Exploring the Traumatic Impact of Advanced Cancer

The number of individuals living longer after a diagnosis of advanced cancer (AC) is increasing. To provide effective care for this population, a sound understanding of the psychological impact of AC is necessary. Cancer has been shown to have a traumatic impact and can precipitate both post-traumatic stress (PTS) and post-traumatic growth (PTG). In individuals with cancer, PTS is manifested through intrusive thoughts and images related to the experience of cancer, avoidance of thoughts and feelings connected with this experience, hyper arousal, and negative changes to one’s mood and thinking. PTG describes the positive changes that can occur in response to managing a challenging life event, such as cancer. While PTS and PTG have been explored extensively in response to primary cancer, the traumatic impact of AC has received less attention. A review of the literature on PTS in response to AC identified 11 studies, which were collated and critiqued. Across studies, individuals reported high rates of PTS, which were influenced by numerous factors. In completing this review, the researcher noted that studies on PTG in response to AC were lacking. There was also a paucity of qualitative research in this area, and few studies with the partners of those with AC, despite evidence of high rates of traumatisation in this group. To remedy these limitations in the evidence base, a Q-methodology study (n=11) was conducted. This study explored patients’ and partners’ responses to living with AC, to determine whether the constructs of PTS and PTG resonated with their subjective experiences. This analysis interpreted four differing accounts of the impact of AC, three of which could be understood as stories involving PTG and PTS. The final paper in this thesis provides a reflective account of the research experience.