The novel coronavirus disease 2019 (COVID 19), caused by corona virus, has affected
the whole world. Infected cases are in lakhs but the “fear of getting corona infection”
has affected almost everyone in the world. Cancer, on the other hand, is an already
existing major health burden with high morbidity and mortality.[1] Cancer patients usually have lower immunity, and those on chemotherapy or radiation
therapy (RT) are even more vulnerable to any kind of infection due to reduced immunity
to combat any pathogen. First, research till date mentions that corona patients with
comorbidities, like diabetes mellitus, hypertension, or cancer, have more mortality
rate.[2] Second, many cancer patients have already existing psychological problems secondary
to illness or its treatment. The fear of getting infected with corona may further
jeopardize their mental health and coping ability to fight with cancer.
With daily increase in spread of corona virus, worries about infection, uncertainty
about the end of its spread, psychological effects of lockdown (feeling of restriction
in freedom, irritability, and frustration), fear, panic, etc., are found in majority
of cancer patients. This is over and above their worries and preoccupation about the
cancer, chemotherapy schedules, adverse effects of chemotherapy or radiotherapy, financial
burden, stigma and myths related to cancer, issues regarding the personal cancer care,
etc. This has resulted in many cancer patients to present with increased severity
of their psychological problems, aggravation of preexisting mental health issues,
corona-related anxiety as a separate problem in addition to already diagnosed psychiatric
illness and newly experiencing anxiety in patients who are otherwise coping well with
cancer.[3]
[4] Few patients are found to have new appearance of symptoms of obsessive compulsive
disorder and depression during the corona pandemic.
Psychological problems are known to affect the overall treatment outcome, prognosis
and compliance to the cancer treatment,[5] and additional anxiety of suffering corona infection may further complicate the
course of cancer. It is therefore necessary to monitor all the cancer patients for
this additional anxiety during the corona pandemic.
Many patients are found to request their oncologists to reschedule their chemotherapy
or RT appointments which is happening from health care provider’s side also. Elective
surgeries are getting postponed either by surgeon or on the request of patient. Overall,
the decisions about cancer treatments are being changed or delayed due to this “fear
of corona infection” which can lead to the harmful consequences in cancer patients.
To reduce this fear, it is advisable for the cancer patients and their family members
to take all the precautions necessary to avoid contracting the corona infection including
frequent hand sanitization, wearing of mask while going out, avoid visiting others/going
out of home as far as possible, and not to listen the news related to COVID 19 every
now and then. Patients should seek help of mental health care provider whenever needed.
Cancer care providers also need to be sensitized about the psychological aspects of
corona infection in cancer patients, so that they can refer the patients needing specific
psychosocial care to mental health workers. Psychosocial interventions like reassurance,
supportive therapy, and cognitive behavioral therapy can be useful in this context
along with psychotropic medications if required.
There has to be certain guidelines in all the cancer institutions regarding the screening
and management of the mental health problems in cancer patients during the corona
pandemic, as, if left untreated, it may have long-lasting consequences besides a negative
impact on cancer outcome and compliance.
