Study examines mental health in patients with NSCLC under COVID-19
Study examines mental health in patients with NSCLC under COVID-19

Study examines mental health in patients with NSCLC under COVID-19

Patients with non-small cell lung cancer (NSCLC) reported superior mental health during the COVID-19 pandemic compared to a control population that did not have cancer.

Cancer patients may be more resistant to COVID-19-related stressors, according to new research showing them with advanced non-small cell lunch cancer (NSCLC) coped with the pandemic better than many of their non-cancer peers.

The study, published in Journal of the National Comprehensive Cancer Networkrevealed that these patients exhibited less depression and anxiety than healthy peers, despite having to leave home regularly to receive treatment.

Patients with lung cancer are vulnerable to coronaviral pneumonia and acute respiratory distress syndrome, and if they become infected, they are at greater risk of dying from these complications, the authors explained. In addition, lung cancer deaths in the United States account for “25% more cancer deaths than deaths from prostate, breast, and colon cancer combined, in part because 84% of lung cancer patients are diagnosed at an advanced stage.”

To compare patients’ psychological responses at diagnosis and those under COVID-19, and to compare their coping responses with cancer-free controls from the same community, the researchers analyzed data collected in Ohio between April and July 2020.

All patients (N = 76) had stage IV NSCLC, and 67 controls with similar sociodemographic information and smoking histories were recruited. Participants completed the online questionnaire Brief Illness Perception Questionnaire, Patient Health Questionnaire-9 (PQH-9) and General Anxiety Disorder-7 (GAD-7) questionnaire using Qualtrics.

Those with NSCLC had a mean age of 62.6 years, were 40.8% women, were 80.3% white, and most of the tumors were adenocarcinoma (77.6%).

Analyzes revealed:

  • Depressive and anxiety symptoms in patients with NSCLC were greater at diagnosis (P <.02) than during COVID-19, approximately 1 year later
  • Patients and controls did not differ in terms of concern, understanding, or perceived control over COVID-19 (P > .406)
  • Patients with NSCLC reported significantly fewer depressives (β = -0.206; 95% CI, -4.142 to -0.355; P = 0.020) and anxiety symptoms (β = -0.196; 95% CI, -4.037 to -0.308; P = .023) than controls after control for breed group, age and smoking status
  • Controls expected the COVID-19 threat to last longer, practiced more social distancing, were more concerned about the family (P .04), and reported worse psychological symptoms (P <.023) than patients
  • For controls, COVID-19 was more prominent (ie, new, unexpected), increasing concerns and psychological symptoms

“It is important to understand and appreciate how patients with NSCLC with the most severe disease burden and symptom severity – those who are uniquely susceptible to COVID-19 infection and death – are emotionally and behaviorally able to travel to the hospital and receive treatment. , monthly if not weekly, “the researchers noted.

Before conducting the study, some investigators assumed that patients’ PHQ-9 and GAD-7 scores would be elevated. These notions were proven wrong when the authors outlined patients’ resilience to the pandemic, defining the term as “adapting well in the face of adversity, trauma, tragedy, threats, or significant stress.”

A potential explanation for the divergence in responses could be the fact that “COVID-19 for patients with NSCLC occurred in the midst of an ongoing life threat, comorbidities, symptoms, and routines already disrupted by receiving cancer treatment,” the authors wrote.

However, they stressed the importance of using the American Society of Clinical Oncology – recommended measures for depression and anxiety at the time of diagnosis and thereafter for patients with NSCLC.


Arrato NA, Lo SB, Coker CA, et al. COVID-19 cancer treatment: resistance in people with advanced non-small cell lung cancer versus community controls. J Natl Compr Canc Netw. Published online February 2022. doi: 10.6004 / jnccn.2021.7076

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