Exploring the psychological impact of living with and after cancer following major pancreatic surgery: a qualitative study

Abstract

Introduction: Pancreatic cancer is the 11th most common cancer in the UK. Most patients are diagnosed after metastasis but around 10% undergo a pancreaticoduodenectomy. There is limited research focusing on the psychological wellbeing of patients diagnosed with pancreatic cancer, and unmet support needs will impact negatively on quality of life. Our study aimed to explore patients' experiences of surgery and living with pancreatic cancer, as well as identifying opportunities to optimize psychological wellbeing. Methods: Semi-structured interviews were conducted with patients from an NHS Trust in Northwest England who had undergone a pancreaticoduodenectomy for pancreatic or biliary duct cancer. Interviews explored their experience of the diagnostic process and surgery, the impact of cancer on their life, and sources of support. Data were analysed using a thematic approach. Results: Initial analysis has yielded several themes, including: reactions to diagnosis; self-identity and 'redefinement of self' following diagnosis or recurrence; and life being considered a trajectory measured by scans. Participants also described difficulties navigating the healthcare system and being unclear on when and from whom to ask for help. They expressed a desire for a proactive approach from healthcare professionals for both physical and emotional problems. A sense of stoicism was alluded to throughout interviews. Conclusion: An awareness of the impact of treatment on identity, and recognition of psychological sequelae following diagnosis, is vital in order to offer emotional support proactively. Understanding patients' experience of living with cancer and the impact of treatment is crucial in enabling the development of improved support interventions.