title: Late effects of cancer and cancer treatment--the perspective of the patient.
abstract: OBJECTIVE
  Understanding the experience of late effects from the perspective of cancer survivors is essential to inform patient-centred care. This study investigated the nature and onset of late effects experienced by survivors and the manner in which late effects have affected their lives.
  
  
  METHODS
  Sixteen purposively selected cancer survivors participated in a qualitative interview study. The data were analysed inductively using a narrative schema in order to derive the main themes that characterised patients' accounts of late effects.
  
  
  RESULTS
  Individual survivors tended to experience more than one late effect spanning a range of physical and psychological effects. Late effects impacted on relationships, working life, finances and the ability to undertake daily activities. Survivors reported experiencing psychological late effects from around the end of treatment whereas the onset of physical effects occurred later during the post-treatment period. Late effects were managed using formal health services, informal social support and use of 'wellbeing strategies'. Survivors engaged in a process of searching for reasons for experiencing late effects and struggled to make sense of their situation. In particular, a process of 'peer-patient comparison' was used by survivors to help them make sense of, or cope with, their late effects. There appeared to be an association between personal disposition and adaptation and adjustment to the impact of late effects.
  
  
  CONCLUSIONS
  Cancer survivors identified potential components for supported self-management or intervention programmes, as well as important considerations in terms of peer comparisons, personal disposition and making sense of experienced late effects.
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK. c.treanor@qub.ac.uk.|Institute of Clinical Sciences-B Building, Royal Victoria Hospital Site, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland. c.treanor@qub.ac.uk.
authors.forename: Charlene
authors.initials: C
authors.lastname: Treanor
authors.affiliation: Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, UK.|UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, UK.|Institute of Clinical Sciences-B Building, Royal Victoria Hospital Site, Grosvenor Road, Belfast, BT12 6BJ, Northern Ireland.
authors.forename: Michael
authors.initials: M
authors.lastname: Donnelly
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D000067656:Optimism; D036301:Qualitative Research; D012648:Self Care; D012944:Social Support; D017741:Survivors / Q000523:psychology*; D014937:Work
keywords: Cancer; Cancer survivorship; Late effects; Qualitative research methods