Study Finds Over Half of Patients With Cancer Experiencing Loneliness and Symptom Burden During the COVID-19 Pandemic

Research utilized a convenience sample of patients to determine loneliness during the COVID-19 pandemic, emphasizing factors including anxiety, depression, and fatigue, among other things.

Research into loneliness and symptom burden for patients with cancer during the COVID-19 pandemic found that more than half of the study’s population are experiencing loneliness, according to data published in Cancer.1

The reported loneliness is likely due to the mandated social distancing and isolation, with symptom burden among this group of patients also reported at high rates.

“Patients with cancer, as well as survivors, need to realize that feelings of loneliness and social isolation are very common during the COVID-19 pandemic,” lead author Christine Miaskowski, PhD, RN, FAAN, of the University of California, San Francisco, explained in a press release.2 “In addition to this sense of loneliness, they may be having feelings of anxiety, sadness, and fatigue, as well as problems sleeping and high rates of unrelieved pain—all at the same time.”

A convenience sample of 606 patients completed online surveys to evaluate loneliness, social isolation, and common symptoms. Of that population, 53% of patients were categorized to the lonely group, while 47% were categorized to the non-lonely group.

Patients in the lonely group reported higher social isolation levels and higher severity scores for the symptoms than patients in the non-lonely group, including anxiety, depression, fatigue, sleep disturbance, cognitive dysfunction, and pain.

Four specific variables were found to be significant between the groups, including marital status, Social Isolation Scale (SIS) score, depression group membership, and anxiety group membership.

The data found that patients who were not married were 2.94 times more likely to be in the lonely group than the nonlonely group. More, it was 1.52 times more likely that a patient would be in the lonely group for every 1-point decrease in their SIS score. Focusing on depression and trait anxiety group membership, patients who fit those categories were 3.24 and 3.17 times more likely to be in the lonely group, respectively.

“This study is the first to evaluate for the occurrence of and risk factors associated with loneliness in a relatively large sample of oncology patients during COVID-19,” wrote the investigators. “Consistent with a previous report that used the UCLA Loneliness Scale and found occurrence rates for loneliness of 48% and 62% in the general US population during the pandemic, 53% of our oncology patients were in the lonely group.”

Patients in the lonely group were more likely to not be married or have a partner, live alone, and have a lower annual income.

A major limitation of the research centers around sex, as almost 92% of the study’s population was female. Because of this, it is difficult to generalize the results regarding sex differences in loneliness for patients with cancer.

More, the research team reported that an overwhelmingly majority of patients in this study were White, well-educated, and reported an annual income of more than $60,000. Considering the racial disparities associated with the COVID-19 pandemic, future research should expand its cohort of patients to include a more diverse cohort, both racially and economically.

Moving forward, the research team emphasized the importance for clinicians to speak with patients about loneliness and similar symptoms they may be experiencing.

“Patients may warrant referrals to psychological services to assist with symptom management,” Miaskowski said in a press release “In addition, to decrease these feelings, patients and survivors can develop a schedule of social interactions; develop a structure to their daily activities; engage in regular exercise particularly in the outdoors; use stress reduction exercises; and eat a healthy diet.”


1. Miaskowski C, Paul SM, Snowberg K, et al. Loneliness and symptom burden in oncology patients during the COVID-19 pandemic. Cancer. Published online April 27, 2021. doi:10.1002/cncr.33603

2. Many patients with cancer are experiencing loneliness and related symptoms during the COVID-19 pandemic. News release. Wiley. Published May 5, 2021. Accessed May 14, 2021.