Eindwerk psycho-oncologie 2018-2020: Existential themes in the background of cancer-related cognitive impairments in breast cancer survivors: An interpretative phenomenological analysis

Background

Cancer-related cognitive impairments (CRCI) are an important issue for breast cancer patients during the re-entry phase. This study aims to explore the existential themes that interact with the experience of CRCI in breast cancer survivors at the re-entry phase, to gain a holistic insight into the lived experience of breast cancer survivors.

Methods

Eleven breast cancer patients with CRCI 6-36 months after their last chemo treatment were interviewed. The semi-structured in-depth interviews were analysed using Interpretative Phenomenological Analysis (IPA).

Results

The qualitative analysis identified four themes: ‘Awareness of death’, ‘Personal changes’, ‘Schism with others’, and ‘Responsibility’. A heightened ‘Awareness of death’ was evident in all participants at the re-entry phase, which appeared to invoke feelings of fear and gratitude. The experience of ‘Personal changes’seemed to depend on the subjective orientation in illness-trajectory. Heightened emotionality and different view on life were identified as profound changes, the latter leading to a re-evaluation of life. Participants felt a ‘Schism with others’ due to a lack of acknowledgement for their CRCI and difficulties to share their new outlook on life with others. Participants differed in their perceived ability to take up ‘Responsibility’ to live their lives authentically and in accordance with their new view on life.

Conclusions

These four themes closely aligned with Yalom’s four existential concerns: death, meaninglessness, loneliness, and freedom. This research emphasized the importance to acknowledge the existential concerns that are latently present at the re-entry phase and optimize current interventions accordingly.