Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 1/2019

Open Access 01-02-2019 | Care | Review

Living with and beyond cancer with comorbid illness: a qualitative systematic review and evidence synthesis

Authors: Debbie Cavers, Liset Habets, Sarah Cunningham-Burley, Eila Watson, Elspeth Banks, Christine Campbell

Published in: Journal of Cancer Survivorship | Issue 1/2019

Login to get access

Abstract

Purpose

To identify the qualitative evidence on the experience of cancer and comorbid illness from the perspective of patients, carers and health care professionals to identify psycho-social support needs, experience of health care, and to highlight areas where more research is needed.

Methods

A qualitative systematic review following PRISMA guidance. Relevant research databases were searched using an exhaustive list of search terms. Two reviewers independently screened titles and abstracts and discussed variations. Included articles were subject to quality appraisal before data extraction of article characteristics and findings. Thomas and Harden’s thematic synthesis of extracted findings was undertaken.

Results

Thirty-one articles were included in the review, covering a range of cancer types and comorbid conditions; with varying time since cancer diagnosis and apparent severity of disease for both cancer and other conditions. The majority of studies were published after 2010 and in high income countries. Few studies focused exclusively on the experience of living with comorbid conditions alongside cancer; such that evidence was limited. Key themes identified included the interaction between cancer and comorbid conditions, symptom experience, illness identities and ageing, self-management and the role of primary and secondary care.

Conclusions

In addition to a better understanding of the complex experience of cancer and comorbidity, the review will combine with research prioritisation work with consumers to inform an interview study with the defined patient group.

