Perspective of Oncology Patients During COVID-19 Pandemic: A Prospective Observational Study From India

JCO Glob Oncol. 2020 Jun:6:844-851. doi: 10.1200/GO.20.00172.

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has imposed a unique challenge to oncology patients and their treatment. There is no study related to the patients' preference for systemic therapy during this pandemic. We have conducted a prospective study to analyze that aspect.

Methods: All consecutive patients who visited during the lockdown period from April 1-10, 2020, for systemic chemotherapy were included in the study for a questionnaire-based survey to evaluate the willingness to continue chemotherapy during this pandemic and factors influencing the decisions.

Results: A total of 302 patients were included (median age, 56 years; range, 21-77 years). Most common sites of cancer were breast (n = 114), lung (n = 44), ovary (n = 34), and colon (n = 20). Home address was within the city for 125 patients (42%), outside the city for 138 (46%), and outside the state for 37 (12%). Treatment was curative in 150 patients and palliative in 152. Educational status was primary and above for 231 patients and no formal schooling for 71. A total of 203 patients wanted to continue chemotherapy, 40 wanted to defer, and 56 wanted the physician to decide. Knowledge about COVID-19 strongly correlated with intent of treatment (P = .01), disease status (P = .02), knowledge about immunosuppression (P < .001), home location (P = .02), and education status (P = .003). The worry about catching SARS-CoV-2 was high in those with controlled disease (P = .06) and knowledge about immunosuppression (P = .02). Worry about disease progression was more with palliative intent (P < .001).

Conclusion: This study shows that oncology patients in our country are more worried about disease progression than the SARS-CoV-2 and wish to continue chemotherapy during this pandemic. The treatment guidelines in the COVID-19 scenario should incorporate patients' perspectives.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Immunological / adverse effects
  • Betacoronavirus / immunology*
  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / immunology
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / virology
  • Disease Progression
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Immunotherapy / adverse effects
  • Immunotherapy / methods
  • Immunotherapy / standards*
  • India / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / immunology
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Palliative Care / psychology
  • Palliative Care / standards*
  • Palliative Care / statistics & numerical data
  • Pandemics / prevention & control*
  • Patient Preference / psychology
  • Patient Preference / statistics & numerical data
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / virology
  • Practice Guidelines as Topic
  • Prospective Studies
  • SARS-CoV-2
  • Surveys and Questionnaires / statistics & numerical data
  • Young Adult

Substances

  • Antineoplastic Agents, Immunological