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The impact of cancer on mental health during COVID-19

by Hubert Bland, Executive Medical Director, Bristol Myers Squibb UK and Ireland

The COVID-19 pandemic has further highlighted mental health as a prominent topic in healthcare, with more than half of adults and over two-thirds of young people reporting that their mental health worsened during lockdown restrictions.1

But what does this mean for those who are already challenged by conditions such as cancer? Hear from Bristol Myers Squibb’s (BMS) UK and Ireland Executive Medical Director, Hubert Bland, who believes that to continue with a patient-centric approach to cancer care innovation, we must recognise the importance of mental health, and ensure that support is provided throughout the whole patient journey, including post-treatment.

The focus of the pharmaceutical industry has always been to provide innovative medicines to improve physical health and make long-term survival a possibility. Despite the milestones achieved through clinical research and scientific innovation, we, in the pharmaceutical industry, are now presented with new psychological challenges, as patients are experiencing the effects of diseases for longer.

A key area where this has become a fundamental challenge is in cancer. Over the last 40 years, we have seen the percentage of those living with cancer for more than 10 years double.2

Emerging figures highlight the disparities in the mental health support provided to cancer patients. According to findings from an All.Can UK* survey, only 50% of cancer patients could access the mental health support they required.3

Conversations around mental health have been pulled into the spotlight as a result of COVID-19, and we must address the added strain and impact on cancer patients’ psychological well-being. For cancer patients, not only has the pandemic added further pressure to mental health challenges associated with their treatment and diagnosis,4 but it has also resulted in exacerbated mental health support inefficiencies.5

The impact of cancer on the body and the mind

Through research, we now understand that there are multiple points in a patient’s cancer journey that may induce psychological distress.6 Whilst research findings show us that the reasons may be complex, we know that the link between cancer and mental health challenges is clear, with around 10% of cancer patients developing clinical levels of depression at some point in their journey.7

We know that 90% of patients will experience cancer-related fatigue,8 which may continue for months or even years after treatment and can have a large impact on the way patients handle day-to-day tasks. These physical issues can lead to patients feeling anxious and isolated, which is particularly emphasised post-treatment.7 They may withdraw from social situations, which only magnifies these negative feelings.

Cancer costs

We cannot discuss the distressing impact of cancer without highlighting the financial burden of treatment, which can also challenge patients’ mental health. Four out of five patients with cancer will incur a financial burden as a result of their diagnosis.9 Taking extended time off work is known to impact mental health;10 this may be due to the lack of routine and sense of purpose, with financial worries further increasing a patients’ stress levels.

The impact of a global pandemic

Over the last year, we have witnessed the disruption caused by the COVID-19 pandemic on cancer care in the UK, with many in the industry questioning the future of cancer care. A Macmillan report shows that more than 650,000 people are experiencing disruption and delays to their cancer treatment or care, meaning that those who are living with advanced cancer, and rely on regular treatment, are even more uncertain about the future.11

Patient group charities are fundamental in providing mental health support. However, a survey estimated that the charity sector is faced with a £12.4 billion shortfall from 2020.12 With more patients seeking support, and less funding to provide it, patient charities are struggling to cope, and as a result, so are cancer patients.

There is so much more to be done

The 2020 All.Can UK* report, Placing the psychological wellbeing of people with cancer on equal footing to physical health, highlights the current barriers to providing quality, accessible, personal mental health support to cancer patients in the UK, and how these barriers can be overcome to ensure all patients have access to holistic support throughout their cancer journey.3

It found that only 20% of respondents did not need some sort of psychological support during their care.3 Of those who did need support in the UK, half were unable to access it, compared to roughly a third internationally.3 It is clear from these results that significant barriers must be overcome if we are to accomplish our goal of enhancing the psychological support available for cancer patients in the UK.

All.Can UK, a collaborative working group of patient groups and industry experts including BMS set up to tackle inefficiencies in cancer care, proposed five recommendations to help improve mental health care during, and beyond, the COVID-19 pandemic:3

  • Mandatory training and support for the Multi-Disciplinary Team (MDT)
  • Early mental health assessments following cancer diagnosis
  • Increased awareness of the psycho-social interventions offered by the third sector
  • Avoidance of a ‘one size fits all’ approach to psycho-oncology services
  • Addressing regional variations in mental health support

As members of All.Can UK, we at BMS are calling for further collaboration in the healthcare industry to reduce the disparities in the quality and accessibility of mental health support for cancer patients in the UK.

