8 cancer care hurdles amid the pandemic and how patients are reacting to them

A new qualitative study in JAMA Oncology analyzed cancer patients' reactions to certain challenging situations during the pandemic.

Conducted at a Midwestern academic medical center between March 25 to April 2, eight physicians identified eight oncology-specific scenarios in which communication with patients had been challenging. Forty-eight cancer patients then provided their reactions to each scenario in an anonymous online survey. For most scenarios, patient reactions involved anger, fear and anxiety.

Below are some of the COVID-19-related scenarios, along with common patient survey responses.

1. Worse outcomes from COVID-19. Patients raised fears about being vulnerable ("Am I more susceptible to getting the virus?") or not being able to prevent contracting the virus. 

2. Delays in cancer screening. Patients were worried about the late discovery of a new malignant neoplasm ("What if my cancer comes back and by the time I do get screened it's too late?"). 

3. Diagnostic workup delays. Patients weighed the seriousness of cancer against COVID-19 ("Why is COVID considered more critical than cancer?"). 

4. Delaying initiation of treatment. Patients had strong emotions, stating, "Why am I being punished when I followed directions and made sure to self-isolate?"

5. Offer of nonstandard treatment. Patients noted feeling unimportant ("You're making me feel that my care and health aren't important to you.").

6. Treatment breaks. Patients raised the likelihood of bad outcomes ("This sounds like a death sentence.").

7. Delay in follow-up imaging or care. Patients expressed feelings of abandonment ("You're leaving me to deal with this alone."). 

8. Inability to be admitted into the hospital. Patients expressed thoughts consistent with, "Why is my life not as valuable as the life of someone with COVID-19?"

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