The Impact of the COVID-19 Pandemic on Lung Cancer Patients

The COVID-19 pandemic has had a significant impact on hospitals and healthcare systems around the world. Hospitals, and, by default, their doctors, nurses, medical professionals and health workers have been overwhelmed by the disease. This article will delve deeper into the impact of the pandemic on lung cancer patients.

First, let’s take a look at the impact of COVID-19 in healthcare settings during the pandemic:

• Elective surgeries (surgeries that are not immediately urgent) were deferred
• The scheduling of tumor biopsies and re-biopsies faced delays, potentially impeding timely diagnosis and treatment adjustments
• Clinical research initiatives experienced setbacks, with enrollment and patient inclusion halted or significantly curtailed.
• Elderly patients and those deemed high-risk for COVID-19 complications were advised against pursuing third-line chemotherapy, introducing complexities in treatment decision-making.
• Eligible patients were encourage to discuss with their doctors and decide on a delay or suspension of ongoing treatment – the concept of a ‘drug holiday’

“The European Cancer Organisation predicts that because of COVID-19, there have been 100 million missed cancer screenings across Europe and a million missed diagnoses. The American Cancer Society Cancer Action Network reported that more than three-quarters of people actively undergoing treatment for cancer had to delay some aspect of their care as a result of COVID-19,”

– David Fredrickson, Executive Vice-President, Oncology Business Unit, AstraZeneca.

From the point of view of lung cancer patients during the pandemic, many:

• Experienced a delayed diagnosis
• Had frequent questions about whether immunotherapy could influence COVID-19 infections; there were limited studies to rule out any risks
• Patients were strongly advised to isolate themselves at home, away from the crowd, and visit their doctors every 2-3 months or adopt the telemedicine approach and get their drugs via the drug delivery system

“Here is an educated patient with access to care but simply could not just do a regular follow-up. There were plenty of cases where elective surgery had to be deferred because ICUs were full, the beds were not available and the transportation was extremely difficult,”

– Dr Jagannath Palepu, the head of surgical oncology at Lilavati Hospital in Mumbai, talking about his experience at the front line of cancer-fighting in India during COVID-19 pandemic.

A recent study addressed the impact of COVID-19 on the delivery of healthcare services to lung cancer patients and their personal lives, namely their quality of life (QOL). The limitations on social interactions affected them emotionally and psychologically.

“I’d like for COVID not to exist then I could perhaps get out for lunch and things like that and sometimes I feel a bit angry about it…I’ve not got over long left and I would prefer if COVID wasn’t around I can come and go as I please while I feel fit,” says a lung cancer patient in the interview.

Some patients were “sad” and “frustrated” about visiting hospitals or attending doctor consultations without family support.

“I wasn’t able to have visitors in hospital because of COVID and that impacted on me greatly, psychologically”, says a patient.

Based on the findings, the researchers concluded that lung cancer patients had unmet needs in four categories, resulting in a decrease in their quality of life:

• Support with their daily tasks
• Provision of guidance and advice, especially in the new modes of communication with their cancer care team (e.g. Zoom calls)
• Love, protection and care
• A sense of social belonging

Other lung cancer patients who reported having their needs in these four categories met, expressed positive impacts from the pandemic. Many of them claimed that they were getting more support from self-help groups with the new modes of communication.

The world has moved on since the pandemic, but the COVID-19 virus lingers. And, the harms it imposes on lung cancer patients remain.

“When you see people still wearing masks, please don’t give us a hard time. You don’t know the health conditions we or people we love may have,”

– Janet Freeman-Daily, metastatic lung cancer patient and survivor and patient advocate/activist.

It is vital to recognize that lung cancer patients are facing additional challenges to their health and well-being in light of COVID-19. These patients may need to limit their social interactions to stay safe, which can be difficult for them as they continue their cancer journey. However, it is crucial that they continue to receive support, care, and attention from others during this time. Thankfully, there are new modes of communication available to help patients adjust to these changes and feel more comfortable. Healthcare providers can also play an important role by providing patients with information on new resources that may be available to them.

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