Implications for Cancer Survivors

Expanding this evidence base will help to illuminate developing models of cancer patient-centred follow-up care for the large proportion of patients with comorbid conditions.
Appendix
Available only for authorised users
Literature
1.
2.
Boyle D. In: Bush NJ, Gorman L, editors. Survivorship, in Psychosocial Nursing Care Along the Cancer Continuum: Oncology Nursing Society; 2018. p. 27–41.
3.
McLean G, Gunn J, Wyke S, Guthrie B, Watt GCM, Blane DN, et al. The influence of socioeconomic deprivation on multimorbidity at different ages: a cross-sectional study. Br J Gen Pract. 2014;64(624):e440–7.CrossRefPubMedPubMedCentral
4.
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37–43.CrossRefPubMed
5.
Leach CR, Weaver KE, Aziz NM, Alfano CM, Bellizzi KM, Kent EE, et al. The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions. J Cancer Surviv. 2015;9(2):239–51.CrossRefPubMed
6.
Williams GR, Deal AM, Lund JL, Chang YK, Muss HB, Pergolotti M, et al. Patient-reported comorbidity and survival in older adults with cancer. Oncologist. 2018;23(4):433–9.CrossRefPubMed
7.
Sarfati D, Koczwara B, Jackson C. The impact of comorbidity on cancer and its treatment. CA Cancer J Clin. 2016;66(4):337–50.CrossRefPubMed
8.
Mayer DK, Nasso SF, Earp JA. Defining cancer survivors, their needs, and perspectives on survivorship health care in the USA. Lancet Oncol. 2017;18(1):e11–8.CrossRefPubMed
9.
Department of Health, Cancer reform strategy 2007.
10.
NHS Health Improvement and Macmillan Cancer Support, National Cancer Survivorship Initiative: Vision. 2010.
11.
Scottish Government, Better Cancer care: an action plan. 2008.
12.
Jacobs LA, Shulman LN. Follow-up care of cancer survivors: challenges and solutions. Lancet Oncol. 2017;18(1):e19–29.CrossRefPubMed
13.
Nekhlyudov L, O'Malley DM, Hudson SV. Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities. Lancet Oncol. 2017;18(1):e30–8.CrossRefPubMedPubMedCentral
14.
Smith SM, Allwright S, O'Dowd T. Does sharing care across the primary-specialty interface improve outcomes in chronic disease? A systematic review. Am J Manag Care. 2008;14(4):213–24.PubMed
15.
Snyder CF, Frick KD, Herbert RJ, Blackford AL, Neville BA, Lemke KW, et al. Comorbid condition care quality in cancer survivors: role of primary care and specialty providers and care coordination. J Cancer Surviv. 2015;9(4):641–9.CrossRefPubMedPubMedCentral
16.
Williams GR, et al. Comorbidity in older adults with cancer. J Geriatr Oncol. 2015.
17.
Smith SM, Soubhi H, Fortin M, Hudon C, O'Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. Bmj. 2012;345:e5205.CrossRefPubMedPubMedCentral
18.
Harrison SE, Watson EK, Ward AM, Khan NF, Turner D, Adams E, et al. Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. J Clin Oncol. 2011;29(15):2091–8.CrossRefPubMed
19.
Adams E, Boulton M, Rose PW, Lund S, Richardson A, Wilson S, et al. A qualitative study exploring the experience of the partners of cancer survivors and their views on the role of primary care. Support Care Cancer. 2012;20(11):2785–94.CrossRefPubMed
20.
21.
Watson EK, et al. Views of health professionals on the role of primary care in the follow-up of men with prostate cancer. Fam Pract. 2011;28(6):647–54.CrossRefPubMed
22.
O'Brien R, Wyke S, Guthrie B, Watt G, Mercer S. An ‘endless struggle’: a qualitative study of general practitioners’ and practice nurses' experiences of managing multimorbidity in socio-economically deprived areas of Scotland. Chronic Illn. 2011;7(1):45–59.CrossRefPubMed
23.
Mason B, et al. My body’s falling apart. Understanding the experiences of patients with advanced multimorbidity to improve care: serial interviews with patients and carers. BMJ Support Palliat Care. 2014.
24.
France EF, Wyke S, Gunn JM, Mair FS, McLean G, Mercer SW. Multimorbidity in primary care: a systematic review of prospective cohort studies. Br J Gen Pract. 2012;62(597):e297–307.CrossRefPubMedPubMedCentral
25.
Hemingway P, Brereton N. What is a systematic review? In: What is...? series: Haywood Medical Communications; 2009. p. 1–8.
26.
27.
28.
29.
30.
Information Services Division. Measuring long term conditions in Scotland. Scotland: NHS National Services; 2008.
31.
Glaser B, Strauss A. The discovery of grounded theory: strategies for qualitative research: Sociology Press; 1967.
32.
Charmaz K. Constructing grounded theory: a practical guide through qualitative analysis. 2nd ed: SAGE; 2013.
33.
Baker AM, Smith KC, Coa KI, Helzlsouer KJ, Caulfield LE, Peairs KS, et al. Clinical care providers’ perspectives on body size and weight management among long-term cancer survivors. Integr Cancer Ther. 2015;14(3):240–8.CrossRefPubMed
