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Patients’ experiences undergoing cancer surgery during the COVID-19 pandemic: a qualitative study

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Abstract

Purpose

This study aimed to understand patients’ experiences undergoing cancer surgery during the COVID-19 pandemic. In response to COVID-19, many elective cancer surgeries were delayed creating a massive backlog of cases. Patients’ experiences with surgical delays may inform healthcare systems’ responses to the backlog of cases and guide preparations for future healthcare emergencies.

Methods

This was a qualitative description study. Patients undergoing general surgery for cancer at two university-affiliated hospitals between March 2020 and January 2021 were invited to one-to-one interviews. Patients were purposefully selected using quota sampling until interviews produced no new information (i.e., thematic saturation). Interviews were conducted using a semi-structured guide and analyzed according to inductive thematic analysis.

Results

Twenty patients were included [mean age 64 ± 12.9; male (n = 10); surgical delay (n = 14); cancer sites: breast (n = 8), skin (n = 4), hepato-pancreato-biliary (n = 4), colorectal (n = 2), and gastro-esophageal (n = 2)]. When determining their willingness to undergo surgery, patients weighed the risk of COVID-19 infection against the urgency of their disease. Changes to the hospital environment (e.g., COVID-19 preventative measures) and deviations from expected treatment (e.g., alternative treatments, remote consultations, rescheduled care) caused diverse psychological responses, ranging from increased satisfaction to severe distress. Patients employed several coping strategies to mitigate distress, including eliciting reassurance from care providers, seeking information from unconventional sources, and reframing care interruptions.

Conclusions

Changes in care during the pandemic elicited diverse psychological responses from patients undergoing cancer surgery. Coping was facilitated by consistent communication with providers, emphasizing the importance of patient-centered expectation setting as we prepare for the future within and beyond the pandemic.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This study was supported by a grant from the McGill University Health Centre (MUHC) Foundation awarded to JF. The study funders had no role in project development, data collection or analysis, writing of the report, or the decision to submit this article for publication. The remaining authors have no sources of financial support to disclose.

Author information

Authors and Affiliations

  1. Division of Experimental Surgery, McGill University, Montreal, QC, Canada

    Makena Pook, Maxime Lapointe-Gagner, Philip Nguyen-Powanda, Lawrence Lee, Liane S. Feldman & Julio F. Fiore Jr

  2. Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 1650 Cedar Ave, H3G 1A4, Montreal, QC, Canada

    Tahereh Najafi, Lawrence Lee, Liane S. Feldman & Julio F. Fiore Jr

  3. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada

    Tahereh Najafi, Hiba Elhaj, Pepa Kaneva, Lawrence Lee, Liane S. Feldman & Julio F. Fiore Jr

  4. Department of Systems and Computer Engineering, Carleton University, Ottawa, ON, Canada

    Fateme Rajabiyazdi

  5. Department of Surgery, McGill University, Montreal, QC, Canada

    Lawrence Lee, Liane S. Feldman & Julio F. Fiore Jr

Authors
  1. Makena Pook
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  10. Julio F. Fiore Jr
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Contributions

All authors contributed to the study conception and design. Makena Pook and Maxime Lapointe-Gagner performed data collection. Makena Pook, Tahereh Najafi, Maxime Lapointe-Gagner, and Philip Nguyen-Powanda performed data analysis. Tahereh Najafi, Hiba Elhaj, Pepa Kaneva, Fateme Rajabiyazdi, Lawrence Lee, Liane S. Feldman, and Julio F. Fiore Jr. oversaw the study conduct and contributed to data interpretation. Makena Pook prepared the first draft of manuscript and all authors provided revisions and feedback on previous versions of the manuscript. All authors reviewed and approved of the final manuscript. All authors agree to be accountable to all aspects of the work.

Corresponding author

Correspondence to Julio F. Fiore Jr.

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Competing interests

The authors declare no competing interests.

Conflict of interest

JF has received research funding from Merck Canada. The remaining authors declare no competing interests.

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Pook, M., Najafi, T., Lapointe-Gagner, M. et al. Patients’ experiences undergoing cancer surgery during the COVID-19 pandemic: a qualitative study. Support Care Cancer 31, 400 (2023). https://doi.org/10.1007/s00520-023-07861-w

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