Colorectal Cancer Survivors Say Smartphone Support Could Ease a Lonely Road After Treatment

When the last infusion is finished and the final scan comes back clear, many people treated for colorectal cancer assume the hardest part is over. A new qualitative study suggests that, for a large group of survivors in Vietnam, the end of active treatment marks the beginning of a different and in some ways lonelier struggle. Researchers from The Nethersole School of Nursing at The Chinese University of Hong Kong, working with clinicians at oncology and general hospitals across Vietnam, interviewed thirty colorectal cancer survivors who had completed primary treatment and found a consistent pattern: survivors were coping with lingering physical symptoms, emotional upheaval and financial strain, often while searching for reliable information in isolation. Their answer to that gap, the survivors said, could fit in a pocket. Most participants expressed clear preferences for a mobile health, or mHealth, program that would deliver trustworthy survivorship information, reminders for follow-up appointments and practical strategies for staying well after cancer.

The study, published in BMC Health Services Research, used a qualitative descriptive design and individual semi-structured interviews conducted online between February and April 2025. The participants, whose mean age was 59.9 years, represented a demographic that is often overlooked in digital health research: middle-aged and older adults in a middle-income country, many of whom had limited access to structured follow-up care after finishing treatment. The research team analyzed the interview transcripts using inductive thematic analysis, an approach that lets patterns emerge from the data itself rather than testing predefined categories, and reported the work in accordance with the COREQ guideline, a 32-item checklist designed to make qualitative research transparent and reproducible. Ethics approval came from both The Chinese University of Hong Kong and Nam Dinh University of Nursing in Vietnam, and all participants gave documented informed consent.

Three major themes emerged from the analysis. The first captured what the researchers call multidimensional survivorship experiences: physical changes that persisted long after treatment ended, emotional turmoil that survivors frequently kept hidden, financial challenges associated with cancer care, a sense of navigating the journey in isolation, and a search for spiritual support. This clustering is significant because it underscores that cancer survivorship is not simply a medical state defined by the absence of disease. It is a lived experience in which bodily changes, psychological distress, economic pressure and existential questions interact and compound one another. A survivor who cannot afford transport to a follow-up visit is also a survivor who may miss early detection of recurrence, and the anxiety of not knowing what symptoms matter can amplify both the emotional and financial burdens at once.

The second theme mapped the survivors’ supportive care needs, and it reads almost like a specification document for a digital health intervention. Participants wanted information from reliable sources, which is a pointed request in an era when cancer misinformation spreads readily on social media. They wanted help recognizing the symptoms of cancer recurrence, so that normal post-treatment sensations could be distinguished from warning signs that warrant a clinic visit. They wanted reminders for post-treatment follow-up, a low-technology feature with potentially high-impact consequences for early detection. And they wanted health promotion strategies, concrete guidance on diet, activity and lifestyle choices that could reduce the risk of the cancer returning or a second cancer developing. Each of these needs maps directly onto a function that a well-designed smartphone application can deliver at scale and at low marginal cost.

The third theme addressed how such a program should actually be designed, and here the survivors offered technical and cultural guidance that developers rarely hear from this population. Participants expressed preferences for specific features of mHealth design, but they also flagged age-related digital support as essential. With a mean age approaching sixty, many survivors are not digital natives, and an application that assumes fluency with menus, notifications and account creation risks excluding precisely the people it aims to serve. The survivors indicated they would need assistance and simplified interfaces to use such tools confidently. They also asked that cultural elements be incorporated into the program, reflecting beliefs, practices and communication styles familiar to Vietnamese patients, and they identified practical barriers to using mHealth, from unfamiliarity with smartphones to concerns about privacy and the sheer novelty of managing health through a screen.

The researchers situated their findings within the Cancer Survivorship Care Framework, a conceptual model that organizes survivorship care around the domains of surveillance for recurrence, prevention of new cancers, intervention for delayed physical and psychosocial effects, and coordination of care among specialists and primary providers. The alignment matters because frameworks only become useful when they can be translated into interventions that patients will actually adopt. The study’s results provide exactly that bridge: each theme corresponds to a framework domain, and each expressed need corresponds to a candidate feature for an mHealth program. Information from reliable sources supports prevention and health literacy; symptom-recognition guidance supports surveillance; follow-up reminders support coordination of care; and attention to emotional and spiritual needs supports intervention for psychosocial effects.

Why does this matter on a global scale? Colorectal cancer is among the most commonly diagnosed cancers worldwide, and as screening and treatment improve, the population of survivors continues to grow. Health systems in high-income countries are already straining to provide survivorship care, and in countries like Vietnam the challenge is magnified by uneven access to specialists, long travel distances and resource constraints at the primary care level. Mobile health offers a technological shortcut, but only if the programs are built around what survivors actually need rather than what developers assume they want. Studies like this one, grounded in the lived experience of patients, are the raw material for that co-design process. The authors explicitly frame their findings as informing the future co-design and development of a culturally appropriate mHealth survivorship program involving colorectal cancer survivors and relevant healthcare stakeholders.

The emphasis on co-design is more than a methodological flourish. Digital health has a well-documented attrition problem: applications are downloaded with enthusiasm and abandoned within weeks, often because they were designed without meaningful input from end users. For older cancer survivors, the stakes of abandonment are higher than engagement metrics suggest. A survivor who stops opening an application may also stop tracking symptoms, miss a follow-up reminder, and delay reporting a recurrence signal that could have been caught early. By interviewing survivors before a single line of code is written, the research team is following a model that treats patients as partners in engineering, not merely recipients of a finished product. The preferences on digital support for older users and cultural tailoring are the kind of specifications that emerge only when the people who will use the system are asked directly.

The study also carries a quieter but equally important message about isolation. The theme of navigating the journey in isolation and searching for spiritual support suggests that many survivors leave the hospital with their medical needs addressed but their social and existential needs unmet. An mHealth program cannot replace human connection, but it can reduce isolation by providing a continuous, reliable channel of information and reassurance between clinical visits, and by signaling to survivors that their ongoing needs are seen and taken seriously. Whether delivered as tailored educational content, structured check-ins or follow-up reminders, that continuity of care is precisely the gap that survivors in this study described.

For now, the findings are descriptive rather than interventional; no application has been built or tested, and the study captured the perspectives of thirty survivors in a single national context. The authors note that the research received no specific grant funding, and the published version is open access under a Creative Commons Attribution 4.0 license, allowing clinicians, designers and patient advocates anywhere to build on it. The next step, informed by this work, will be developing and evaluating an mHealth survivorship program designed with colorectal cancer survivors rather than for them. If it succeeds, the result could turn the most isolating phase of cancer care, the quiet months and years after treatment ends, into one where a trusted companion lives on the survivor’s own phone, ready with answers, reminders and reassurance whenever the uncertainty returns.

Subject of Research: Survivorship experiences and mobile health support preferences among colorectal cancer survivors in Vietnam

Article Title: Cancer survivorship experiences and preferences for mHealth program among colorectal cancer survivors: a qualitative study

Article References: Vi, D. P. N., Khanh, N. T., Duyen, D. T. H., Tuyet, N. H. A., Quyen, T. T. M., Tse, M., & Wong, C. L. (2026). Cancer survivorship experiences and preferences for mHealth program among colorectal cancer survivors: a qualitative study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15648-y

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15648-y

Keywords: colorectal cancer, cancer survivorship, mHealth, mobile health, supportive care, qualitative research, Vietnam, digital health, health informatics, thematic analysis, patient-centered design, Cancer