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Key points A monthly videoconference was maintained over 1 year, allowing senior psychooncologists from German Comprehensive Cancer Centers to discuss the implications of the Covid‐19 pandemic for psychooncological care.In the early phase of the pandemic, a widespread disruption of psychooncological services was noted.Rapidly developed adaptations of regular services worked well and sometimes brought about unexpected, creative solutions.In March 2021, the high numbers of infections, the occurrence of new variants of the coronavirus, and the slow progress in vaccination raise fears about new disruptions and restrictions in service provision.In coping with the pandemic, many therapists have felt like many cancer patients do feel in the process of coping with cancer, and this might help to better understand our patients.

Hintergrund Fortgeschritten erkrankte Krebspatienten erleben eine Vielzahl psychischer Belastungen. Anliegen psychotherapeutischer Interventionen sind die Reduktion dieser Belastungen und der Erhalt oder die Verbesserung der Lebensqualitat. Bisher liegen wenige Studien zu psychotherapeutischen Interventionen fur Patienten in palliativer Versorgung und deren Erfahrungen vor.

Background In this prospective multicenter study, we investigated cancer-and-treatment–specific distress (CTXD) and its impact on symptoms of posttraumatic stress disorder (PTSD) in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Methods Patients were consulted before (T0, N = 239), 3 (T1, N = 150), and 12 months (T2, N = 102) after HSCT. Medical (eg, diagnosis and pretreatment) and demographic information, CTXD and PTSD (PCL-C) were assessed. Results Random intercept models revealed that the sum score of CTXD was highest pre-HSCT (T0), decreased by T1 (γ = −.18, 95% CI [−.26/−.09]), and by T2 (γ = −.10, 95% CI [−.20/−.00]). Uncertainty, family strain, and health burden were rated most distressing during HSCT. Uncertainty and family strain decreased from T0 to T1 (γ = −.30, 95% CI [−.42/−.17]; γ = −.10, 95% CI [−.20/−.00]) and health burden from T1 to T2 (γ = −.21, 95% CI [−.36/.05]). Women were more likely to report uncertainty (γ = .38, 95% CI [.19/.58]), family strain (γ = .38, 95% CI [.19/.58]), and concerns regarding appearance and sexuality (γ = .31, 95% CI [.14/.47]) than men. Uncertainty (γ = .18, 95% CI [.12/.24]), appearance and sexuality (γ = .09, 95% CI [.01/.16]), and health burden (γ = .21, 95% CI [.14/.27]) emerged as predictors of PTSD symptomatology across the 3 assessment points. Conclusions Our data provide first evidence regarding the course of 6 dimensions of CTXD during HSCT and their impact on PTSD symptomatology. Specifically, results emphasize the major burden of uncertainty pre-HSCT and the impact of uncertainty and concerns regarding appearance and sexuality on PTSD symptomatology.

Context Due to toxicity and invasiveness, allogeneic hematopoietic stem cell transplantation causes severe and longstanding symptom burden. Longitudinal studies on symptoms and symptom clusters (SC) would be helpful to optimize symptom control but are rare to date. Objectives The objective of this study was to investigate stability of symptoms, extract time stable SC, and determine their priority in symptom management. Methods In this multicenter study, patients diagnosed with hematologic cancer were assessed before conditioning (T0) and three months (T1), one year (T2), and five years (T3) after transplantation. Symptoms were assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Symptoms were stable when rated as present at three consecutive time points. Applying factor analysis, stable SC were composed of symptoms loading on the same factor across all time points. Priority in symptom management was derived from a combination of severity and predictive power for quality of life (QoL). Results Two hundred thirty-nine patients participated at T0, 150 (63%) at T1, 102 (43%) at T2, and 45 (19%) at T3. We identified three stable SC, composed of rest-tired-weak-dyspnea-loss of appetite (exhausted), tense-worried-irritable-depressed (affective), and nausea-vomiting (gastrointestinal). Fatigue was most persistent and also most severe and predictive for QoL, both as symptom and in cluster (exhausted). Conclusion Given its high stability, severity, and impact on QoL, fatigue should have priority in symptom management. The treatment of this symptom could be enhanced by also incorporating interventions addressing dyspnea and loss of appetite.