Perspectives, Knowledge, and Fears of Cancer Patients About COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) is expected to significantly affect cancer patients due to adverse outcomes with COVID-19 and disruptions in cancer care. Another important point is the stress and anxiety burden of COVID-19, which could affect quality of life. Patient education is vital due to the vulnerability of the topic to disinformation. To determine the areas needing improvements in patient education, and coping with stress, the burden of the problem should be pictured. From this point, we aimed to assess the perspectives and fears of cancer patients about COVID-19 with resources of COVID-19 knowledge with a questionnaire. A total of 250 adult cancer patients applied to the outpatient chemotherapy unit of Hacettepe University Cancer Center between May 27, 2020, and June 9, 2020, invited to answer a questionnaire of 13 multiple-choice questions with a return rate of 78% (195/250). Most patients acquired their knowledge about COVID-19 from television (91.9%). Social media were the second most common source of knowledge (43.8%) with a predilection in younger patients, nonsmokers, targeted therapy-or immunotherapy-treated patients, and breast cancer patients (>65 vs. <65 years of age, p = 0.057; nonsmoker vs. ever-smoker, p = 0.036; targeted therapy and immunotherapy vs. chemotherapy, p = 0.004; breast cancer vs. other cancers, p = 0.019). The percentage of patients seeing the information about COVID-19 as adequate (38.9%) or inadequate (35.1%) was similar. More than 90% of the patients had a moderate to severe degree of COVID-19 fear. In addition, 27.6% of patients had false knowledge of glove using as a protective measure for COVID-19. More than half of the patients had another wrong knowledge as the need for the supplements for COVID-19 protection. A significant percentage of patients (84.7%) expected some level of disruption in oncological care with the expectation of a moderate-to-severe disruption was more common in the advanced-stage patients (p = 0.026). In our experience, most cancer patients had a significant degree of fear about both infecting COVID-19 and the disruption of cancer care by COVID-19. A significant amount of our patients had wrong information about the protection necessities, which denotes the need for better patient education about COVID-19.

Experiences of people affected by cancer during the outbreak of the COVID-19 pandemic: an exploratory qualitative analysis of public online forums

“…People with cancer faced the dilemma of going to the cancer center and potentially being exposed to the virus versus postponing or cancelling their treatment to avoid exposure and having their treatment outcome compromised. This finding is consistent with previous studies that noted that treatment delays or interruptions, as well as concerns related to COVID-19, were the dominant factors associated with fears of disease progression, as well as higher levels of anxiety and depression [ 13 , 30 , 34 , 37 ]. In addition and related to the limited access to the healthcare system, an important number of threads corresponded to people suspecting symptoms related to cancer, who sought advice or similar experiences from their peers.…”

“…During a lockdown, the internet and social media are a major source of information [34]. However, because these sources are not always reliable, they may increase fear-and stress-related disorders [34,35].…”

“…During a lockdown, the internet and social media are a major source of information [34]. However, because these sources are not always reliable, they may increase fear-and stress-related disorders [34,35]. Cancer online forums represent a virtual place to share and seek information and emotional support from peers going through or who have had similar experiences [2,36].…”

Tumor patients’ fears and worries and perceived changes of specific attitudes, perceptions and behaviors due to the COVID-19 pandemic are still relevant

“…This reflects their insecurity about how to behave. Recently, another study with 195 cancer patients demonstrated that more than half of them did not know how to correctly use supplements for corona protection; most of them received information on COVID-19 related topics via social media or the television (Guven et al 2020 ). Therefore, many patients are unsure whether or not to visit hospitals and oncological wards to be treated.…”

Impact of COVID‐19 pandemic on cancer surgery: Patient's perspective

“…Nearly one‐fifth of our patients faced denial of treatment by other hospitals due to fear of an ongoing pandemic. In a study from Turkey, more than 80% of cancer patients were concerned about treatment interruption 14 . Most of our patients (80%) were scared of getting exposed to coronavirus infection during the hospital stay.…”