Abstract
The coronavirus disease 2019 (COVID19) pandemic has overwhelmed healthcare systems and disrupted patient care worldwide. Thoracic cancer patients are at increased risk of morbidity and mortality due to underlying malignancy and immunosuppressive anti-cancer therapies, in combination with older age, smoking habits, and pre-existing lung disease. The objective of the TERAVOLT-PAPER survey is to understand thoracic cancer patients’ perceptions of the impact of COVID19 on their cancer thereby informing providers of efforts needed to encourage ongoing care. Adults with a diagnosis of NSCLC, SCLC, mesothelioma, thoracic carcinoid and/or thymoma from TERAVOLT-affiliated institutions and advocacy organizations were invited to complete an anonymous, multilingual web-based survey. As of April 2021, 156 patients have participated. Of the total responses received in each survey field: 57% female, 60% over 60 years old, 64% white, 51% current or former smokers, 64% with undergraduate-level education or higher, and 38% have not received the flu vaccine in the past 12 months. 68% of respondents were on active anti-cancer treatment, majority (68%) on palliative therapy. While most (76%) reported no impact of COVID19 on their treatment schedule, those who experienced delays more commonly reported them to be at the physician’s decision vs patient request (17% vs 4%). Among those with delays, 52% did not feel these delays would impact their long-term cancer care. As for 32% of respondents undergoing surveillance, 70% reported no change in their appointment schedule, 18% reported delays at the physician’s decision, and 2% delays at patient request. Among those with delays, most respondents either did not feel these changes would impact their long-term cancer care (36%) or were uncertain of the impact (36%). The risk of contracting COVID19 is a major concern with 59% of respondents worrying about this “often” or “always” and 55% changing how frequently they go to their cancer center. Only 5% have considered stopping their anti-cancer therapy due to COVID19. Most respondents (60%) reported no change in the format of their appointments, compared to 20% and 14% who reported increased use of phone and video visits, respectively. Although 21% of respondents felt that having virtual appointments affected their cancer care negatively, most reported either no impact (61%) or a positive impact (13%) on their care. Regarding patient knowledge about the impact of cancer/anti-cancer therapy on risks of COVID19, 69% and 62% believed that having cancer and being on treatment increases severity of COVID19 illness, respectively. Up to 25% of respondents reported not knowing the impact of their cancer diagnosis/treatment. Despite the known impact of the pandemic on patient care, our global survey illustrates that most thoracic cancer patients do not perceive that their overall cancer care has been compromised. Virtual appointments will continue to be useful in light of patients’ concerns about COVID19. Considering the high proportion of respondents indicating uncertainty, continued patient education regarding the impact of cancer and anti-cancer therapies on risks of COVID19 is critical during this challenging time. Data collection is ongoing and updates will be presented.
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