Oncologist wellbeing and job performance have been hard hit by the COVID-19 pandemic with factors such as having to work remotely and missing out on training contributing to anxiety and burnout.

Findings presented at ESMO 2020 Virtual Congress come from an international survey of more than 1500 oncologists including Australians, with the greatest impact being seen in countries that have the highest burden of COVID-19.

But common themes reported by all oncologists show there is an urgent need to provide more support in areas such as flexible working hours and psychological counselling, says Dr Susana Banerjee, Chair of the ESMO Resilience Task Force and an oncologist at The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London.

An initial survey conducted in April/May found that two thirds of oncologists had major changes in their professional duties, including remote consultations, reduced inpatient care, working more out of hours and reduced clinical trial activity.

Oncologists’ concerns about working environment included general fears for safety during the pandemic, access to PPE and not feeling valued and supported by management of the institution.

The first survey showed that 25% of oncologists had poor scores on the extended welling index (EWBI), reflecting high levels of distress. And wellbeing declined further during the pandemic, with a second survey in August showing 33% distress levels and 49% of oncologists showing levels of burnout compared to 38% in the initial survey.

Predictors of poor wellbeing included longer working hours, concerns about impact on training and career, worries about personal health and need to self isolate due to contact with COVID-19. Younger oncologists (aged ≤40 years) and female oncologists were at higher risk of distress.

In terms of job performance, only one third of oncologists believed this had been maintained to pre-pandemic levels on the initial survey, but job performance self ratings improved to 51% on the second survey.

When asked what they thought would be helpful in terms of wellbeing and job performance, oncologists suggested more flexible working hours and working from home, more psychological support, and workshops or courses on wellbeing and coping strategies.

“These identified predictors of wellbeing and performance are a useful way for us to understand where we can make the most positive impact on those who may be particularly at risk,” said Dr Banerjee.

“Urgent measures to address wellbeing and improve resilience are essential. Our results based on feedback from oncology professionals must be taken seriously and action should be taken.”

In a discussion session on oncologist wellbeing, Dr Banerjee said the pandemic had meant making tough decisions in cancer care, such as whether to stop treatment, change treatment regimens, modify doses and in some cases, reverse previously planned treatment decisions.

Pandemic restrictions also meant oncologists had to relay bad news via video link instead of in person, and were faced with the heart-breaking situation of patients not being allowed visits from loved ones during inpatient stay, even at the end of their lives.

And while cancer care is now getting back on track and adjusting to the “new normal”, many restrictions and challenges remain, she said.

“It is essential that we understand the impact of COVID-19 on the experiences of oncology professionals so that we can make evidence-driven decisions on how to optimise resources for the benefit of professionals and organisations in the oncology community,” she concluded.