The lived experiences of Maltese patients with colorectal cancer following (cessation of) adjuvant treatment : a qualitative analysis

Abstract

Background: For individuals with colorectal cancer, the transition into the phase following completion of adjuvant chemotherapy treatment is a significant landmark, as well as a critical time for the person’s long-term health. Regardless of the emerging body of literature about survivors` with colorectal cancer at its various stages, relatively few studies focus on the immediate phase following cessation of adjuvant chemotherapy. Objective: The aim of this dissertation is to explore the lived experiences of individuals with colorectal cancer in Malta as they transition from being chemotherapy patients, to life after treatment as cancer survivors. The study explores what positive or negative impacts the illness trajectory has on the life of these individuals following the transition period understudy. Furthermore, this study subsequently explores the facilitators and barriers to the normal life and self that these study participants face when recalling what they perceive as the “self throughout the journey”. Design: Phenomenology informed the methodology using the principles of Interpretative Phenomenological Analysis. Setting: The setting of this study is the local oncology hospital. Participants: Six Maltese participants with colorectal cancer Methodology: Participants were recruited by purposeful sampling. The collection of data took place between October and December, 2018. Each of the participants took part in semi-structured interviews. The data was transcribed verbatim and analysis was done using Interpretative Phenomenological Analysis. Results: Three super-ordinate themes emerged with the overriding concept of exploring the self throughout the journey. The themes are: (1) Being cast into the uninvited journey (2) Journeying through the obstacle course and (3) Journeying into a new path. Conclusion: Adults with colorectal cancer experienced both different and similar challenging experiences during their illness trajectory. These participants were found to transition through three-time points namely; being diagnosed with cancer, following the early weeks on completion of adjuvant chemotherapy and the time of recovery, when participants regained some form of control and ‘normality’ in their life. The dimensions that challenged the participants understudy throughout the immediate transition included physical, psychological, social and spiritual issues. Throughout the transitional journey participants mainly coped by understanding the issues of self, issues of meaning and issues which impinged on their lifestyle. Participants acknowledge the need for further professional support, but this should be provided by professionals who are experienced in their particular problems. This study has increased knowledge related to the transitional survivorship issues as individuals with colorectal cancer transition to the life after adjuvant chemotherapy. Implications for education and training, clinical practice and further research including, gaps in participant’s knowledge and transition issues, are provided.