Navigating Concurrent Diagnoses With Cancer and Mental Health Disorder: Patients' Perspectives on Personalised Treatment and Care

Background: People living with concurrent cancer and mental health disorders face heightened vulnerability within healthcare systems that are predominantly organised around biomedical treatment pathways. Although cancer care has advanced substantially, less is known about how these patients experience recognition of their psychological vulnerability, continuity of care, communication and opportunities to participate meaningfully in decisions about treatment. Aim: To explore patients' experiences of living with concurrent cancer and mental health disorders, with particular focus on how they experience being met in their individual needs within oncology care. Methods: This qualitative study used individual semi-structured interviews with 11 adult patients receiving current or recent cancer treatment and living with an existing mental health or neurodevelopmental condition. Participants were recruited purposively from oncology and haematology departments at two Danish hospitals between September 2024 and December 2025. Data were analysed using interpretive qualitative content analysis. Results: Six interrelated themes were identified: (1) being treated for cancer while mental illness was left outside the room; (2) the hidden work of self-coordination in a fragmented system; (3) communication as care: the need for predictability and adaptation; (4) cancer treatment as a trigger for mental health deterioration; (5) stigma, legitimacy and self-silencing; and (6) relational continuity and being remembered as protective factors. Across themes, participants described a persistent tension between technically competent somatic treatment and insufficient recognition of psychological vulnerability, support needs and relational needs. Conclusion: Patient-centred oncology care for people living with co-morbidity depends not only on clinical expertise, but on recognition, adapted communication, shared responsibility and relational continuity. The findings suggest that vulnerability is shaped not only by illness itself, but also by how care systems and professional practices are organised. Relevance to Clinical Practice: Small but meaningful changes in everyday oncology practice including psychologically informed communication, continuity of contact persons, explicit recognition of mental health needs and shared coordination of care—may substantially improve safety, participation and patient experience for this population. Patient or Public Contribution: Patients living with concurrent cancer and mental health disorders contributed to this study through individual qualitative interviews. Their lived experiences formed the empirical foundation of the study and informed the analysis and interpretation of findings. Patients were not involved in the design of the study or the preparation of the manuscript.