Psychological Impact of Corona on Mental Health of Cancer Patients

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.34 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.