The real-world impact of the COVID-19 pandemic on patients with cancer: a multidisciplinary cross-sectional survey.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to cancer care worldwide. We conducted a multidisciplinary survey of the real-world impact of the pandemic, as perceived by patients with cancer. METHODS: A total of 424 patients with cancer were surveyed using a 64-item questionnaire constructed by a multidisciplinary panel. The questionnaire examined patient perspectives regarding COVID-19-related effects (eg, social distancing measures) on cancer care delivery, resources, and healthcare-seeking behaviour, along with the physical and psychosocial aspects of patient well-being and pandemic-related psychological repercussions. RESULTS: Overall, 82.8% of respondents believed that patients with cancer are more susceptible to COVID-19; 65.6% expected that COVID-19 would delay anti-cancer drug development. Although only 30.9% of respondents felt that hospital attendance was safe, 73.1% expressed unaltered willingness to attend scheduled appointments; 70.3% of respondents preferred to receive chemotherapy as planned, and 46.5% were willing to accept changes in efficacy or side-effect profile to allow an outpatient regimen. A survey of oncologists revealed significant underestimation of patient motivation to avoid treatment interruptions. Most surveyed patients felt that there was an insufficient amount of information available concerning the impact of COVID-19 on cancer care, and most patients reported social distancing-related declines in physical, psychological, and dietary wellness. Sex, age, education level, socio-economic status, and psychological risk were significantly associated with patient perceptions and preferences. CONCLUSION: This multidisciplinary survey concerning the effects of the COVID-19 pandemic revealed key patient care priorities and unmet needs. These findings should be considered when delivering cancer care during and after the pandemic.

Cancer patients' perspectives on the real-world impact of COVID-19 pandemic: A multidisciplinary survey

Background: The outbreak of the COVID-19 pandemic has led to unprecedented disruptions to global cancer care delivery. We conducted this multidisciplinary survey to gain insights into the real-life impact of the pandemic as perceived by cancer patients. Methods: Cancer patients at various stages of their cancer journeys were surveyed with a questionnaire constructed by a multidisciplinary panel of oncologists, clinical psychologists, occupational therapists, physiotherapists and dieticians. The 64-question survey covered patient's concerns on cancer care resources, treatment provision and quality, changes in health-seeking behaviour;the impact of social isolation on physical wellbeing and psychological repercussions. Results: 600 cancer patients in Hong Kong were surveyed in May 2020. Preliminary results showed that 70% of respondents related a COVID-19 diagnosis to compromised cancer treatment and outcome. Although only 45% considered hospital attendance as safe, 80% indicated their willingness to attend oncology appointments remained unaffected. 91% of patients stated their decision to receive chemotherapy was not changed;however, 40% would be willing to trade off the efficacy/side-effect profile for an outpatient regimen. Patients also reported compromised physical wellbeing due to social isolation, in particular, deterioration in exercise tolerance & limb power (44%), reduced appetite (29%), worse sleep quality (35%). Interestingly, 59% of pts reported better care support as a result of family spending more time together. Anxiety and depression were reported in 70% and 54% of patients, respectively. In addition, 20 oncologists provided their predictions on changes in pt's health-seeking behaviours under the pandemic. Results showed that they significantly underestimated patients' willingness and preference to keep their scheduled oncology appointments and treatments despite the risk involved. Conclusions: This original survey revealed the breadth and profoundness of the impact of the COVID-19 pandemic as perceived by cancer patients, headlining patients’ care priorities and showing their unmet needs. It should be taken into consideration as we modify the way cancer care is provided during this unsettling period and beyond. Legal entity responsible for the study: The authors. Funding: The Kowloon Central Cluster Research Committee KCC Research Grant 2020/21, Hong Kong (KCC/RC/G/2021-B01). Disclosure: All authors have declared no conflicts of interest.