would have had a better chance of cure. Half of our cohort stated that due to social distancing and usage of masks, there is a communication gap between them and the doctors. They also felt that now, with decreased nonverbal communication; they felt lack of empathy. 14.9% patients were more concerned about corona pandemic as compared to malignancy. This study is about the challenges and perspective of cancer patients during the CP. It indicates a need for more systematic and patient friendly approach by the regulatory authorities, hospital management and staff. Timely intervention of those under stress is recommended more frequently during CP.

Background The limited access to palliative care resources along with the social stigma around cancer largely explains the poor quality of life (QoL) of Indian advanced cancer patients. As advanced cancer patients with poor QoL often harbour a desire for hastened death (DHD), it is imperative to understand factors affecting DHD, or the desire to live (DTL) among advanced cancer patients in India. We aim to examine the relationship between DTL and physical, psychological, spiritual, and social factors measuring patients’ QoL alongside their awareness of their late cancer stage. Methods We surveyed 200 patients from a tertiary cancer hospital in India to collect their DTL, awareness of cancer stage, demographic characteristics, and standardized measures for patients’ QoL. We used a linear probability regression model to quantify the association between these factors and patients’ DTL among the final sample of 192 patients with no missing information for the variables of interest. Results Among the various domains affecting cancer patients’ QoL, we found that the pain severity score (ranging from 0 to 10) and psychological distress score (ranging from 0 to 42) are negatively associated with the DTL. One point increase in each score reduced the DTL by 2.2% (p < 0.05) and 0.7% (p < 0.05), respectively. Our results also showed that patients whose perceived socio-economic status (SES) is poor have a 16% (p < 0.05) lower probability of DTL, compared to those with higher SES (lower middle class, upper middle class, and wealthy). Controlling for caste, religion, gender, age, marital status and years of education, we found psychological distress is statistically higher among patients belonging to this bottom SES. Conclusions We found that pain severity, psychological distress and perceived low SES are negatively associated with the desire to live in advanced cancer patients. Future research should focus on developing interventions to improve physical pain and psychological distress, particularly for patients who are socially and economically disadvantaged.

Madam d The diagnosis of cancer leads to many psychological problems e denial, self-pity, guilt, change in interpersonal relationships, loss of job, self-image, fear of lifelong morbidity, fear of death, managing logistics of treatment and prolonged follow-up. The suffering of cancer patients has further increased due to the ongoing coronavirus pandemic [1,2]. Considering the pervasive and diverse effect the coronavirus pandemic is having on cancer patients [3], we carried out a systematic qualitative analysis of newly diagnosed and under-treatment patients between 1 June 2020 and 6 July 2020. It was a cross-sectional, descriptive and hospital-based study conducted at a tertiary care oncology super specialty hospital in western India. In total, 294 patients were interviewed.Among our subjects, cancer diagnosis and treatment were delayed in 25.17% and 61.90%, respectively, due to the ongoing coronavirus pandemic. Despite the huge psychological impact cancer has, 15% of our patients were more worried about coronavirus infection and 63.2% of patients thought they would have a better chance of cure if it were not for the coronavirus pandemic. Significant levels (moderate to severe) of anxiety and depression were noticed in 28.91% and 26.50% of patients, respectively, which could be attributed to worsening of instrumental and/or emotional support in nearly 59% during the coronavirus pandemic. Another noteworthy observation was that 35% of the patients were dissatisfied with the distancing between them and the doctors. In a study, half of neuro-oncology patients preferred the face-to-face consultations rather than telephone clinics [4].Without compromising the outcomes, we may have to regularly treat COVID-19-positive cancer patients as there seems to be no relief from the pandemic in the near future [5]. With coronavirus infection looming all over, the psychological issues of cancer patients have exacerbated. It is important to reassure them that it is safe and essential to seek medical advice with due precautions. It is imperative to address the mental health of cancer patients to mitigate their anxiety and depression as they fight against two devils e cancer and coronavirus.

Background The limited access to palliative care resources along with the social stigma around cancer largely explains the poor quality of life (QoL) of Indian advanced cancer patients. As advanced cancer patients with poor QoL often harbour a desire for hastened death (DHD), it is imperative to understand factors affecting DHD, or the desire to live (DTL) among advanced cancer patients in India. We aim to examine the relationship between DTL and physical, psychological, social and spiritual factors measuring patients’ QoL alongside their awareness of their late cancer stage. Methods We surveyed 200 patients from a tertiary cancer hospital in India to collect their DTL, awareness of cancer stage, demographic characteristics, and standardized measures for patients’ QoL. We used a linear probability regression model to quantify the association between these factors and patients’ DTL among the final sample of 192 patients with no missing information for the variables of interest. Results Among the various domains affecting cancer patients’ QoL, we found that the pain severity score (ranging from 0 to 10) and psychological distress score (ranging from 0 to 42) are negatively associated with the DTL. One point increase in each score reduced the DTL by 2.2% (p <0.05) and 0.7% (p <0.05), respectively. Our results also showed that patients whose perceived socio-economic status (SES) is poor have a 16% (p <0.05) lower probability of DTL, compared to those with higher SES (lower middle class, upper middle class, and wealthy). Controlling for caste, religion, gender, age, marital status and years of education, we found psychological distress is statistically higher among patients belonging to this bottom SES. Conclusions We found that pain severity, psychological distress and perceived low SES are negatively associated with the desire to live in advanced cancer patients. Future research should focus on developing interventions to improve physical pain and psychological distress, particularly for patients who are socially and economically disadvantaged.