34.
Bartlett A, Clarke B. An exploration of healthcare professionals’ beliefs about caring for older people dying from cancer with a coincidental dementia. Dementia (14713012). 2012;11(4):559–65.CrossRef
35.
Beck SL, Towsley GL, Caserta MS, Lindau K, Dudley WN. Symptom experiences and quality of life of rural and urban older adult cancer survivors. Cancer Nurs. 2009;32(5):359–69.CrossRefPubMed
36.
Clarke LH, Bennett E. You learn to live with all the things that are wrong with you’: gender and the experience of multiple chronic conditions in later life. Ageing Soc. 2013;33:342–60.CrossRefPubMed
37.
Corner J, et al. Qualitative analysis of patients' feedback from a PROMs survey of cancer patients in England. BMJ Open. 2013;3(4) (no pagination)(e002316).
38.
Courtier N, Milton R, King A, Tope R, Morgan S, Hopkinson J. Cancer and dementia: an exploratory study of the experience of cancer treatment in people with dementia. Psycho-Oncology. 2016;25(9):1079–84.CrossRefPubMed
39.
Dahlhaus A, Vanneman N, Guethlin C, Behrend J, Siebenhofer A. German general practitioners’ views on their involvement and role in cancer care: a qualitative study. Fam Pract. 2014;31(2):209–14.CrossRefPubMed
40.
Fenlon D, Frankland J, Foster CL, Brooks C, Coleman P, Payne S, et al. Living into old age with the consequences of breast cancer. Eur J Oncol Nurs. 2013;17(3):311–6.CrossRefPubMed
41.
Fix GM, Cohn ES, Solomon JL, Cortés DE, Mueller N, Kressin NR, et al. The role of comorbidities in patients' hypertension self-management. Chronic Illness. 2014;10(2):81–92.CrossRefPubMed
42.
Hannum SM, Rubinstein RL. The meaningfulness of time; narratives of cancer among chronically ill older adults. J Aging Stud. 2016;36:17–25.CrossRefPubMed
43.
Hershey DS, Tipton J, Given B, Davis E. Perceived impact of cancer treatment on diabetes self-management. Diabetes Educ. 2012;38(6):779–90.CrossRefPubMed
44.
Kantsiper M, et al. Transitioning to breast cancer survivorship: perspectives of patients, cancer specialists, and primary care providers. J Gen Intern Med. 2009;24(Suppl 2):S459–66.CrossRefPubMed
45.
Loerzel VW, Aroian K. Posttreatment concerns of older women with early-stage breast cancer. Cancer Nurs. 2012;35(2):83–8.CrossRefPubMed
46.
Loerzel VW, Aroian K. A bump in the road-older women’s views on surviving breast cancer. J Psychosoc Oncol. 2013;31(1):65–82.CrossRefPubMed
47.
Morgan JL, Collins K, Robinson TG, Cheung KL, Audisio R, Reed MW, et al. Healthcare professionals' preferences for surgery or primary endocrine therapy to treat older women with operable breast cancer. Eur J Surg Oncol. 2015;41(9):1234–42.CrossRefPubMed
48.
Nanton V, et al. The threatened self: considerations of time, place, and uncertainty in advanced illness. Br J Health Psychol. 2015.
49.
Norman A, et al. Family physicians and cancer care. Palliative care patients’ perspectives. Can Fam Physician. 2001;47:2009–12 2015–6.PubMedPubMedCentral
50.
Palmer NRA. Goals, plans, and behavior changes: a relevant part of the post-treatment cancer experience. Dissertation Abstracts International: Section B: The Sciences and Engineering, 2011; 71(9-B):5413.
51.
Palmer NRA, Bartholomew LK, McCurdy SA, Basen-Engquist KM, Naik AD. Transitioning from active treatment: colorectal cancer survivors’ health promotion goals. Palliat Support Care. 2013;11(2):101–9.CrossRefPubMed
52.
Sada YH, et al. Primary care and communication in shared cancer care: a qualitative study. Am J Manag Care. 2011;17(4):259–65.PubMedPubMedCentral
53.
Saunders Sturm CM. Breast cancer illness narratives: examining the experience of living with breast cancer. Dissertation Abstracts International Section A: Humanities and Social Sciences, 2003; 63(10-A):3622.
54.
Sawin EM. “The body gives way, things happen”: older women describe breast cancer with a non-supportive intimate partner. Eur J Oncol Nurs. 2012;16(1):64–70.CrossRefPubMed
55.
Sinding C, Wiernikowski J. Disruption foreclosed: older women’s cancer narratives. Health. 2008;12(3):389–411.CrossRefPubMed
56.
Sowerbutts AM, Griffiths J, Todd C, Lavelle K. Why are older women not having surgery for breast cancer? A qualitative study. Psycho-Oncology. 2015;24(9):1036–42.CrossRefPubMedPubMedCentral
57.
Thomé B, Dykes AK, Gunnars B, Hallberg IR. The experiences of older people living with cancer. Cancer Nurs. 2003;26(2):85–96.CrossRefPubMed
58.
Volker DL, Becker H, Kang SJ, Kullberg V. A double whammy: health promotion among cancer survivors with preexisting functional limitations. Oncol Nurs Forum. 2013;40(1):64–71.CrossRefPubMedPubMedCentral
