Patient and relative experiences with cancer and pre-existing mental disorders

INTRODUCTION: Patients with cancer and pre-existing severe mental disorders (SMD) have higher cancer mortality rates, but research on barriers to optimal treatment is limited, particularly from the perspectives of patients and relatives. This qualitative study aimed to highlight the experiences of patients and relatives regarding their cancer trajectories in Denmark to explore barriers to optimal cancer care for this patient population.

METHODS: A total of 11 semi-structured individual interviews were conducted with eight patients with cancer and pre-existing SMD and three relatives. An eclectic theoretical framework was applied to explore the participants' and relatives' experiences.

RESULTS: Identified barriers included mental health stigma and lack of direct communication about the patients' SMD with oncology staff. While most participants wished to undergo the recommended cancer treatment, some feared adverse psychiatric side effects and worsening of mental health symptoms. Additionally, participants reported barriers such as limited consultation time, lack of clinician continuity and social isolation, which impeded access to sufficient information and support during their cancer trajectory.

CONCLUSIONS: The study identified barriers such as mental health stigma and insufficient communication about patients' mental disorders. A patient-centred approach to cancer care, which includes formal guidelines and training for healthcare professionals, is recommended.

FUNDING: The work was supported by the Danish Cancer Society [grant number R283-A16499].

TRIAL REGISTRATION: Not relevant.