Complexities in supportive care for people with metastatic breast cancer: a qualitative study

Marika Franklin; Sophie Lewis; Andrea L Smith

doi:10.1007/s11764-024-01646-8

Complexities in supportive care for people with metastatic breast cancer: a qualitative study

J Cancer Surviv. 2024 Aug 17. doi: 10.1007/s11764-024-01646-8. Online ahead of print.

Authors

Marika Franklin^{1

2

3}, Sophie Lewis⁴, Andrea L Smith⁵

Affiliations

¹ School of Health Sciences, The University of Sydney, Sydney, Australia. marika.franklin@sydney.edu.au.
² The Daffodil Centre, The University of Sydney (a joint venture with Cancer Council NSW), Sydney, Australia. marika.franklin@sydney.edu.au.
³ School of Nursing & Midwifery, The University of Sydney, Sydney, Australia. marika.franklin@sydney.edu.au.
⁴ School of Health Sciences, The University of Sydney, Sydney, Australia.
⁵ The Daffodil Centre, The University of Sydney (a joint venture with Cancer Council NSW), Sydney, Australia.

PMID: 39153049
DOI: 10.1007/s11764-024-01646-8

Abstract

Purpose: The complexity of metastatic breast cancer, its rapidly evolving treatment, and the changing trajectory toward long-term survivorship create unique challenges for the provision of supportive care. The experiences of health professionals enacting supportive care in contexts of those living long-term with incurable cancer have received limited research attention. This qualitative study aimed to gain further insight into health professionals' experiences of supportive care in this context.

Method: Semi-structured interviews were conducted via phone and online with 25 health and community-care professionals who support people living with metastatic breast cancer in Australia. A mix of sampling strategies was used. Thematic analysis was undertaken. Findings were interpreted through an ethics of care lens.

Results: Three key themes were identified. First, participants experienced supportive care as highly relational. Second, they encountered numerous moral and ethical dilemmas in enacting supportive care. Finally, enacting supportive care was complicated by fragmented and sporadic provision in a system in which supportive care is differentially valued across professions and settings.

Conclusion: Findings draw attention to complexities in enacting supportive care in the context of metastatic breast cancer, with implications to patients and professionals. To improve the quality of care provided to patients and minimise the risk of professional burnout, greater attention is needed in supportive care guidelines to the ethical, moral, and emotional complexities experienced by professionals in this context.

Implications for cancer survivors: People living with metastatic breast cancer are a growing proportion of cancer survivors. The knowledge gained through this study may help professionals to better meet the supportive care needs of people living with metastatic breast cancer, a treatable but not curable condition.

Keywords: Ethics of care; Health and community-care professionals; Metastatic breast cancer; Patient-professional relationships; Qualitative research; Supportive care.