Quality of Life and Cancer-Related Experiences of Late-Stage and Metastatic Colorectal Cancer Survivors: A Mixed-Methods Study

Background People with late-stage and metastatic colorectal cancer (CRC) are living longer, with rates increasing over time, necessitating a greater understanding of their survivorship experiences. Objective The purpose of this study was to explore the quality of life (QoL) and cancer-related experiences of stages III and IV CRC survivors and to inform oncology nursing practice and survivorship care. Interventions/Methods This sequential, explanatory mixed-method study used a cross-sectional Functional Assessment of Cancer Therapy - Colorectal survey and semistructured interviews to explore QoL and cancer-related experiences of stages III and IV CRC survivors. The study was guided by the Ferrell QoL model. Descriptive statistics and directed and summative content analysis were utilized, followed by integration using joint displays. Results Thirty-one CRC survivors participated in the study; 24 completed the Functional Assessment of Cancer Therapy - Colorectal, and 12 participated in the semistructured interviews. Results identified 8 QoL themes: control, acceptance, normalcy, resilience, trust, isolation, and anger/frustration with support needs, including ostomy appliance management and shared experiences from other CRC survivors. Conclusions Stage III/IV CRC survivors experience substantial physical, psychological, social, and spiritual cancer-related challenges. Integration of quantitative and qualitative data in this study highlighted QoL domains for future clinical intervention. Implications for Practice These data inform oncology nurses and other healthcare providers regarding QoL domains that may warrant greater assessment among late-stage and metastatic CRC survivors experiencing low, moderate, or high QoL. Interventions to facilitate social and community support for late-stage and metastatic CRC survivors through support groups, one-on-one interactions, or virtual online platforms are warranted.