How COVID-19 Has Impacted Anxiety, Mental Health in Patients with Cancer

Patients with cancer struggle with anxiety frequently. In fact, according to Dr. Scott Irwin, at least 80% of patients experience an increase in anxieties during their initial diagnosis.

Patients develop anxieties about what will happen to them in the future, how they’re going to get through treatment and much more. And although many of those anxieties disappear not long after diagnosis, there is still a percentage of patients who battle consistent anxiety. Imagine throwing an additional layer into the mix with a pandemic, the likes of which the world has not seen in a century.

In an interview with CURE®, Dr. Scott A. Irwin, director of the patient and family support program at Cedars-Sinai Medical Center, discussed the common anxieties patients with cancer experience, how the COVID-19 pandemic has added additional layers to a patient’s anxiety, as well as, how some patients have reported feeling less anxious.

Transcript:

Patients with cancer have lots of anxieties and at initial diagnosis at least 80 percent if not more have heightened anxiety about what the future is going to hold, what this means, what the treatment is going to be, how they're going to get through treatment and if and how they will come out on the other side.

For most people that actually really subsides within a month, but for about 20 percent of people they continue to have heightened anxiety and it's around any of those things, treatment-related side effects, how well the treatment is working, what their prognosis is going to be and then lots of practical issues, how am I going to get to the cancer center to get my treatments, what's going to happen with work, who is going to take care of my kids, just about anything you could imagine. Very similar to how we've actually had to change our lives with COVID-19 now. Lots of little things in our lives have become big things in our lives, that we focus our attention on and may be anxious about, like how to get toilet paper.

As you know, people with medical illnesses are at higher risk for worse outcomes with COVID-19. Many cancer patients, because of their treatments, have lowered immune systems so this has really impacted our patients because they still need to come to the cancer center to get their treatments, if they're beyond treatment or on a treatment that's once every three weeks, they can stay away and we're doing our office visits by video, but if you need chemo or radiation you have to come in so anything we can do to mitigate the anxiety to demonstrate that we're being as safe and cautious as possible with them really helps. But they are afraid to leave their house, for some that's leading to a lot of loneliness, I mean we're all to some extent afraid to leave our house, but they really don't want to be around other people.

Interestingly though, I have a handful of patients that actually say their anxiety is better, and I wonder if that's because a lot of things in our lives that we have had to focus on, like commuting are no longer part of the picture. So, it's been interesting to me that some patients actually are feeling a little bit better. Maybe not having to deal with as much outside of their cancer and then protecting themselves at home.

I think number one, trying to think about what's leading to having less anxiety, what are the things that are missing now where anxiety may have been heightened before and is not now, and how do we better cope with those issues or mitigate those issues, or avoid those issues going forward, at least during the cancer experience. At least many of us, if not all of us, have stresses in our lives that we just have to we can't avoid. For example, if you have to get your kids to school on your way to work and deal with traffic and the commute, especially here in Los Angeles, that's not going to go away once we go back to work. So, how do we better cope with that reality? What things can we put in place to lower that stress?

The flip side and you asked about the impact on health, is that anxiety in general, for any of us, whether you have cancer or not, has negative consequences for our physical health. It lowers our immune system, it makes us more susceptible to illnesses, it worsens cancer care outcomes, patients sometimes struggle to make important decisions because they're anxious, which can delay care and treatment or keep them from getting the treatment that they need.