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The health crisis in recent months has caused an increase among the general public of unpleasant emotions like anxiety, uncertainty or fear. Furthermore, a lot of people have not followed any routine and have suffered stress due to having to manage telework, loss of employment, problems in family relationships with partners or children, and so on. But what has happened to people who were surprised by the pandemic while already in a stressful, uncertain situation due to a diagnosis of a disease like cancer?

 During the health emergency, cancer patients were also identified as high-risk, on top of the situation that this group of people already found themselves. Now, during the easing of lockdown, some patients continue to be afraid and, given this, Marta de la Fuente, head of the Psycho-Oncology Service at MD Anderson Cancer Center Madrid, points out that the important thing is “to accompany patients in their emotional process - understand, without judging or putting pressure on them, offering flexibility and confidence”. As she explains, “we have not all been exposed in the same way by going out and that is why it is important that each person ease the conditions of lockdown at their own pace - there is a fine line between caution and risk”.

 An important aspect is not to encourage fearful behavior or create apprehension, not to limit the patient. Unless the patient is behaving recklessly, "it is vital not to transfer our fears, anxieties and phobias", stresses Ms. de la Fuente, who does recommend listening and being there. “When someone is suffering from anxiety, you have to try to reassure them, but listening to and respecting the concerns and fears that this person may have, without quarreling, lecturing or arguing", she explains.

 In any case, the psychologist does not believe that all cancer patients have lived this situation in the same way and describes two clear profiles. "For many patients it has been hard to bear, as they have felt more vulnerable and afraid, and have found it difficult to manage the uncertainty of having to postpone tests or medical treatments".

Other patients, on the other hand, have not felt their symptoms of stress increase, but have taken advantage of their coping strategies to deal with the uncertainty, which they had developed while ill with cancer, to manage the situation better than the general public in many cases. "A lot of patients already had personal strategies", explains the specialist in psycho-oncology, who points out that "it is true that these patients have fears, but they are rational, objective fears because they are high-risk, so they are normal and adaptive, it is important to help so that these fears do not interfere too much with their everyday life”.

 In pointing out this difference, Ms. de la Fuente considers that personality traits and emotional state also play a role, as well as the stage of the cancer or the type of tumor (whether it is related to the respiratory system or not); however, she does not believe that age is relevant. "There are patients who think they are in the final phase of their life and are not afraid, while there are others who, at the same age, want to live and are, therefore, more afraid", Ms. de la Fuente points out.

A gradual return to routine, the key to successfully easing lockdown

The key to getting out of this situation in a well adapted manner is, as far as possible and complying with protective measures, to get back to our habitual routines, gradually getting back to our normal lives. A normal life that includes our personal relationships, but also a return to health centers.

Here, it is important for patients to see what measures are being taken in hospitals and health centers to guarantee their safety. "If patients see that we are wearing masks, that we disinfect spaces and respect social distancing, they will feel safer," says Ms. de la Fuente, who also urges the general public to resume their regular check-ups. "It is important to give information and remind the public of the incidence of cancer so that people continue to attend their screening appointments," says Ms. de la Fuente, who states that, although being afraid is normal, we have to begin to face them little by little so that they do not stop us living our lives”.

30% of psycho-oncology consultations are now by video call

 Feelings of fear, anguish and uncertainty are completely normal, adaptive and necessary, since they fulfill a function. The problem is when these feelings become destructive and, as Ms. de la Fuente explains, “become very intense, they last a long time, we feel we cannot control them, they overwhelm us and affect us significantly". In these cases, consulting a Psycho-oncology Service like that at MD Anderson Madrid is recommended. la Fuente and her team are currently working with the aim of helping cancer patients regain normalcy in their lives and, due to the situation, 30% of consultations are now made by video call or by phone, which more and more people are opting for. "Now we have to speak with a mask on and at two meters distance, so the video call for consultations where facial expression is so important, is a very good option", stresses Ms. de la Fuente, who also says that many patients prefer the online option