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Peer-reviewedCC BYCancers

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

4 affiliations
  1. 1School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre 97 Lisburn Road, Belfast BT9 7BL, UK.
  2. 2Department of Nursing, School of Health Sciences, University of Melbourne, The Alan Gilbert Building, Level 6, 161 Barry Street, Carlton, VIC 3010, Australia.
  3. 3Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia.
  4. 4Northern Ireland Pancreatic Cancer (NIPANC), 384 Belmont Road, Belfast BT4 2NF, UK.

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.

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BibTeX
@article{cook2026negotiating,
  title = {{Negotiating Mortality: A Qualitative Systematic Review and Thematic Synthesis of the Psychosocial Experiences of Pancreatic Cancer Across the Illness Trajectory.}},
  author = {Lana Cook and Gillian Prue and Caitlin McShane and Mei Krishnasamy and Kate Furness and Susan McLaughlin and Gary Mitchell},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18193177},
  url = {https://europepmc.org/article/MED/42882871},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Negotiating Mortality: A Qualitative Systematic Review and Thematic Synthesis of the Psychosocial Experiences of Pancreatic Cancer Across the Illness Trajectory.
AU  - Lana Cook
AU  - Gillian Prue
AU  - Caitlin McShane
AU  - Mei Krishnasamy
AU  - Kate Furness
AU  - Susan McLaughlin
AU  - Gary Mitchell
PY  - 2026
DA  - 2026/10/01
JO  - Cancers
DO  - 10.3390/cancers18193177
UR  - https://europepmc.org/article/MED/42882871
AB  - 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.
SN  - 2072-6694
ER  -