The cost of living with cancer during the second wave of COVID-19: A mixed methods study of Danish cancer patients' perspectives

Eur J Oncol Nurs. 2021 Jun:52:101958. doi: 10.1016/j.ejon.2021.101958. Epub 2021 Apr 18.


Purpose: This study investigated experiences and levels of distress and resilience of Danish cancer patients during the second wave of the COVID-19 pandemic.

Methods: The mixed methods design included a subset of cancer patients who responded to a cross-sectional survey in May 2020. Data were collected through telephone interviews. The National Comprehensive Cancer Network Distress Thermometer (NCCN DT), and Connor-Davidson-Resilience Scale (CD-RISC2) were used to measure distress and resilience. Data were analysed by thematic analysis and descriptive statistics.

Results: Forty patients with lung, breast, colorectal and skin (melanoma) cancer were included; 65% were women. Mean age was 62.2 years (standard deviation [SD], 13.2). Most patients had curable disease (65%); 50% were in treatment and 50% in post-treatment follow up. The interviews revealed four themes: 1) the cost of living with cancer during COVID-19, 2) changes in cancer care delivery, 3) particularly vulnerable, and 4) importance of family support. Mean NCCN DT score was 2.3 (SD, 2.6) while the mean CD-RISC2 score was 7.25 (SD, 1.1).

Conclusion: Despite drastic changes in daily life imposed by COVID-19 restrictions, Danish cancer patients had remarkably low levels of distress and high levels of resilience. Patients in active treatment, with comorbidities or elderly felt vulnerable. Family support was invaluable in critical times.

Keywords: CD-RISC2; COVID-19; Cancer; Distress; Experiences; Mixed-methods; NCCN DT; Qualitative; Resilience.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • COVID-19 / psychology*
  • Cross-Sectional Studies
  • Denmark / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy*
  • Pandemics
  • SARS-CoV-2
  • Stress, Psychological*