The Psychological Impact of Therapeutic Changes During the COVID-19-Lockdown for Gynaecological and Breast Cancer Patients

Abstract

The psychological impact of therapeutic changes during the COVID-19-lockdown for gynaecological and breast cancer patients 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 patients (59.5%), postponed for 72 (35.1%) and cancelled for 11 (5.4%). During the lockdown period, 35 of 118 patients (29.7%) suffered from confirmed anxiety, fatigue and insomnia, with EORTC scores of 48.00 ± 2.51 and 42.13 ± 3.03 respectively. After the lockdown and compared to the lockdown period, the mental SF-12 score and overall health status EORTC score were significantly higher (p = 0.02 and 0.0007). The number of cases of confirmed anxiety was higher (p = 0.04) among patients for whom treatment was delayed (18 of 76 or 23.7%) or cancelled (17 of 42 or 40.5%). 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.