Application of a revised model for coping with advanced cancer to qualitatively explore lung cancer survivors' experiences of ongoing physical effects, novel treatments, uncertainty, and coping

Rebekah Laidsaar-Powell; Phyllis Butow; Bernadette Bea Brown; Kimberley Mander; Jane Young; Emily Stone; Venessa Chin; Emily Banks; Chloe Yi Shing Lim; Nicole M Rankin

doi:10.1007/s11764-023-01417-x

Application of a revised model for coping with advanced cancer to qualitatively explore lung cancer survivors' experiences of ongoing physical effects, novel treatments, uncertainty, and coping

J Cancer Surviv. 2023 Jul 27. doi: 10.1007/s11764-023-01417-x. Online ahead of print.

Authors

Rebekah Laidsaar-Powell¹, Phyllis Butow², Bernadette Bea Brown³, Kimberley Mander³, Jane Young^{4

5}, Emily Stone^{4

6

7}, Venessa Chin^{7

8

9}, Emily Banks¹⁰, Chloe Yi Shing Lim², Nicole M Rankin¹¹

Affiliations

¹ Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia. rebekah.laidsaar-powell@sydney.edu.au.
² Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
³ NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁴ Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁵ The Daffodil Centre, The University of Sydney, a joint venture With Cancer Council, Sydney, NSW, Australia.
⁶ Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, Sydney, Australia.
⁷ School of Clinical Medicine, UNSW, Sydney, Australia.
⁸ The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
⁹ The Garvan Institute of Medical Research, Sydney, NSW, Australia.
¹⁰ National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
¹¹ Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.

PMID: 37495907
DOI: 10.1007/s11764-023-01417-x

Abstract

Purpose: Lung cancer remains underrepresented in cancer survivorship research. This study aimed to understand survivors' physical/psychological challenges, experiences of immunotherapy (IO) and targeted therapy (TT), and psychological adjustment through application of the Roberts et al. (2017) advanced cancer adaptation of Folkman and Greer's appraisal and coping model.

Methods: Adults 6-24 months post-initial treatment completion were recruited via an Australian cohort study. Participant demographic, clinical, quality of life, and distress data were obtained through the cohort database. Qualitative interviews were conducted and analyzed using Framework methods. Roberts et al. (2017)'s model informed data interpretation and presentation.

Results: Twenty interviews were conducted (10 females; average age 69 years). Participants' diagnostic stages varied (stage I = 2, stage II = 4, stage III = 8, stage IV = 6); most had received IO/TT (n = 14) and were on average 17 months (range 10-24) post-diagnosis. Three themes were identified and mapped to the Roberts' framework: (1) Ongoing illness events: most participants reported functioning well despite ongoing physical effects. Those on IO/TT reported side effects; some were unexpected/serious. (2) Adjusting to life with lung cancer: most expressed hope for the future while simultaneously preparing for disease progression. Those receiving IO/TT experienced uncertainty given limited survival information. (3) Learning to live with lung cancer: participants described emotion, problem, and meaning based on coping strategies.

Conclusions: Findings may guide development of supportive care resources/interventions focused on uncertainty, IO/TT communication and decision-making, and coping.

Implications for cancer survivors: Many people with lung cancer are living well with their ongoing illness. Despite challenges, many survivors are adapting to issues as they arise and are maintaining a sense of hope and optimism.

Keywords: Coping and adjustment; Immunotherapy; Lung cancer; Qualitative; Survivorship.

Abstract

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