The experience of persistent pain in adult cancer survivors: A qualitative evidence synthesis

Introduction There have been significant improvements in cancer survival in recent decades but not everyone is living well. Nearly 40% of cancer survivors have chronic pain, however, little is known about their experiences (1). Those with chronic pain may be cared for across specialities, including primary care, secondary care and specialist pain clinics (2). To enable continuity of care across specialties, and to improve services, it is important to understand the experiences chronic pain in cancer survivors. Aim To identify, review and synthesise qualitative literature surrounding the experience of chronic pain in adult cancer survivors. Method A systematic qualitative evidence synthesis was conducted between October 2017 and February 2018. Studies were included if they explored cancer survivors’ experience of chronic pain and adopted a qualitative methodology. Quality assessment of studies was undertaken using an adapted version of the Critical Appraisal Skill Programme (CASP) Checklist for Qualitative Research (3). Data synthesis followed Thomas and Harden’s (2008) (4) method of thematic synthesis of qualitative research. Results Four studies were identified that generated findings from 52 breast cancer survivors. Sample sizes ranged from 8 to 21. The main themes that emerged included the physical impact of pain, pain is not isolation but related to the cancer experience, there are multimodal ways of coping, pain is unexpected then people are left to manage it alone and pain is an emotional experience. Furthermore, there is a temporal nature to chronic pain and cancer survivors’ experience of it. Conclusions/implications Chronic pain in cancer survivorship has physical and emotional consequences that are unique to this population. There is limited qualitative research into this area, and what is available is exclusively in the breast cancer population. More research is needed to understand the experience of survivors from different tumour types at various stages of survivorship.