59.
Wallace HM. Getting to the other side: An exploration of the head and neck cancer treatment experience. Dissertation Abstracts International Section A: Humanities and Social Sciences, 2015. 75(12-A(E)): p. No Pagination Specified.
60.
Wimberley PL. Living in the long shadow of breast cancer: Saint Louis University; 2012. p. 196.
61.
Yoo GJ, Levine EG, Aviv C, Ewing C, Au A. Older women, breast cancer, and social support. Support Care Cancer. 2010;18(12):1521–30.CrossRefPubMed
62.
63.
Meiklejohn JA, Mimery A, Martin JH, Bailie R, Garvey G, Walpole ET, et al. The role of the GP in follow-up cancer care: a systematic literature review. J Cancer Surviv. 2016;10:990–1011.CrossRefPubMed
64.
Kuluski K, Gill A, Naganathan G, Upshur R, Jaakkimainen RL, Wodchis WP. A qualitative descriptive study on the alignment of care goals between older persons with multi-morbidities, their family physicians and informal caregivers. BMC Fam Pract. 2013;14(1):133.CrossRefPubMedPubMedCentral
65.
Lewis R, Neal RD, Williams NH, France B, Wilkinson C, Hendry M, et al. Nurse-led vs. conventional physician-led follow-up for patients with cancer: systematic review. J Adv Nurs. 2009;65(4):706–23.CrossRefPubMed
66.
Lewis RA, Neal RD, Hendry M, France B, Williams NH, Russell D, et al. Patients’ and healthcare professionals’ views of cancer follow-up: systematic review. Br J Gen Pract. 2009;59(564):e248–59.CrossRefPubMedPubMedCentral
67.
Lewis RA, Neal RD, Williams NH, France B, Hendry M, Russell D, et al. Follow-up of cancer in primary care versus secondary care: systematic review. Br J Gen Pract. 2009;59(564):e234–47.CrossRefPubMedPubMedCentral
68.
69.
Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23(34):8884–93.CrossRefPubMed
70.
Watson E, et al. PROSPECTIV-a pilot trial of a nurse-led psychoeducational intervention delivered in primary care to prostate cancer survivors: study protocol for a randomised controlled trial. BMJ Open. 2014;4(5):e005186.CrossRefPubMedPubMedCentral
71.
Walter FM, Usher-Smith JA, Yadlapalli S, Watson E. Caring for people living with, and beyond, cancer: an online survey of GPs in England. Br J Gen Pract. 2015;65(640):e761–8.CrossRefPubMedPubMedCentral
72.
Williams GR, Mackenzie A, Magnuson A, Olin R, Chapman A, Mohile S, et al. Comorbidity in older adults with cancer. J Geriatr Oncol. 2016;7(4):249–57.CrossRefPubMed
73.
74.
Reeve J, Lloyd-Williams M, Payne S, Dowrick C. Revisiting biographical disruption: exploring individual embodied illness experience in people with terminal cancer. Health (London). 2010;14(2):178–95.CrossRef
75.
Frank A. The wounded story teller: body, illness and ethics. Chicago: University of Chicago Press; 1997.CrossRef
76.
77.
Ristovski-Slijepcevic S, Bell K. Rethinking assumptions about cancer survivorship. Can Oncol Nurs J. 2014;24(3):166–8 174-7.CrossRefPubMed
78.
May CR, Eton DT, Boehmer K, Gallacher K, Hunt K, MacDonald S, et al. Rethinking the patient: using burden of treatment theory to understand the changing dynamics of illness. BMC Health Serv Res. 2014;14:281.CrossRefPubMedPubMedCentral
79.
Doyle N. Cancer survivorship: evolutionary concept analysis. J Adv Nurs. 62(4):499–509.
80.
Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. New York: Springer Publishing Company; 2007.
Metadata
Title
Living with and beyond cancer with comorbid illness: a qualitative systematic review and evidence synthesis
Authors
Debbie Cavers
Liset Habets
Sarah Cunningham-Burley
Eila Watson
Elspeth Banks
Christine Campbell
Publication date
01-02-2019
Publisher
Springer US
Keyword
Care
Published in
Journal of Cancer Survivorship / Issue 1/2019
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-019-0734-z

Other articles of this Issue 1/2019

Journal of Cancer Survivorship 1/2019 Go to the issue

OriginalPaper

Evaluation of a survivorship needs assessment planning tool for head and neck cancer survivor-caregiver dyads

OriginalPaper

Financial toxicity is more than costs of care: the relationship between employment and financial toxicity in long-term cancer survivors

OriginalPaper

Development of the perceived barriers scale: a new instrument identifying barriers to career development and employment for young adult survivors of pediatric CNS tumors

OriginalPaper

Integrating self-management into daily life following primary treatment: head and neck cancer survivors’ perspectives

Review

The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review

Review

Unpacking the layers: a meta-ethnography of cancer survivors’ loneliness
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits