gms | German Medical Science

Background: In March 2020 the spread of a novel corona virus, Sars-Cov2, was declared a global pandemic. Consequently, policy makers have prioritized health care services to treat serious cases and limit the infection rate. This has led to shortages and affected the care for other vulnerable patients, such as those with cancer. Beyond uncertainty with regard to their care and their risk of infection patients may also experience distress as a consequence of social distancing measures or be affected financially. This is reflected in thousands of individual “Corona inquiries” from cancer patients that reached the authors´ institution.

Aim: The aim of this pilot survey study is to provide insight into how changes in medical care during a pandemic, as well as the pandemic at large, affect cancer patients in terms of distress and economic consequences.

Methods: Using an anonymized online questionnaire, we examined a convenience sample of cancer patients who contacted a cancer organization in Germany with questions and concerns regarding their disease. The questionnaire captures information on cancer type and phase and changes in cancer care and includes items assessing distress and financial impact.

Results: An interim evaluation with data collected from July 2020 to January 2021 (n=372; 35% return rate) showed a median age of 60 years (IQR: 50-68), 76.4% were women, and breast cancer was the most frequent cancer type (51.4%). The majority of patients had completed their first round of treatment (42.3%), 24.0% of respondents were still in their primary treatment phase, and 24.8% reported a cancer recurrence or were in an advanced phase. Overall 14% (n=51) of patients reported changes in medical care. Of these, the majority took place in the follow-up after treatment (68.8%), followed by treatment control checks (29.4%), and drug-based tumour therapy (19.6%). Thirty-seven percent of the overall sample agreed or strongly agreed to worrying that the pandemic might affect their quality of care, and 65.7% missed personal contact with family and friends rather or very much. Regarding finances, 67.9% reported increased expenditures for health care due to their cancer, 18.2% additional expenditures due to the pandemic, and 17.4% a loss of income.

Discussion: These results confirm patient well-being and finances, in addition to treatment and care, have been affected by the corona pandemic. Based on this pilot study, a larger trend study is planned (to begin in July 2021) with representative samples of patients from an epidemiological cancer registry. This study will include five common cancer types and will run in four waves to identify changes over time. A control group of non-cancer individuals serves to identify cancer specific impact.

Implications: In view of the observed changes to cancer care during the current pandemic, it is important that health care organisations are fully prepared for a crisis situation and ascertain equitable care for all patients. Our results underscore cancer patient vulnerabilities. As the study covers the whole range of effects of the pandemic on patients, results may help healthcare professionals and policy makers to assess needs and prioritize services and support accordingly.