Counterbalancing COVID-19 with Cancer Surveillance and Therapy: A Survey of Patients with Renal Cell Carcinoma

Impact of COVID-19 on Uro-Oncological Patients: A Comprehensive Review of the Literature

Background: The aim of this paper is to discuss the impact of COVID-19 on patients with urological malignancies (prostate cancer, bladder and upper tract urothelial cancer, kidney cancer, penile and testicular cancer) and to review the available recommendations reported in the literature. Methods: A review was performed, through the PubMed database, regarding available recommendations reported in the literature, to identify studies examining the impact of COVID-19 on treatment and clinical outcomes (including upstaging, recurrence, and mortality) for uro-oncological patients. Results: The COVID-19 pandemic dramatically changed the urological guidelines and patients' access to screening programs and follow-up visits. Great efforts were undertaken to guarantee treatments to high-risk patients although follow up was not always possible due to recurrent surges, and patients with lower risk cancers had to wait for therapies. Conclusions: Physically and mentally, uro-oncological patients paid a heavy price during the COVID-19 pandemic. Long term data on the "costs" of clinical decisions made during the COVID-19 pandemic are still to be revealed and analyzed.

Fear of Cancer Recurrence or Progression: What Is It and What Can We Do About It?

Patients with cancer face a trajectory marked by emotional and physical distress that can be associated with both diagnosis and treatment. Fear of cancer recurrence or progression has been considered one of the most common unmet needs reported by patients diagnosed with both localized and metastatic disease. Fear of cancer recurrence or progression has been defined as the "fear, worry, or concern relating to the possibility that cancer will come back or progress." Often overlooked by health care teams, fear of cancer recurrence or progression has been associated with impaired quality of life and psychosocial adjustment, elevated emotional distress, and a range of physical symptoms. Several interventions for fear of cancer recurrence or progression are currently under investigation. Early recognition, support, and validation of feelings associated with fear of cancer recurrence or progression, and appropriate referrals to psychosocial oncology, can be beneficial for many patients. Assessing patients early in their cancer trajectory, and at important milestones, including a change in therapies, at the end of active treatment, and during follow-up visits, can help identify individuals at risk and help individuals engage in supportive programs.

Experiences of Young Adults With Lymphoma During the COVID-19 Pandemic

PURPOSE

To investigate the experiences of young adults with lymphoma during the COVID-19 pandemic.

PARTICIPANTS & SETTING

8 young adults with Hodgkin or non-Hodgkin lymphoma from one National Cancer Institute-designated cancer center in the northeastern United States.

METHODOLOGIC APPROACH

Secondary data analysis of a study that investigated the experiences of young adults with lymphoma during acute survivorship was used. Thematic analysis was chosen for the secondary data analysis methodology.

FINDINGS

Three themes define the experiences of young adults with lymphoma during the COVID-19 pandemic.

IMPLICATIONS FOR NURSING

Nurse-led survivorship care and education of young adults with cancer may mitigate COVID-19-related anxiety and threats.

Cancer management during the COVID-19 pandemic: Choosing between the devil and the deep blue sea

COVID-19 was declared a "Public Health Emergency of International Concern" in March 2020. Since then, drastic measures were implemented to reduce the virus spread. These measures prevented cancer patients from receiving prompt medical care. A delay in testing and treating cancer patients is thought to protect them from serious COVID-19 complications but exposes them at the same time to the risk of disease progression and cancer related mortality. Healthcare providers are therefore facing the dilemma of choosing between two unpleasant scenarios. To shed light upon the matter, we present in this review article, based on an extensive search of the literature, an overview of the delay in the management of cancer patients, possible contributors to this delay and its benefits and risks on cancer patients' health.

Depression and Anxiety Among Patients with Cancer During COVID-19 Pandemic: A Systematic Review and Meta-analysis

BACKGROUND

Investigations about the impact and consequences of the COVID-19 infection on the mental health of patients with chronic diseases and those with immunosuppressive conditions are growing. The current study aimed to systematically review and meta-analysis of studies that evaluated the level of depression and anxiety in cancer patients during the COVID-19 pandemic.

METHODS

The PubMed, Scopus and Web of Sciences databases were searched to retrieve potential studies from January 2020 to 3 January 2021. Summary data on frequency and mean of depression and anxiety were extracted. Random-effect meta-analysis was conducted to estimate overall prevalence, mean and standardized mean difference.

RESULTS

Thirty-four studies were included in the systematic review, of them 21 studies included in meta-analysis. Overall depression and anxiety were 0.37 (0.27, 0.47); I² = 99.05%, P value < 0.001 and 0.38 (0.31, 0.46); I² = 99.08%, P value < 0.001, respectively. Compared to controls, cancer patients had higher anxiety level [standard mean difference (SMD 0.25 (95% CI 0.08, 0.42)].

CONCLUSION

Overall, the findings of this study suggest that the prevalence of depression and anxiety among patients with cancer during the COVID-19 pandemic can reach considerable levels, although observed substantial heterogeneity should be considered when interpreting the results.

Patients' Responses to the Sudden Interruption of Chemotherapy During the Outbreak of the Novel Coronavirus: A Cross-Sectional Study

Purpose

This cross-sectional study aimed to describe the responses of cancer patients’ indifferent chemotherapy cycles to the unstructured treatment interruption during the COVID-19 pandemic in China.

Patients and Methods

Data from 156 adult patients with common solid tumors undergoing chemotherapy or ready to begin chemotherapy after surgery before the COVID-19 outbreak were analyzed in the study. Patients’ responses to the chemotherapy interruption and their anxiety were assessed.

Results

Overall, 141 (90%) patients completed the study, and 115 (81.6%) accepted a switch from their previous intravenous chemotherapy to oral chemotherapy. Of these, 29 (65.9%) patients with lung cancer, 25 (86.2%) with gastric cancer, 33 (89.2%) with colorectal cancer and 28 (90.3%) with breast cancer switched from intravenous to oral treatment, heeding their doctor’s advice. Of the participants, 85 (60.3%) patients reported that they had taken at least one kind of complementary and alternative medicine (CAM). The hospital anxiety and depression scale (HADS) scores increased in patients with advanced refractory cancer compared with the scores of adjuvant chemotherapy patients (P < 0.05). The prevalence of anxiety was high in cancer patients aged 60 years or older. Furthermore, anxiety was associated with advanced incurable cancer (P < 0.05), and this finding remained after adjusting for chronic pain. In addition, there were significantly increased scores of anxiety in patients with lung cancer (P <0 0.05).

Conclusion

Our study shows that most cancer patients remained relatively stable and had switched from intravenous to oral treatment at home. Among them, an increasing number of patients began to seek CAM as a complementary therapeutic approach. Patients with advanced refractory cancer were more likely to experience anxiety, and lung cancer patients should receive special attention.