Focusing on Lung Cancer Management and Palliative Care During the COVID-19 Pandemic

Web Exclusives —April 2, 2021


Lung Cancer

There have been many challenges to the distribution of healthcare resources due to the COVID-19 pandemic. Because there has been a surge in cases, with a high volume of patients requiring hospitalization and treatment in the intensive care unit, clinicians have been redeployed to oversee COVID-19 treatment and have moved beyond the purview of their original area of expertise and training. Oncology patients’ care has therefore potentially been compromised.

Patients with multiple comorbidities, as well as cancer patients and the elderly, are at high risk of developing COVID-19–related morbidity and mortality. Reported mortality rates vary; according to a 1-month, retrospective review of 1878 medical records of COVID-19 patients who had detectable cumulative evidence of lung cancer, patients with lung cancer have a higher mortality rate than the general population, as demonstrated by the fact that patients with lung cancer and a COVID-19 diagnosis died disproportionately (52.3%).1

Numerous severe COVID-19 risk factors can be observed in the cluster of patients with lung cancer: cancer itself, treatment is often immunosuppressive, a high median age (>70 years), frequent history of smoking, as well as a high proportion of comorbidities.

Further exacerbating the risk of contracting COVID-19 is the fact that outpatient clinics, daycare, and hospital visits serve as potential vectors for the spread of the virus.

To reduce COVID-19 risk, it is therefore critical for clinicians to evaluate the risk and benefit for all lung cancer treatments, particularly intravenous systemic anticancer therapies that generally require a team of healthcare providers to administer.2

There is a clear need to define the risks and benefits of diagnostic and treatment strategies for lung cancer, particularly in light of the coronavirus pandemic. Additionally, during the COVID-19 pandemic, palliative care for non-COVID lung cancer patients is a critical concern.

From a psychological perspective, COVID-19 has increased anxiety generally, but also regarding potential treatment changes required due to hospital and clinical priorities. Furthermore, the pandemic has increased social isolation and depression, and minimized face-to-face contact between patients and physicians. Telemedicine has played a role in assisting clinicians with overcoming psychological concerns for patients. Video applications have been used to support patients who lacked social networks and were challenged by social distancing guidelines.

Patients who have been challenged spiritually and lost a sense of meaning in life may be encouraged to seek local spiritual counselors or partners.

The coronavirus pandemic has impacted healthcare systems, reducing face-to-face contact, and caused a shortage of resources globally. This has been particularly challenging in the palliative care setting for patients with lung cancer. Clinicians have tried to maintain the best possible scenario, considering these particularly challenging circumstances, by rapidly modifying their guidelines based on the changing conditions and deploying new communication tools, such as telemedicine.

Maintaining resilience and flexibility of the healthcare system as well as healthcare providers, has been a critical take-away message that will extend well beyond the pandemic.


Schoenmaekers JJAO, Hendriks LEL, van den Beuken-van Everdingen MHJ. Palliative care for cancer patients during the COVID-19 pandemic, with special focus on lung cancer. Front Oncol. 2020;10:1405.


  1. Rogado J, Pangua C, Serrano-Montero G, et al. Covid-19 and lung cancer: a greater fatality rate? Lung Cancer. 2020;146:19-22.
  2. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21:335-337.
Related Articles
American Cancer Society Cancer Action Network Releases Recommendations to Increase Cancer Biomarker Testing
Web Exclusives
The American Cancer Society Cancer Action Network has published data that demonstrate there are multiple barriers to biomarker testing access and released recommendations that address these barriers.
Sotorasib Demonstrates Efficacy in CodeBreaK 100 Phase 2 Study Results
Web Exclusives
Sotorasib has shown promising antitumor activity in phase 2 of a clinical trial of patients with heavily treated advanced NSCLC.
Results of an International Study Identify Barriers to Molecular Testing in NSCLC
Web Exclusives
Recently released survey responses identified multiple barriers to, and dissatisfaction with, the current state of molecular testing in lung cancer.
Last modified: April 2, 2021

Subscribe to the Journal of Oncology Navigation & Survivorship®

To sign up for our print publication or e-newsletter, please enter your contact information below.

  • First Name *
    Last Name *
    Profession or Role
    Primary Specialty or Disease State
  • Please enter your mailing address.

    Address Line 2
    Zip Code