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Loneliness, Anxiety Felt by Many People With Cancer During COVID-19 Pandemic

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More than half of people who have been diagnosed with cancer feel lonely, most likely as a result of social distancing and isolation during the COVID-19 pandemic, according to a small study.

The research was published online on April 27, 2021, by the journal Cancer. Read the abstract of “Loneliness and symptom burden in oncology patients during the COVID-19 pandemic.”

Impact of loneliness
About the study
What this means for you

Impact of loneliness

While the effect of loneliness on cancer outcomes hasn’t been thoroughly studied, researchers know that feeling lonely and socially isolated can damage your health. One researcher has suggested that loneliness is more dangerous than obesity1 and as damaging to health as smoking 15 cigarettes a day.2

Other research suggests that having social connections can influence how well people stick to their treatment plans and can positively affect blood pressure, immune system function, and inflammation.

The researchers who did this study wanted to see how lonely a group of people with cancer felt, as well as identify any factors linked to loneliness.

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About the study

The study included 606 people who were diagnosed with cancer. Most were diagnosed with breast cancer:

  • 82.8% were diagnosed with breast cancer
  • 4.7% were diagnosed with gastrointestinal cancer
  • 0.2% were diagnosed with lung cancer
  • 0.2% were diagnosed with malignant melanoma
  • 1.5% were diagnosed with gynecological cancer
  • 3.7% were diagnosed with prostate cancer
  • 7.0% were diagnosed with more than one type of cancer listed above or with another type of cancer
  • 25.4% were diagnosed with metastatic cancer (cancer that has spread to other parts of the body away from the original site)

The people in the study filled out an online survey that asked about:

  • demographic information (age, marital status, living arrangements, etc.)
  • how well they were able to do daily activities
  • any other health conditions they had
  • cancer diagnosis and treatment
  • cancer symptoms and treatment side effects
  • height and weight
  • feelings of loneliness and social isolation

Based on the survey results, the researchers classified 53.0% of the people in the study as lonely. Compared with people who weren’t lonely, lonely people were more likely to:

  • be younger
  • be unmarried or unpartnered
  • live alone
  • have a lower annual household income
  • have difficulty doing daily activities
  • have other health conditions
  • say they felt depressed
  • have back pain
  • have more severe side effects and cancer symptoms, including anxiety, depression, fatigue, problems sleeping, problems thinking and remembering, and pain

The researchers noted that studies done before the COVID-19 pandemic found that 32% to 47% of people diagnosed with cancer were lonely. This new study strongly suggests that the number of people diagnosed with cancer who feel lonely has gone up because of the pandemic.

In a statement about the study, the researchers stressed that doctors should ask their patients about feelings of loneliness, and people should report any feelings of loneliness and anxiety to their primary care doctors or oncologists.

“Patients may warrant referrals to psychological services to assist with symptom management,” said lead author Christine Miaskowski, R.N., Ph.D., FAAN, of the University of California, San Francisco. “In addition, to decrease these feelings, patients and survivors can develop a schedule of social interactions; develop a structure to their daily activities; engage in regular exercise particularly in the outdoors; use stress reduction exercises; and eat a healthy diet.”

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What this means for you

Based on comments in the Breastcancer.org Discussion Boards, we know that the COVID-19 pandemic made many of you feel lonely and isolated.

Kelly Grosklags — licensed clinical social worker, board-certified diplomate in clinical social work, and fellow of the American Academy of Grief Counseling — told Breastcancer.org that she also heard from people diagnosed with cancer who felt very anxious about the pandemic.

“But when they take a step back, many people are realizing that they have the tools that they developed already [by] going through [a] health crisis, going through the loss, that they’re relying on now,” she said. “It can feel really isolating... but I want to reiterate that we are actually in this together. This is truly an experience that probably most of us in our lifetime have never experienced where we can relate to people, and we’re in this. And we’re all impacted maybe a little differently. Some of us are losing our jobs, some of us have another preexisting health condition that’s compounding the fear. But if we step back for a minute, if we can realize that we’re all in this together, I think that in itself can be a form of support.”

If you’ve been diagnosed with breast cancer and are feeling lonely and anxious for any reason, here are some tips from Grosklags on how to have social and emotional connections while maintaining physical distance, especially if you are being treated with therapies that can weaken your immune system:

  • If you have access to technology, use Google Hangouts, FaceTime, Facebook, Messenger, and even phone calls to stay in touch with your family and friends or to continue meeting with your support group virtually.
  • If you want to join a virtual support group but have no internet access, have someone who does call you on the phone and put you on speakerphone so you can still participate.
  • Send cards and letters to people. It’s not face-to-face, but sharing your feelings in writing goes a long way in helping people feel cared for and connected.
  • Be intentional about asking people about topics other than cancer and the pandemic.

We also asked the Breastcancer.org Community how they were coping with isolation and loneliness during the pandemic. Here’s what has worked for them:

  • Go outside if you can: Walking in your neighborhood, going to the dog park, and taking the kayak out boosted many of our community members’ moods.
  • Exercise inside: Many of our community members committed to making exercise part of their daily routines. Whether it was using the mini trampoline or taking yoga or other fitness classes online, our community members said working out helped them feel better. One person even pulled out old Richard Simmons videos.
  • Experiment with cooking new things: Many of our community members told us they dug up recipes they had never had the time to try out before.
  • Connect with people virtually: From a Facebook virtual sing-along group to prayer group texts, our community members used technology to keep in touch with loved ones.

For more information on coping with loneliness and anxiety during the pandemic, listen to the Breastcancer.org Podcast episode with Kelly Grosklags.

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Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser

References

  1. Holt-Lunstad, J. The Potential Public Health Relevance of Social Isolation and Loneliness: Prevalence, Epidemiology, and Risk Factors. Public Policy & Aging Report; Jan. 2018. Available at: https://doi.org/10.1093/ppar/prx030
  2. Human Resources & Services Administration. The “Loneliness Epidemic.” Available at: https://www.hrsa.gov/enews/past-issues/2019/january-17/loneliness-epidemic

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