ABSTRACT
Background/Purpose: We present a case study demonstrating how cancer support services assisted a patient diagnosed with diffuse large B-cell lymphoma (DLBCL) to cope throughout the COVID-19 pandemic. Perceived social isolation and loneliness were exacerbated for this patient due to the interaction of 1) cancer diagnosis, 2) COVID- 19 social distancing, 3) inability of vaccination to produce immunity to COVID-19, and 4) diminution of her social network due to aging. Methods: We summarize clinical encounters and chart review for an 88-year-old female patient (divorced, living with son) with DLBCL evaluated at a large urban university hospital to illustrate the impact of cancer support service interventions on social isolation and loneliness. Results: Systematic review revealed that interventions such as exercise, mindfulness-based practice, Tai Chi Qigong meditation, and art therapies decrease loneliness and increase perceived social support. The patient consistently observed COVID-19 social distancing precautions throughout the pandemic, receiving Pfizer vaccine immediately once available, and Moderna vaccine thereafter. However, she did not develop antibodies, reinforcing her need to strictly isolate. The patient has participated in a regimen of online cancer support activities: twice-weekly group exercise physiology sessions and gentle chair yoga sessions, twice-monthly individual exercise physiology, weekly music therapy, weekly chaplain meetings, and daily treadmill walking. She recognizes distress and anxiety as temporary feelings and understands how these support activities enhance her repertoire of coping strategies. Despite being restricted to home;she states that regular interaction with her support services team-and attentive care from her son-have decreased feelings of loneliness. Conclusions and Implications: Our patient has demonstrated resilience, overcoming the combined challenges that amplify loneliness and social isolation: DLBCL diagnosis, lack of COVID-19 antibody response, and aging. Although she is unable to socialize in person, her interactions with cancer support services staff and engagement in a suite of activities have mitigated loneliness and isolation.