Delaying Radical Prostatectomy, Cancer Screening, and Care Due to COVID-19

A retrospective analysis published in the Journal of Urology indicated that a delay of up to 12 months did not result in worse outcomes when compared with immediate surgery within 3 months of diagnosis.1 When compared with patients receiving RP within 3 months of diagnosis, patients undergoing surgery 4 to 12 months after diagnosis did not have increased odds of adverse pathology, upgrading on RP, or node-positive disease. The multivariable analysis demonstrated no significant association between surgical delay and upgrading on final specimen (OR, 0.98;95% CI, 0.94-1.02;P = .3), pathologically locally advanced disease (OR, 1.00;95% CI, 0.97-1.03;P = .8), need for adjuvant therapy (OR, 0.96;95% CI, 0.84-1.11;P = .6), or lymph node invasion (OR, 0.88;95% CI, 0.77-1.01;P = .07). While the investigators noted that most men in the study were operated on within a postdiagnosis period of close to 3 months, and they warned of extrapolating the results for much longer treatment delays, similar studies demonstrated that proposals of delays of up to 6 months for high-risk disease were reasonable, while low-and intermediate-risk groups could be delayed further.

Understanding the Impact of COVID-19 on Chronic Lymphocytic Leukemia (CLL) Caregiving and Related Resource Needs.

Chronic lymphocytic leukemia (CLL) caregivers play a central role in disease management-a role that has been heightened during the COVID-19 pandemic given the healthcare system's reliance on frontline family caregivers and CLL patients' increased risk of infection and mortality. Using a mixed-method design, we investigated the impact of the pandemic on CLL caregivers (Aim 1) and their perceived resource needs (Aim 2): 575 CLL caregivers responded to an online survey; 12 spousal CLL caregivers were interviewed. Two open-ended survey items were thematically analyzed and compared with interview findings. Aim 1 results showed that two years into the pandemic, CLL caregivers continue to struggle with coping with distress, living in isolation, and losing in-person care opportunities. Caregivers described experiencing increasing caregiving burden, realizing the vaccine may not work or didn't work for their loved one with CLL, feeling cautiously hopeful about EVUSHELD, and dealing with unsupportive/skeptical individuals. Aim 2 results indicate that CLL caregivers needed reliable, ongoing information about COVID-19 risk, information about and access to vaccination, safety/precautionary measures, and monoclonal infusions. Findings illustrate ongoing challenges facing CLL caregivers and provide an agenda to better support the caregivers of this vulnerable population during the COVID-19 pandemic.

Faith-Based Community Members, Family, and COVID-19: The Role of Family Cohesion, Social Support, and Spiritual Support on Quality of Life, Depression, and COVID-19-Prevention Behaviors.

This study examined relationships between family cohesion, social support/spiritual support, and quality of life and depression among faith-based community members during the 2020 COVID-19 restrictions. Drawing upon the buffering model of social support and family cohesion as theoretical frameworks, the authors examined these factors in a survey of 551 faith-based community members between March 2020 and June 2020. Family cohesion had a direct and indirect effect (mediated by overall social support and spiritual support on quality of life). Moreover, family cohesion only had a direct effect on depression (e.g., not mediated by overall social support or spiritual support). Greater family cohesion and overall social support were predictive of increased COVID-19-prevention behaviors, while spiritual support was predictive of reduced COVID-19-prevention behaviors.

Blood cancer caregiving during COVID-19: understanding caregivers' needs.

The COVID-19 pandemic likely exacerbated caregiving challenges for caregivers of parents diagnosed with a blood cancer. Providing care during a public health crisis presents a complex web of uncertainties regarding cancer care, personal health, and COVID-19 risk. Identifying caregivers' uncertainty experiences during the COVID-19 pandemic can be a first step in learning where to direct resources or alter policies to ensure that they can not only perform their caregiver role but also cope in health-promoting ways. Using uncertainty management theory, this study explored how the pandemic has impacted adult child caregivers' experiences caring for a parent diagnosed with a blood cancer, as well as their experiences of uncertainty and uncertainty management. As part of a larger study on blood cancer caregivers' needs, a survey was administered from March 30 to June 1, 2020, to recruit caregivers through the Leukemia and Lymphoma Society. A qualitative and quantitative content analysis was conducted on open-ended responses from 84 caregivers. Caregivers described changes illustrating the complexity of providing care during a pandemic: (a) increased fears and uncertainty-related distress, b) reduced in-person care opportunities, (c) increased isolation, and (d) enhanced family communication. Caregivers with parents diagnosed with acute blood cancers used significantly more uncertainty management strategies and had more sources of uncertainty than caregivers with parents living with chronic blood cancer types. Findings highlight the need for supportive services to help caregivers manage uncertainty and improve their capacity to provide care in an unpredictable global health crisis. Such support may reduce poor psychosocial outcomes.

Two Retrospective Analyses Show No Associated Adverse Outcomes With Delayed RP.

The results of 2 studies showed no association between delayed radical prostatectomy(RP) and adverse oncological outcomes, supporting current recommendations of urologic societies for surgical treatment of patients with intermediate- and high-risk prostate cancer during the coronavirus disease 2019 (COVID-19)pandemic.