Cancer Patients' Psychological Enemies During the Coronavirus Pandemic

The outbreak caused by the novel coronavirus, which began in China at the end of 2019, spread rapidly around the world, and in March a COVID-19 pandemic was declared. COVID-19 affects people negatively not only physically but also psychologically and socially, and cancer patients are particularly exposed to this emotional threat. In addition, psychosocial problems and needs have increased for all of us because of the pandemic. Isolation stress, together with cancer patients' concerns, may have caused these needs to increase further.

Research Assessing the Psychology of Cancer Patients in the COVID-19 Era

In March 2020, a psychological study of 1090 cancer patients and their families in Hubei Province (the province with the highest concentration of COVID-19 cases in China) found that, since the emergence of COVID-19, 43.8% of cancer patients identified as having psychological problems had requested psychosocial support. The increase in requests for psychological support during the COVID-19 outbreak shows that patients had recognized the importance of psychological health.

In this study, psychologists conducted interviews assessing the patient's general condition, emotions (anxiety, depression), sleep patterns, pain intensity, and the impact of the COVID-19 outbreak.

The most common psychosocial problems identified in cancer patients during COVID-19 were:

• sleep disorders (33.3%),
• emotional problems (23.3%),
• poor physical condition (13.3%), and
• economic problems (10%).

In the interviews, patients said that during the COVID-19 outbreak, the high rate of anxiety and depression resulted from the following main reasons:

• Patients' concerns about delays in treatment
• Patients' concerns about becoming infected with coronavirus
• Patients' concerns about the negative economic impact of the COVID-19 outbreak on themselves and their families
• Lack of social support
• Misunderstandings about information related to COVID-19
• Breakdown in communication with healthcare workers

What Are the Psychological Enemies?

• To limit the spread of the virus, social closeness and physical contact were restricted.
• In addition, mandatory mask wearing removed a fundamental human connection, smiling, from our lives.
• These factors disrupted the channel of empathetic communication with the social environment and even with healthcare workers.
• The result is a profound sense of loneliness.

Because of the constant media coverage of the COVID-19 outbreak, fear can rise rapidly. Because cancer patients may be susceptible to severe COVID-19, their fears may resist reassurance. Patients may also fear that doctors' attention to them will decrease because of the outbreak, which may lead them to believe that they are receiving inadequate treatment. Cancer patients may also worry that those caring for them could be a source of infection. For example, hospitals represent places where patients receive medical care but also where COVID-19 can be transmitted.

When a cancer patient feels that their life is in danger, the feeling of helplessness can be particularly devastating. Moreover, by creating a conflict between expectations and reality, helplessness can weaken the patient's trust in their doctor and worsen feelings of loneliness.

These days, many cancer patients face bad news from two areas: oncology and the pandemic.

When multiple adverse circumstances accumulate, strain increases, and feelings of hopelessness may even increase. This perception can trigger a complex, dynamic range of emotions such as anger, sadness, and depression. These emotions were described by Kübler-Ross in 1970 as emotional siege.

Conclusion and Suggested Solutions

We can say that loneliness, fear, helplessness, and emotional siege constitute the psychological threats COVID-19 poses to cancer patients.

When addressing the psychology of cancer patients during COVID-19, attention should be paid to the following:

• The loneliness experienced by cancer patients requires special attention.
• To alleviate this loneliness, every effort should be made to facilitate communication between patients and their loved ones (for example, providing smartphones or tablets for video calls).
• In addition, providing online therapy can create a real and irreplaceable support network for cancer patients.

Communication with healthcare workers has become even more important during this period; patients and their relatives should not decide on their own to postpone or cancel treatments and checkups.

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