Work

Negotiating Mortality: A Qualitative Systematic Review and Thematic Synthesis of the Psychosocial Experiences of Pancreatic Cancer Across the Illness Trajectory

Year: 2026

Type: review

Abstract: Background/Objectives: Pancreatic cancer is associated with poor survival and substantial psychosocial burden, yet little is known about the psychological, emotional, and social dimensions of patients’ experiences across the illness trajectory. This review aimed to identify, analyse, and synthesise empirical qualitative literature on the psychosocial aspects of receiving, living with, dying with, or surviving pancreatic cancer. Methods: Seven bibliographic databases were searched from inception to 4 September 2025, with reference list screening and forward citation tracking undertaken. Records were managed in Covidence. Following screening of 4357 titles and abstracts and 412 full texts, 30 papers representing 28 studies were included. Methodological quality was appraised using the JBI Critical Appraisal Checklist for Qualitative Research. Data were extracted into a shared Excel workbook and synthesised using Thomas and Harden’s thematic synthesis approach. Results: Four overarching themes were developed: (1) from ambiguous symptoms to the shock and threat of diagnosis; (2) navigating care, information, and support; (3) embodied disruption, relational change, and reworking everyday life; and (4) living on borrowed time and coping with uncertainty and mortality. Across the included studies, pancreatic cancer was experienced as a profound disruption to participants’ lives, futures, and sense of selves; involved complex informational and care-navigation work; altered everyday lives; and provoked ongoing uncertainty around progression, recurrence, and survival. Conclusions: Pancreatic cancer exerts a profound psychosocial impact across early and advanced disease, with psychological, social, and emotional challenges intertwined with complex symptomatology, functional decline, uncertainty, and mortality awareness. Thus, substantial unmet psycho-oncology and supportive care needs exist for patients and their families.

Source: Cancers

DOI: 10.3390/cancers18193177