"Ahead on points": Understanding the long-term impact of colorectal cancer with liver metastases on quality of life and survivorship experiences

Abstract

The aim of this study was to investigate the impact of colorectal cancer (CRC) with liver metastases on long-term quality of life (QOL) and survivorship experiences, and to explore the relevance of the EORTC QOL questionnaires to this population, using a qualitative approach. Overall 15 participants were interviewed, 5 women and 10 men. Interviews were analysed using inductive theoretical thematic analysis. Three main themes were identified: Cancer and me: establishing a relationship with cancer; Living with cancer; and Aligning the long-term impacts: the person I’ve become. The results illustrate that CRC survivors with liver metastases define QOL in different ways and have a broad and diverse range of experiences. As long-term cancer survivors, the focus on short-term physical symptoms is no longer relevant. Instead, the relationship with cancer, development of coping strategies, and coming to terms with a post-cancer self are of far more importance. As QOL is a subjective experience, there is no ‘one size fits all’ approach to definition and measurement. Health care professionals and policy makers need to understand the variety in meaning and be clear about the purpose of QOL measures. In attempts to promote long-term positive adjustment, cancer survivors may benefit from a wider range of support and expertise. Health Psychologists in particular could offer valuable insight and support in relation to adaptive coping strategies, mental framing, adjustment to physical changes, and the development and adjustment to the ‘post-cancer self’. Future work would benefit from holistic definition of QOL and from using a broad range of assessment techniques