The psychological impact of therapeutic changes during the COVID-19-lockdown for gynaecological and breast cancer patients.

J Gynecol Obstet Hum Reprod

Department of Obstetrics and Gynaecology Surgery, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France; LabTAU, Unité INSERM U 1032, Université Claude Bernard Lyon 1, Lyon, France.

Published: March 2022

AI Article Synopsis

  • The COVID-19 pandemic led to significant changes in gynaecological cancer care, prompting a study to evaluate the psychological effects of these modifications on patients during the lockdown period in France.
  • In a study of 205 patients, treatment was maintained for 59.5%, delayed for 35.1%, and cancelled for 5.4%, with notable levels of anxiety (29.7% reported) and fatigue during the lockdown.
  • Post-lockdown, patients reported improved mental health scores, but those with delayed or cancelled treatments experienced higher anxiety levels, indicating that treatment changes had a lasting psychological impact.

Article Abstract

Objective: The exceptional health situation related to the Coronavirus 2019 (COVID-19) pandemic has required an in-depth and immediate reorganisation of gynaecological cancer care. The main objective was to assess the psychological impact of such treatment modifications during the lockdown period for gynaecological and breast cancer patients.

Patients And Methods: A multicentre prospective study was conducted in three university gynaecological cancer wards (Hospices Civils de Lyon, France) during the French first lockdown (16th March to 11th May 2020). All patients with non-metastatic breast cancer or gynaecological cancer were included. Data was collected regarding treatment modifications (delay, cancellation, change of therapeutic plan). The psychological impact of treatment modifications during and after the lockdown was assessed by validated questionnaires (SF-12, EORTC-QLQ-C30, HADS).

Results: A total of 205 consecutive patients were included, aged 60.5 ± 1.0 years. Seven patients (3.4%) presented a SARS-CoV-2 infection, and two patients died. Treatment was maintained for 122 (59.5%) patients, postponed for 72 (35.1%) and cancelled for 11 (5.4%). During the lockdown, 35/118 (29.7%) patients suffered from confirmed anxiety and the mean fatigue-EORTC score was 48.00 ± 2.51; it was 38.64 ± 2.33 (p = 0.02) after the lockdown. After the lockdown and compared to the lockdown period, the mental SF-12 score and overall health status EORTC score were significantly higher (45.03 ± 1.06 vs 41.71 ± 1.15, p = 0.02 and 64.58 ± 1.66 vs 57.44 ± 2.02, p = 0.0007, respectively). The number of confirmed-anxiety cases was significantly higher amongst patients for whom treatment was delayed or cancelled (40.5% vs 23.7%, p = 0.04).

Conclusion: This study quantified the treatment modifications of gynaecological cancer patients during the COVID-19 lockdown and revealed a poorer psychological state and quality of life during this period, even for patients whose treatment plan was not actually modified. Anxiety was more significant in patients with a delayed or cancelled treatment.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739811PMC
http://dx.doi.org/10.1016/j.jogoh.2022.102311DOI Listing

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