Patient Advocate Lisa Briggs on Impact of Depression, Anxiety, and Distress in Patients With Thoracic Malignancies During the COVID-19 Pandemic

Lisa Briggs

Lisa Briggs, STARS participant

The collateral damage of the COVID-19 pandemic in lung cancer care is real. This pandemic has highlighted a number of challenges faced around the world that require immediate attention. The abstract by Dr. Arrieta and colleagues (OA17.03) provides critically needed data regarding the psycho-emotional effects of the COVID-19 pandemic and the consequential delays in medical care for the Latin American population. Delays were defined as a change in primary treatment due to the originally planned treatment not being possible during pandemic conditions. It was quite a large study, which recruited 548 patients. The study appeared to have broad eligibility criteria by including all thoracic cancers and all clinical stages. Not surprisingly, non-small cell lung cancer was the most common cancer type featured, and patients with the most advanced stages of that disease were the majority of those included. Given that late-stage diagnoses and the associated higher rates of anxiety and depression that accompany them, are already common problems faced within the lung cancer community, this study is exceedingly relevant. It was pleasing to see that, although anxiety was reported more commonly than depression, it was not found to be associated with direct delays in care. However, the same could not be said for patients with depression, who had a significant chance of delays to their treatments. Changes in treatment were reported by almost one-quarter of all patients, with almost 80% of these changes being direct results of the pandemic. Unfortunately, changes to primary treatment were also associated with poorer overall survival rates. This highlighted a clear correlation among mental health status, delays in medical care, and survival outcomes.

The mental health challenges experienced by patients as a result of a lung cancer diagnosis are well documented. However, this is uncharted territory when compounded by the effects of a global pandemic and highlights the need for appropriate support systems to be put into place to help patients manage their mental health needs more effectively. Therefore, as a patient advocate, I would encourage medical professionals to identify their patients’ mental health needs promptly, referring them to the appropriate psychological interventions at the earliest point in their care and following up to ensure the uptake is successful. Similarly, I would also advocate that patients prioritize their mental own health as much as they would their physical health, by communicating with their health care team about their psychological and emotional needs, joining support groups or self-referring to psychological care if appropriate.

As patients with lung cancer already present as a vulnerable population group with traditionally poorer survival outcomes, we do not have time to wait. Delays in care have devastating outcomes for both the individual and their loved ones and should be avoided where possible. With this in mind, careful consideration must be given when weighing up the risks versus benefits of treatment modifications and delays in the context of the global pandemic.