End-of-Life Experiences for Cancer Patients Dying in Hospital with COVID-19

Abstract

Despite a wealth of research regarding COVID-19, little evidence exists about cancer patients’ specific needs and experiences at end-of-life. This study retrospectively describes the care of 34 hospitalised cancer patients dying with COVID-19. The palliative care needs of patients were described. The main domains of end-of-life care service provision were evaluated including treatment of pain and other symptoms, communication and decision making at end-of-life and level of involvement of the palliative care team. Physical symptoms were managed with relatively low doses of end-of-life medications. High levels of patient and family anxiety, however, highlight the complexity of death from a stigmatised disease. Prompt acknowledgement of the vulnerability of advanced cancer patients with COVID-19 can facilitate proactive symptom management, anticipatory communication and enhance family support.

Symptom Control and Survival for People Severely ill With COVID: A Multicentre Cohort Study (CovPall-Symptom)

“…This provides the first multicentre, outcome-based data on symptom treatments in severely ill COVID patients. 1,25,37 We did not find differences between pandemic waves in symptoms or survival.…”

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

“…On the basis of data drawn from the multinational ISARC database of patients admitted to ICU for COVID-19 illness, only 3.6% had a neoplasm (Laura Merson, Oxford University, personal communication). According to a retrospective study of cancer patients dying of COVID-19 at a tertiary referral cancer centre in the UK, 82% were referred to palliative care prior to death [ 59 ]. During any future pandemic, training and support in recognizing deteriorating patients should be prioritized, to facilitate provision of palliative care services wherever appropriate.…”

The unmet supportive care needs of people affected by cancer during the COVID-19 pandemic: an integrative review

“…The physical needs were commonly reported across the included studies as a well-being concern. Physical needs were well described in the palliative care cancer participants [ 19 ]. Common needs reported included fatigue, weakness, and mobility issues affecting physical functioning and activities of daily living because of restrictions during the COVID-19 pandemic [ 19 – 23 ].…”

“…Physical needs were well described in the palliative care cancer participants [ 19 ]. Common needs reported included fatigue, weakness, and mobility issues affecting physical functioning and activities of daily living because of restrictions during the COVID-19 pandemic [ 19 – 23 ]. People affected by cancer were socially isolated due to the implications of the COVID-19 pandemic.…”

“…People affected by cancer were socially isolated due to the implications of the COVID-19 pandemic. Many experienced exacerbations of additional onset of pain [ 19 , 21 , 24 ] because of a reduction to mobility which made accessing an already restricted health care service significantly more difficult. Furthermore, the negative effect of gastro-intestinal symptomatology of nausea, vomiting, poor appetite, a dry mouth, or constipation were also expressed [ 19 ] compounding the nutritional deficits experienced by those affected by cancer as a daily unmet need during the pandemic [ 21 ].…”