Lived experiences of psychosocial and quality of life outcomes for adults newly diagnosed with breast cancer in interior British Columbia: qualitative research

An exploratory-descriptive qualitative study of 28 adults with newly diagnosed breast cancer in interior British Columbia identified three interconnected areas of difficulty: gaps in transitional care, psychological and financial distress, and changes to body identity, sexuality and relationships. The participants were undergoing or had completed primary treatment within the preceding 12 months. Their interviews showed how fragmented support, travel to cancer services, employment disruption, fear of recurrence and treatment-related changes in appearance and intimacy could shape quality of life during the first year after diagnosis.

The study documents experiences and unmet support needs; it does not estimate how common these problems were across all people with breast cancer or test whether particular interventions improve outcomes. Researchers recruited participants through posters, community newsletters and social media between April 2023 and April 2024. Eligible adults were at least 18 years old, had a histologically confirmed diagnosis of primary stage I, II or III breast cancer, were actively receiving or had completed surgery, radiation, chemotherapy or hormone therapy within the previous year, and lived in interior British Columbia.

People with self-reported distant metastatic disease, those receiving end-of-life or palliative care, and those whose cognitive or neurological impairments prevented informed consent or participation were excluded. Recruitment used purposive sampling, with 12 interviews conducted face to face and 16 online. Each semi-structured interview lasted about 60 to 75 minutes and covered the diagnosis experience, navigation of cancer services, psychosocial and daily-life effects, relationships, financial and occupational challenges, coping and recommended resources.

The interview guide was developed through a three-stage process informed by a supportive-care framework and recent qualitative research. Two oncology nurse specialists, a behavioral psychologist and two people with lived experience of a new breast cancer diagnosis reviewed its questions. A pilot with five eligible participants tested clarity and emotional safety, after which pacing was adjusted slightly.

Transcripts were analyzed in NVivo 14 using directed qualitative content analysis and a deductive-inductive framework. Meaning units could range from words or sentences to paragraphs, and the researchers combined a formative matrix with emergent subcategories. Coding was supported through verbatim transcription, reflexive journals, an audit trail and reconciliation of discrepancies by two independent coders.

Transitional care emerged as the first major category. Participants described uncertainty about whom to contact after diagnosis or treatment, limited continuity between clinicians, inadequate information about available programs, and insufficient advocacy. One participant said a breast cancer survivor group became a “salvation” after a brief exchange with a physician left them feeling unsupported.

Another described losing access to a family doctor when the physician moved, with records not being transferred for two years. Support groups helped participants feel connected, while peer relationships offered reassurance from people who could relate to their experiences. However, these accounts do not establish that mentorship was more valuable when it arrived late, nor do they demonstrate the effectiveness of any particular support group.

Instead, they identify unmet needs for navigation, advocacy, follow-up and accessible information. Participants also described a lack of professional guidance concerning sexuality, body image and intimacy. Some requested support specifically for the effects of aromatase inhibitors, as well as counseling for body dysmorphia and depression after diagnosis.

One participant described an evening hospital group as the only available option but said its timing was too late for people who became exhausted during treatment. Another said they received neither therapy nor counseling and wanted access to nurse navigators, emotional-support counselors, financial counseling and assistance for family members. These preferences were expressed within the first year after diagnosis, when some participants were still undergoing treatment and others had already completed primary therapy.

The findings reveal gaps in information and support, not measured rates of sexual dysfunction, depression or treatment-related body dissatisfaction. Physical symptoms and the cost of care combined to reduce quality of life. Participants described fatigue, pain, nausea, brain fog and other treatment effects, as well as expenses for transportation, parking, meals, accommodation and supportive services.

One participant reported attending hospital appointments as often as three times a week and struggling with parking costs; the account concerned repeated outpatient visits rather than hospitalization. Several traveled long distances for diagnostic testing, surgery, radiation or follow-up appointments, and one described staying in a cancer lodge during radiation. Because the research was qualitative, it cannot quantify the average cost of travel or financial toxicity.

