By Kimberly A. Nelson, MSW, LCSW, OSW-C

Those diagnosed with cancer often can vividly remember the day they found out. The day their world shifted and life changed forever. The day of the week, the time of day. A patient told me several years ago, “It didn’t shift, it blew up.” The shared experience of living with a global pandemic has some parallels to the cancer experience. I can remember the day when my family’s life was forever shifted by this virus. Life seemed to come to a stop. New fears arose including related to our own mortality as well as the potential financial impact of job loss or lost income from furlough. The simple task of going to the grocery store now felt like a risky endeavor. I can remember one of my patients saying, “Now people know how I feel.” There are many uncertainties in the world of cancer and the world of COVID but as oncology social workers we know in our practice and in our lives people are resilient. From the initial crisis phase including disbelief and shock comes adaptation, new learning and settling into a different routine and a new normal.

I am fortunate to practice in a large academic medical system. Our 10-year plan to go digital prior to March 2020 turned into a two-month pivot to virtual consults and sessions thereby increasing access for our local, regional, national and international patients to our cancer center services. Our support groups also followed suit and attendance in some cases has increased as patients and caregivers are still able to participate in group sessions even after they return home. More patients are setting up and using their online portal account to view their medical record and communicate with their medical team. This is the beauty and gift of the pandemic to push us beyond our comfort in expanding our service access.

The phrase often heard in the community, “We’re all in this together,” feels like a misnomer when it comes to the cancer experience. The experience of cancer is normally very isolating and lonely and the layer of COVID for many of our patients added to that sense of loneliness and isolation. Coming to the clinic or to the emergency department often meant they had to go it alone due to COVID protocols. Additional fears especially in the pandemics early months of “will I have access to my treatment?”, “if I get sick and need hospitalization will there be a bed for me?”, “what if I need a clinical trial, are those still being offered?”, “I’m too afraid to come in for my surveillance visit, is it safe?”, added to the threat to life and touch with mortality that our patients already experience thus adding to profound feelings of loneliness and isolation.

The uncertainty and lack of control that is the cancer experience has been heightened by the uncertainty and lack of control that is the collective COVID experience. Our patients and family members sense of anxiety and threat has certainly been heightened beyond what any of us have seen before.

The pandemic has highlighted the need and value of mental health support during the cancer experience but also beyond in the broader community. It has started the conversation about collective traumas, individual and family traumas and normalized the topic of emotional wellness. A person’s first experience with counseling may be with their oncology social worker. Our clinical skills and expertise are needed more than ever to address psychosocial distress not only within the cancer experience but beyond to life during maintenance and surveillance. Oncology social workers are helping patients and families to identify and process their grief and trauma related to cancer and COVID and move forward into this wild new normal whatever that may be. I am certainly seeing more referrals within my cancer center for this type of support as our clinicians are seeing more value in addressing emotional distress and wellness. The beauty of the crisis is showing us our propensity for resiliency and pushing us out of our comfort zones to attain and strengthen new skills and in so doing benefit and grow the field of psychosocial oncology and access to these very important services.