Experiencing the diagnosis of pancreatic cancer as an acute threat: a grounded theory study on the diagnostic process of people with pancreatic adenocarcinoma

Background
Pancreatic cancer is usually diagnosed late and at an advanced stage. Thus, cure is not possible in most cases and the prognosis is often poor.

Objective
This article explores how people with pancreatic cancer experience their diagnostic process.

Methods
Twenty problem-centered interviews with people diagnosed with pancreatic cancer were conducted and analyzed using grounded theory methodology.

Results
We identified a multicausal central phenomenon: people experience the diagnosis of pancreatic cancer as an acute (life) threat. Communication of the diagnosis initiates a process of consideration, self-reflection, and negotiation. It leads to either being unable to handle the diagnosis or to its acceptance, questioning, or rejection. Prognostically unfavorable findings are not accepted as such at first. This process results in rapid treatment initiation or in seeking a second medical opinion.

Conclusion
This paper provides a model of the diagnostic experience of people with pancreatic cancer. In the early phase after diagnosis, neither shared decision-making nor best supportive care strategies appear to be effective. In the future, this knowledge may be used to develop targeted interventions which could be applied during the diagnostic process and support patients.