The psychosocial aspects of living with pancreatic cancer: A qualitative systematic review

Background/Purpose: Despite improvements in the survival of many cancers, there has been relatively little progress in the outcomes of pancreatic cancer. This is attributed to difficulties in screening and early detection, meaning people are often diagnosed at an advanced stage. Consequently, pancreatic cancer remains a less-survivable cancer with five-year survival rates less than 5% overall and below 1% for inoperable tumours. As a result, people diagnosed with pancreatic cancer often face significant psychosocial challenges. However, research on the psychological and social aspects of their journeys remains scarce globally.
Therefore, this review aims to improve our understanding of the experiences of people with pancreatic cancer by identifying, analysing, and synthesising empirical literature which answers the primary research question: ‘What are the psychosocial aspects of people’s experiences when receiving, living, and dying with (or surviving) a pancreatic cancer diagnosis?’
Methods: This qualitative systematic review was registered in PROSPERO (CRD42025635882) and observed the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. CINAHL, Embase, MEDLINE, PsycINFO, Scopus, Web of Science, and the WHO Global Index Medicus databases were searched from inception until August 2024. Results were imported into Covidence systematic review management software for screening; 6,433 records were identified and 25 studies met inclusion criteria. Included full texts were assessed by two reviewers for methodological validity using JBI critical appraisal tools and data was extracted and thematically analysed.
Results: Four key preliminary themes emerged: (1) psychological distress relating to three sub-themes: a) the shock of diagnosis, b) fears and uncertainty, and c) changes in identity and social roles; (2) the impact of symptom experiences on quality of life and social life, especially gastrointestinal issues secondary to pancreatic exocrine insufficiency; (3) coping mechanisms and sources of support, relating to three sub-themes: a) family support, b) hope, faith, and spirituality, and c) the health care team; and (4) information needs, communication, and decision-making.
Conclusions/Implications: This review emphasises the profound psychosocial challenges faced by people with pancreatic cancer and highlights the importance of interventions which address psychological distress, improve quality of life, and support coping mechanisms. Insights from this review can guide future research and inform the development of interventions which better support people navigating the complexities of a pancreatic cancer journey and which meet their psychosocial needs from diagnosis to survivorship or to end of life.