Background: The psychological impact of breast cancer diagnosis and management are well known, and the COVID-19 pandemic may have exacerbated this distressing experience for these patients.
Objective: We aimed to assess the supportive care outcomes and level of psychological distress experienced by breast cancer patients in our regional survivorship clinic during the COVID pandemic, in comparison to a pre-pandemic population. We also sought to determine whether using telehealth during the pandemic was preferred by oncology patients.
Methods: All 49 patients who attended the breast cancer survivorship clinic in 2019, and 50 patients who attended in 2021, were included in this study. Deidentified data was collected from the end of treatment care plan. We also collected self-reported scores on The National Comprehensive Cancer Network Distress Thermometer (DT). Patients with a self-reported DT score >4 were asked to complete the Kessler Psychological Distress Scale questionnaire as a secondary assessment of depression and anxiety.
Results: Breast cancer patients in the 2021 pandemic cohort recorded higher levels of distress (4.2/10) on the Distress Thermometer compared to the 2019 pre-pandemic cohort (2.4/10) (p= 0.0007). In the pandemic cohort, 38% of breast cancer patients reported a K10 score >16 indicating a moderate-to-high or threefold population risk of having a current anxiety or depressive disorder, compared with 12% of the patients in the pre-pandemic cohort. Patients in the pre-pandemic group most commonly identified physical concerns including fatigue (61%), poor sleep (43%), pain (33%) and neuropathy (31%). The key concerns of patients in the 2021 group were fatigue, anxiety, depression and fear of recurrence.
This study demonstrated the use of supportive care tools to identify breast cancer patients who are vulnerable to increased psychological distress during the COVID pandemic. It also highlights the need to address the limited access to psychological support services for cancer patients in Gippsland.