The Impact of COVID-19 on Cancer Care

ABSTRACT

Background/Purpose: During the COVID-19 pandemic, cancer patients and survivors have been recognized as populations at high risk for infection, disease development, and complications. As a result, significant changes were made to the delivery of cancer care including the delay of surveillance studies, conversion of in-person visits to telehealth, and cancellation of appointments. Methods: In order to improve our understanding of changes in cancer care due to COVID-19, we collected demographic information from and conducted brief, semi-structured interviews with five oncology providers and 12 cancer survivors. Cancer survivors also completed a health history survey. Survey data was summarized using descriptive statistics. Interviews were audio-recorded, transcribed, and are undergoing reflexive thematic analysis. Results: Providers were mostly female (80%) and of Asian descent (60%). Patients were mostly female (75%) and white (67%). The majority of patients had a college degree (83%), but employment status was mixed (42% full-time, 33% unemployed, 25% disabled). Patients had most commonly been diagnosed with breast cancer (33%) and were on active treatment (58%). Initial review of transcripts suggests that minor changes and brief delays to cancer treatments were common early in the pandemic. Additionally, many visits with members of the oncology team were converted to telehealth, which patients found to be as effective as and more convenient than in-person visits. However, ancillary services that require in-person visits (e.g., physical therapy) were more likely to be cancelled or significantly delayed. Conclusions and Implications The COVID-19 pandemic resulted in brief disruptions to the delivery of radiation and chemotherapy. Telehealth was a useful substitute for many other types of visits, but was not a feasible solution in all cases, resulting in delays or cancellations of interventions focused on symptom management. Though such delays may not impact survival, they have likely increased survivors' risk for pain, diminished functional status, and decreased quality of life.