On top of that all, now Covid-19, too. A scoping review of specificities and correlates of fear of cancer recurrence in breast cancer patients during COVID-19

Abstract

Fear of cancer recurrence (FCR) is a normal response in cancer survivors and one of the most prevalent reactions reported by up to 87% of them. However, elevated levels of FCR impair well-being, quality of life and professional functioning, and lead to anxiety, depression or PTSD. COVID-19 pandemic can exacerbate FCR symptoms, given the restricting access to follow-up investigations and treatment, the isolation restrictions imposed and the possibility of the medical system becoming overworked. This scoping review's objective was to synthesize the literature investigating the factors associated with higher levels of FCR in cancer survivors during the COVID-19 pandemic. The focus was on FCR in breast cancer patients, including most of the studies (5 out of 9) on this topic. However, given the novelty of the subject, the increased interest in it, and the fact that there are few studies in this field, the review included 4 other studies with mixed samples of patients with breast cancer and other oncological pathologies. Following rigorous methodological criteria, 9 studies with quantitative or mixed methodology were included (N = 4831 patients). The results indicate that high levels of FCR are associated with distress and concerns regarding the pandemic impact, with most common concerns of patients being changes in treatment plan (delays and interruptions), dysfunctional communication with medical staff or difficult access to food or medicine. The most common correlates of FCR during the pandemic are marital status, childlessness, low financial status, level of education, type of cancer diagnosis, generalized anxiety and depression.

Effect of Cancer-Related Dysfunctional Beliefs About Sleep on Fear of Cancer Progression in the Coronavirus Pandemic

“…As expected, socio-demographic, physical, and psychological factors were associated with FoP in the COVID-19 pandemic according to the most recent review of clinical research. 38 Furthermore, those with a higher level of FoP were more frequently observed during the COVID-19 period than pre-COVID-19. Specifically, cancer patients are even more vulnerable to distress during the pandemic, thus requiring more delicate psycho-oncological care.…”

The prevalence of psychological disorders among cancer patients during the COVID‐19 pandemic: A meta‐analysis

“…57 It has been indicated that the COVID‐19 pandemic can exacerbate the fear of disease progression or recurrence in patients with cancer due to access restrictions on follow‐up and treatment, imposed isolation restrictions, and the possibility that the healthcare systems becomes overworked. 58 The vast majority of patients concern about the impact of delays on treatment and long‐term health. According to recent studies, the fact that most patients reported high fear of recurrence was due to concerns about lack of access to medical services, which were completely limited during the COVID‐19 pandemic.…”

“…57 It has been indicated that the COVID-19 pandemic can exacerbate the fear of disease progression or recurrence in patients with cancer due to access restrictions on follow-up and treatment, imposed isolation restrictions, and the possibility that the healthcare systems becomes overworked. 58 The vast majority of patients concern about the impact of delays on treatment and long-term 59 The level of distress in cancer patients has also increased due to treatment delays. 60 Moreover, changes in treatment have led to concern and fear of disease recurrence in cancer patients, as well as increased levels of depression and anxiety.…”

Resilience as a Source of Easement to Health-Related Worries in Women at Increased Risk for Breast or Ovarian Cancer During the COVID-19 Pandemic

“…[10][11][12][13][14] Patients with breast cancer experienced increased health-related concerns related to recurrence due to the pandemic impact, which affected the access to medicine, the communication with health care providers and treatment plans. 15 Women tend to experience a higher degree of mental health issues, eg anxiety, during the COVID-19 pandemic. 16 Worries are defined as anticipations of possible but yet uncertain negative future events, as opposed to anxiety, which is often accompanied by somatic and behavioral aspects: thus, worries are considered as a component of anxiety.…”

“…17 During the pandemic, vulnerable groups, such as patients with cancer or those at higher risk of cancer, faced a double-trigger: the threat of malignancy, as well as the possibility of acquiring COVID-19 infection. 11,14,15,19,20 To date, several predictors of healthrelated worries have been identified, including younger age or physical impairment in cancer patients, as well as the level of control of the COVID-19 pandemic. 11,19 Resilience allows people to recover or bounce back from adversity or stressful events in their lives.…”