It is vital we continue to strive for integrated and equal mental support for cancer patients, beyond providing effective treatments. By doing this, it is my hope that patients can focus on getting through treatment without added pressures.

We must highlight the crucial role patient organisations can play in providing psychological support for cancer patients and help them emphasise the support that is currently available for patients.

At BMS, we intend to work closely with these groups so that together, we can continue to transform patients’ lives. Through ongoing collaboration, I believe we can improve the level of psychological support available to cancer patients in the UK and provide quality, personal, integrated care for those living with cancer.

ONC-GB-2100023
April 2021

*Disclaimer:

All.Can UK is a multi-stakeholder initiative involving patient group and industry experts. In the UK, All.Can is funded by Bristol Myers Squibb (primary sponsor) and MSD (supporting sponsor).

All.Can UK is chaired by The Patients Association, a leading national charity which is dedicated to supporting the rights and interests of all patients and their families. The initiative brings together a collaborative working group of health charities to identify the current inefficiencies facing cancer services in the UK and to develop recommendations to help improve patient care through best practice implementation and long-term thinking.

If you would like more information on All.Can UK, please visit: https://www.all-can.org/national-initiatives/uk/

Hubert Bland is Bristol Myers Squibb’s UK and Ireland Executive Medical Director

References:

1Mind. 2020. The Mental Health Emergency. Available at: https://www.mind.org.uk/media-a/5929/the-mental-health-emergency_a4_final.pdf Last accessed April 2021.

2Cancer Research UK. 2021. Cancer Survival Statistics For All Cancers Combined. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/survival/all-cancers-combined#heading-One Last accessed April 2021.

3All.Can UK. 2020. Placing the psychological wellbeing of people with cancer on equal footing to physical health. Available at: https://www.all-can.org/national-initiatives/uk/#panel-pub-res Last accessed April 2021

4Cancer Research UK - How coronavirus is impacting cancer services in the UK. Available at: https://scienceblog.cancerresearchuk.org/2020/04/21/how-coronavirus-is-impacting-cancer-services-in-the-uk/ Last accessed April 2021.

5Nuffield Trust - What impact has COVID-19 had on mental health services? Available at: https://www.nuffieldtrust.org.uk/news-item/what-impact-has-covid-19-had-on-mental-health-services Last accessed April 2021.

6Macmillan, n.d. Psychological and Emotional Support. p.3. Available at: https://www.macmillan.org.uk/_images/psychological-and-emotional-support_tcm9-283186.pdf Last accessed April 2021.

7Mental Health Foundation Scotland, 2020. Supporting The Emotional And Mental Health Needs Of People With Cancer. p.10. Available at: https://www.mentalhealth.org.uk/sites/default/files/mh-needs-people-with-cancer.pdf Last accessed April 2021.

8Macmillan. 2020. Tiredness (Fatigue) - Macmillan Cancer Support. Available at: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/tiredness# Last accessed April 2021.

9Salter, J. and Wind-Cowie, M. 2013. Paying The Price. Demos, p.17. Available at: https://www.demos.co.uk/files/Paying_the_price.pdf?1385487417 Last accessed April 2021.

10World Health Organization. 2019. Mental Health In The Workplace. Available at: https://www.who.int/mental_health/in_the_workplace/en/ Last accessed April 2021.

11Macmillan. The Forgotten 'C'? The impact of COVID-19 on cancer care. Available at: https://www.macmillan.org.uk/assets/forgotten-c-impact-of-COVID-19-on-cancer-care.pdf Last accessed April 2021.

12Institute of Fundraising. 2020. Charities Are Facing A £12.4Bn Shortfall In Income For The Year. Available at: https://ciof.org.uk/events-and-training/resources/charities-facing-%c2%a312-4bn-shortfall-in-income-for-t Last accessed April 2021.

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10th May 2021

From: Healthcare

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