The Psychological Distress of Cancer Patients following the COVID-19 Pandemic First Lockdown: Results from a Large French Survey

Abstract

Cancer patients commonly experience psychological distress that may increase with the current COVID-19 pandemic. This prospective study aimed to measure post-traumatic stress disorder (PTSD) and anxiety in cancer patients following France’s first COVID-19-related lockdown, together with associated factors. Cancer patients receiving outpatient treatment or post-treatment follow-up completed a questionnaire which measured, among other things, PTSD (IES-R), anxiety (State-Trait Anxiety Inventory), and fear of cancer recurrence (FCR). Of the 1097 patients included in the study, 14.7% and 30.5% suffered from PTSD and anxiety, respectively. Patients afraid to come to hospital due to the risk of COVID-19 transmission (OR = 3.49, p < 0.001), those with a negative lockdown experience (OR = 0.98, p < 0.001), women (OR = 1.97; p = 0.009), and patients living alone (OR = 1.63, p = 0.045) were all more likely to have PTSD. Older patients (OR = 1.65, p = 0.020), women (OR = 1.62, p = 0.018), those with a higher FCR score (OR = 5.02, p < 0.001), patients unsatisfied with their cancer management (OR = 2.36, p < 0.001), and those afraid to come to hospital due to COVID-19 (OR = 2.43, p < 0.001) all had a higher risk of anxiety. These results provide a greater understanding of the psychological consequences of the COVID-19 pandemic in cancer patients and highlight the need to better integrate psychosocial support in pandemic response measures in order to guide health systems.

What Patients Facing Cancer and Caregivers Want From Communication in Times of Crisis: A Qualitative Study in the Early Months of the COVID-19 Pandemic

“…[26][27][28] In 2020, people with cancer and advanced health conditions experienced heightened vulnerability due to fragmented access to care; many faced health-related anxiety and disease progression. [29][30][31] Amid this and uncertainty about the pandemic's impact on their health, patients with cancer expected clinicians to be transparent about healthcare options and access to care. 28,32 However, clinicians were providing medical care under extenuating circumstances.…”

Post-traumatic stress disorder symptoms and associated factors in breast cancer patients during the first COVID-19 lockdown in France

“…Among cancer patients, it was reported 36% of PTSD symptoms in lymphoma patients during the onset of COVID-19 in Italy ( Romito et al, 2020 ) and 31% in an American study of mostly BC patients ( Miaskowski et al, 2020 ). A French oncological survey identified moderate-to-severe PTSD in 14.7% of cancer patients during the first pandemic COVID-19 lockdown, with a higher rate of 18% in the breast or gynecological patients ( Marino et al, 2022 ). Two Chinese studies that assessed the prevalence of PTSD symptoms very early in the course of the COVID-19 pandemic found 35.5 and 52.2% moderate to severe distress symptoms in BC patients ( Cui et al, 2020 ; Juanjuan et al, 2020 ).…”

“…A British study suggested that the pandemic-induced disruption to scheduled oncology services had a negative impact on cognitive function ( Swainston et al, 2020 ). A French study measured PTSD and anxiety in cancer patients in France following the first COVID-19-related lockdown and associated factors ( Marino et al, 2022 ).…”

Post-traumatic growth in oncological patients during the COVID-19 pandemic

“…Over the past two years, the COVID-19 pandemic has exposed cancer patients to a higher level of stress and a greater risk of developing psychological disorders, such as anxiety, depression ( Savard et al, 2021 ; Turgeman et al, 2022 ) sleep difficulties ( Giotta et al, 2020 ; Savard et al, 2021 ; Steel et al, 2022 ) and PTSD ( Marano et al, 2021 ). It appears that anxiety disorders may result from a sense of loneliness ( Steel et al, 2022 ), fear of being exposed to the virus during hospital treatment, and receiving a worse prognosis ( Marino et al, 2022 ).…”