ABSTRACT
Aims: Survival of people with advanced colorectal cancer (CRC) can be prolonged through treatment pathways including cytoreductive surgery and hypothermic intraperitoneal chemotherapy (CRS-HIPEC), pelvic exenteration, liver resection, and palliative chemotherapy without surgery. Virtually no qualitative research has compared the experiences and needs of advanced CRC survivors who receive these treatments. This study aims to fill this gap. Methods : Adult survivors of CRC who have undergone the aforementioned treatments are being recruited 0.5-2 years post-surgery or, for palliative chemotherapy participants, 0.5-2 years post-diagnosis of advanced CRC. Recruitment will continue until approximately N = 40 or data saturation is reached. Quantitative data include: demographic and clinical data, Functional Assessment of Cancer Therapy - Colorectal (FACT-C), Distress Thermometer, and Comprehensive Score for Financial Toxicity (COST). Quantitative data will undergo descriptive analysis to characterise the sample. All participants will participate in a qualitative semi-structured telephone interview exploring quality of life, employment, finances, stigma, supportive care needs, social functioning, perceptions of survivorship, and impacts of COVID-19. Interviews are analysed via the framework approach of thematic analysis. Results : Preliminary analysis of 36 interviews (n = 10 CRS-HIPEC, n = 10 pelvic exenteration, n = 9 liver resection, n = 7 palliative chemotherapy) reveals some advanced CRC survivors report post-surgical complications and chemotherapy-induced peripheral neuropathy, which can limit physical activity. CRC impacted some participants' psychosocial well-being ability to work, and sense of identity. Participants reportedly manage these impacts through distraction, positive reframing, and contact with other CRC survivors. Most participants appeared satisfied with their cancer treatment teams. Some viewed GPs as important healthcare coordinators. COVID-19 made some participants more cautious when leaving the house. Telehealth was considered less personal, but convenient. Conclusions : The study's findings will help guide development of interventions to improve the survivorship experience of patients who receive treatment for advanced CRC. This may include an information booklet, patient-reported outcome measure, clinical pathway, or targeted intervention.