Document Type : Letter to the Editor


1 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

2 Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

3 Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran

4 Department of Psychiatry, Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran


How to cite this article:

Azizi M, Kamali M, Zaboli E, Elyasi F. Cancer and COVID-19: the synergistic burden on mental health status of patients with cancer. Middle East J Cancer. 2022;13(4):729-32. doi: 10.30476/mejc.2021.88707.1489.

1.Brunning H. Psychoanalytic reflections on a changing world. 1st ed. Routledge, Karnac Books; 2011. p.1-298.
2.Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894-901. doi: 10.1016/j.annonc.2020.03. 296.
3.Shankar A, Saini D, Roy S, Mosavi Jarrahi A, Chakraborty A, et al. Cancer care delivery challenges amidst coronavirus disease - 19 (COVID-19) outbreak: Specific precautions for cancer patients and cancer care providers to prevent spread. Asian Pac J Cancer Prev. 2020;21(3):569-73. doi: 10.31557/APJCP. 2020.21.3.569.
4.Motlagh A, Yamrali M, Azghandi S, Azadeh P, Vaezi M, Ashrafi F, et al. COVID19 prevention & care; A cancer specific guideline. Arch Iran Med. 2020; 23(4):255-64. doi: 10.34172/aim.2020.07.
5.Shahi F, Mirzania M, Dabiri M, Seifi S, Bary A, Ansarineja N, et al. Modifications in breast cancer guidelines in COVID19 pandemic; An Iranian consensus. Arch Breast Cancer. 2020;7(1):14-7. doi: 10.32768/abc.20207114-21.
6.Wei W ZD, Lei Y, Wu S, Verma V, Liu Y, Wei X, et al. Radiotherapy workflow and protection procedures during the coronavirus disease 2019 (COVID-19) outbreak: Experience of the Hubei cancer hospital in Wuhan, China. Radiother Oncol. 2020;148:203-10. doi: 10.1016/j.radonc.2020.03.029.
7. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-7. doi: 10.1016/S1470-2045(20)30096-6.
8.Jing Yu, Ouyang W, Chua ML, Xie C. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. JAMA Oncol. 2020;6(7):1108-10. doi:10.1001/jamaoncol.2020.0980.
9Ganatra S HS, Nohria A. The novel coronavirus disease (COVID-19) threat for patients with cardiovascular disease and cancer. JACC CardioOncol. 2020;2(2):350-5. doi:10.1016/j.jaccao.2020.03.001.
10.Lambertini M TA, Passaro A, Criscitiello C, Cremolini C, Cardone C, Loupakis F, et al, Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists’ perspective. ESMO Open. 2020;5(2):e000759. doi: 10.1136/esmoopen-2020-000759.
11.Jing Yu, Chua ML, Xie C. SARS-CoV-2 transmission in cancer patients of a tertiary hospital in Wuhan. JAMA Oncol. 2020; 6(7): 1108-10. doi: 10.1101/2020. 02.22.20025320.
12.Dorigatti I, Okell L, Cori A, Imai N, Baguelin M, Bhatia S, et al. Report 4: severity of 2019-novel coronavirus (nCoV). Imperial College London, London. 10 February 2020. Available from:
13.Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). [Internet] 16-24 February 2020. [Accessed date: March 9, 2020]. Available at: https://wwwwhoint/docs/defaultsource /coronaviruse/who-china-joint-mission-on-covid-19-final-reportpdf
14.Burki TK. Cancer guidelines during the COVID-19 pandemic. Lancet Oncol. 2020;21(5):629-30. doi: 10.1016/S1470-2045(20)30217-5.
15.Kennedy Yao Yi Ng, Zhou S, Tan SH, Ishak NDB, Goh ZZS, Chua ZY, et al. Understanding the psychological impact of COVID-19 pandemic on patients with cancer, their caregivers, and health care workers in Singapore. JCO Glob Oncol. 2020;6:1494-509. doi:10.1200/GO.20.00374.
16.De Felice F PN. Treatment approach in locally advanced rectal cancer during Coronavirus (COVID-19) pandemic: long course or short course? Colorectal Dis. 2020;22(6):642-3. doi: 10.1111/codi.15058.
17.Al-Shamsi HO AW, Alhuraiji A, Coomes EA, Chemaly RF, Almuhanna M, Wolff R, et al. A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group. Oncologist. 2020;25(6):e936-e945. doi: 10.1634/theoncologist. 2020-0213.
18.Herschbach P, Keller M, Knight L, Brandl T, Huber B, Henrich G, et al. Psychological problems of cancer patients: a cancer distress screening with a cancer-specific questionnaire. Br. J. Cancer. 2004;91(3): 504-11. doi: 10.1038/sj.bjc.6601986.
19.Hulbert-Williams NJ, Storey L, Wilson KG. Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and Commitment Therapy. Eur J Cancer Care (Engl). 2015;24(1):15-27. doi: 10.1111/ecc.12223.
20.Rawl SM, Given BA, Given CW, Champion VL, Kozachik SL, Barton D, et al. Intervention to improve psychological functioning for newly diagnosed patients with cancer. Oncol Nurs Forum. 2002;29(6):967-75. doi: 10.1188/02.ONF.967-975.
21.Yusof S, Zakaria FN, Hashim NK, Dasiman R. Depressive symptoms among cancer patients undergoing chemotherapy. Procedia Soc Behav Sci. 2016;234:185-92. doi:10.1016/j.sbspro.2016.10.233.
22.Souza BFd, Moraes JAd, Inocenti A, Santos MAd, Silva AEBdC, Miasso AI. Women with breast cancer taking chemotherapy: depression symptoms and treatment adherence. Rev Lat Am Enfermagem. 2014;22(5):866-73. doi: 10.1590/0104-1169.3564. 2491.
23.China NHCo. A notice on the issuance of guidelines for emergency psychological crisis intervention in pneumonia for novel coronavirus infections. [Accessed date: Feb 11, 2020; in Chinese]. Available from:
24.Hajebi A. Psychological counseling guidline by hotline special for Coronavirus. Addiction and psychosocial health office of ministry of health. 2nd ed; 2020.p.1-78.
25.Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiat. 2020;7(4):300-2. doi: 10.1016/S2215-0366(20)30073-0.
26.Huremoviić D. Psychiatry of pandemics: A mental health response to infection outbreak. Switzerland: Springer International Publishing; 2019. p.1-185. doi: 10.1007/978-3-030-15346-5.
27.Nirjari Viren Dalal. Social issues faced by cancer patients during the coronavirus (COVID-19) pandemic. Cancer Res Stat Treat. 2020;3(5):s143-144. doi: 10.4103/CRST.CRST_109_20.
28.El-Shakankery, Crusz SM. Caring for our cancer patients in the wake of COVID-19. Br J Cancer. 2020;123(1):3-4. doi: 10.1038/s41416-020-0843-5.
29.Bonomi L, Ghilardi L, Arnoldi E, Tondini CA, Bettini AC. A rapid fatal evolution of coronavirus disease-19 (COVID-19) in an advanced lung cancer patient with a long time response to nivolumab. J Thorac Oncol. 2020;15(6):e83-e85. doi: 10.1016/j.jtho. 2020.03.021.