It nevertheless shows that repeated journeys could consume time, wages and savings, while specialized care in larger centers could require temporary lodging and extended absences from work and family life. Employment disruption was closely connected to these financial and psychological burdens. Participants described sick leave, reduced working hours, disability benefits, difficulty returning to full-time work, early retirement and loss of pension contributions.

Fatigue, anxiety, cognitive problems, medical appointments and side effects limited their capacity to work, while fear of recurrence made returning to a previous workload more difficult. Family members also faced consequences through unpaid leave, early retirement, childcare and household care. One participant linked repeated specialist trips and radiation treatment to time away from work and the need to borrow money.

Another described depleted retirement savings and out-of-pocket costs for care, transport and accommodation. These accounts show that the effects of diagnosis could extend to household finances and employment plans, although the study did not calculate income loss or compare outcomes with a control group. Emotional distress was expressed through fear of recurrence, fear of dying, anxiety, sadness, anger and hypervigilance about physical symptoms.

Participants described checking their bodies, interpreting unexplained sensations as possible recurrence, rumination about mortality and difficulty planning. Treatment-related distress also affected mobility, travel and participation in family activities. One participant said fear of recurrence diminished their sense of control and ability to make retirement plans.

Another described enduring distress after chemotherapy, radiation, multiple surgeries, infection and treatment effects involving the heart and lungs. Some maintained an outward appearance of resilience to avoid worrying relatives, while others withdrew or suppressed emotions to preserve household harmony. The researchers interpreted this concealment as an avoidant coping response that could leave participants isolated, but the interviews do not determine whether such behavior was typical or clinically harmful at a population level.

The third category concerned body identity, interpersonal relationships, sexuality and dysmorphia. Participants described hair loss, mastectomy, lymphedema, menopause, surgical scars, asymmetric reconstruction and endocrine-therapy effects on desire and intimacy. Hair loss and scars were described as visible reminders of cancer and treatment, contributing to shame, embarrassment and reduced confidence.

Some participants avoided being seen by partners or withdrew from sexual relationships, while others said they were reluctant to communicate their physical or emotional needs. Family members provided important practical and emotional support, yet communication barriers could leave relatives unaware of the full extent of a participant’s distress. Conversations with doctors and nurses sometimes helped participants understand treatment and side effects, participate in decisions and articulate their needs.

The findings therefore show that relationships could be both sources of support and sites where unresolved distress remained hidden. The authors recommend integrating professional nurse mentorship and navigation from biopsy onward, routinely screening for emotional distress and financial toxicity, and providing specialized counseling concerning body image, menopause, reproductive health, sexual function and treatment effects. They also propose inclusive support groups with flexible schedules, travel and lodging assistance, and hybrid oncology networks combining virtual specialist consultations with local community services.

These recommendations derive from participants’ reported experiences rather than from trials of effectiveness. Important limitations include the regional setting, purposive recruitment, possible self-selection through community and survivor networks, a cross-sectional design and a sample of 28. Most participants were women, while men and non-binary people were insufficiently represented.

The findings nevertheless provide a detailed account of how care for newly diagnosed breast cancer in rural and remote communities can extend beyond treatment itself to navigation, employment, finances, relationships, identity and intimacy.

Subject of Research: Psychosocial and quality-of-life experiences of adults newly diagnosed with breast cancer in interior British Columbia

Article Title: Lived experiences of psychosocial and quality of life outcomes for adults newly diagnosed with breast cancer in interior British Columbia: qualitative research

Article References: D’Souza, M. S., Manish, A., Nette, H., & Bacsu, J.-D. R. (2026). Lived experiences of psychosocial and quality of life outcomes for adults newly diagnosed with breast cancer in interior British Columbia: qualitative research. Frontiers in Global Women's Health, 7, 1828624. https://doi.org/10.3389/fgwh.2026.1828624

Image Credits: AI Generated

DOI: 10.3389/fgwh.2026.1828624

Keywords: breast cancer, qualitative research, rural health, quality of life, patient navigation, financial toxicity, sexual health, body image, fear of recurrence, early survivorship, Lived, experiences