Assessing the impact of the COVID-19pandemic on cancer patients, survivors, and caregivers
Authors: Amy Leader, Preethi Selvan, Lisa Capparella, Rebecca Cammy, Janene Palidora, Ayako Shimada, Benjamin Leiby, Gregory Garber, Brooke Worster
Journal: Clinical Cancer Research (2020)

Background: The COVID-19 global pandemic created significant and unprecedented disruptions in in medical careand social services  Cancer patients are at increased risk of COVID-19 infection due to their immunosuppressivestate and may fare worse than others who are COVID-19 positive because of their aggressive underlying disease While presumed to be substantial, the extent of the impact of the pandemic on cancer patients, survivors, andcaregivers was unknown  Methods: Between April 23, 2020 and May 19, 2020, our urban, NCI-designated cancer center launched a “COVIDand Cancer” survey for cancer patients, survivors, and caregivers  The purpose of the survey was to assessdisruptions to cancer care, use and perceptions of telemedicine, access to social services and cancer supportprograms, and psychosocial well-being  The online survey was distributed through our cancer center's email list forpatient and survivor programming, via the electronic patient portal to patients in active treatment, and across ourcancer center's social media platforms  Descriptive statistics reported mean scores and frequencies while bivariatestatistics reported differences in outcomes by respondent characteristics  The protocol and survey were approvedby our Institutional Review Board  Results: In less than one month and in the height of the pandemic, 1,107 people completed the survey  Afterremoving duplicate and incomplete responses, the final sample of 985 respondents included 377 (38%) patients inactive treatment, 576 (56%) survivors, and 18 (2%) caregivers  Fifty-six percent (n=555) were female;the mean ageof respondents was 63 years old (SD= 11 9)  Seventy-two percent (n=705) of respondents had solid tumor cancerswhile some had either a heme malignancy (22%) or both (4%)  Among the 688 respondents who needed cancercare during the pandemic, 294 (43%) reported disruptions in appointments, labs, or scans  Fewer (<5%) reporteddisruptions in surgery, chemotherapy, or radiation  Almost half (n=335, 49%) reported a telehealth visit during thistime  Most respondents (n=612, 62%) were worried about contracting COVID-19  Cancer patients who were inactive treatment were significantly more likely to be worried about contracting COVID-19, as well as accessingmedication, transportation, or caregiver support, than those who were not in active treatment  Conclusions: Disruptions in cancer care were observed during the pandemic  Cancer patients in active treatment were more worried that resources needed for their care such as medication, transportation, and caregiver supportwould be impacted by the pandemic  At our cancer center, we tried to mitigate some of the survey observations bydeveloping COVID-specific patient and caregiver support programs, partnering with local agencies to providegroceries and transportation to patients, and enhancing infrastructure to assist with telehealth appointments  Cancercenter support services can overcome these barriers and ensure patient care, even in a pandemic