PURPOSE: People with severe mental illness (SMI) experience disparities in cancer care, including delayed diagnosis, poorer symptom management, and reduced quality of life. This study aimed to explore the lived experiences of individuals with SMI who have also been diagnosed with cancer. METHODS: A qualitative, grounded theory study was conducted with 11 adults in England with lived experience of both SMI and cancer. Participants were recruited via NHS and voluntary organisations. Semi-structured interviews, conducted via telephone or video call, were transcribed verbatim. Coding progressed through initial, focused, and theoretical coding alongside constant comparative methods and memoing. RESULTS: Stigma emerged as a main theme, derived through participant explanations of limited information sharing, restricted involvement in decision-making, and the misattribution of physical symptoms to mental illness. These perceived forms of stigma contributed to delays in cancer diagnosis, reduced opportunities for informed decision-making, and feelings of disempowerment. Collectively, they reinforced existing health inequities and negatively affected participants' mental and physical wellbeing throughout their cancer care and beyond. CONCLUSIONS: Structural and public stigma intersect, resulting in health-related stigma, creating barriers across cancer care pathways for people with SMI. Stigma may compromise quality care and contribute to poorer clinical and experiential outcomes in people with cancer and SMI. IMPLICATIONS FOR CANCER SURVIVORS: Interventions are needed to reduce stigmatising behaviours and beliefs in healthcare settings, to distribute power within clinical settings, and promote shared, person-centred decision-making to ensure comprehensive information provision and recognition of patient expertise. Collectively, these actions may improve early diagnosis, cancer symptom management, recovery, and overall quality of life for cancer survivors with SMI.
Charlesworth et al. (Sat,) studied this question.