‘You know where we are if you need us.’ The role of the GP in supporting patients following major pancreatic surgery for cancer: A qualitative study
Pancreatic cancer is the 10th most common cancer in the UK, and 10-15% patients undergo pancreaticoduodenectomy. There is limited research reporting the experiences of patients living with pancreatic cancer, and minimal specifically focusing on the role of the GP. However, GPs are key in enabling effective coordination of care for people living with life-shortening conditions, and identifying unmet support needs which negatively impact on patients’ lives.
Ethical approval was obtained. Semi-structured interviews were conducted with patients who had undergone pancreaticoduodenectomy for pancreatic or distal biliary duct cancer at a specialist hepato-pancreatic-biliary centre in Northwest England. Interviews explored participants’ experience of the diagnostic process, life after surgery, and sources of support. Data were analysed thematically using constant comparison.
Analysis of 20 interviews is reported. Participants described immense treatment burden, challenges navigating the healthcare system, and uncertainty of the role of the GP in their ongoing care. They recognized that GPs may have little experience with patients who have had a pancreaticoduodenectomy. However, they felt that GPs should be proactive and could play a vital role in offering support. Participants expressed a wish for support post-operatively, but found that asking for help was difficult. Participants felt they would value greater recognition by GPs of both physical and psychological sequelae of major pancreatic surgery, and the impact on their families.
Why It Matters
Patients may be reluctant to ask for psychological support post-operatively, and are often unsure who to ask. Therefore, an awareness of both physical and psychological sequelae is crucial in order for GPs to proactively offer such support, and enable more effective liaison with secondary care. Understanding the impact of cancer on quality of life is vital in enabling the development of improved support interventions.
Dr Anna Kathryn Taylor. Visiting Academic Clinical Fellow in Psychiatry, School of Medicine, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, LS2 9JT. Email email@example.com Twitter @Anna_K_Taylor
Miss Ambareen Kausar. Consultant HPB Surgeon, Department of General Surgery, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Haslingden Road, BB2 3HH. Email firstname.lastname@example.org
Mr David Chang. Consultant HPB Surgeon, Department of General Surgery, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Haslingden Road, BB2 3HH. Email email@example.com
Prof Carolyn Anne Chew-Graham. School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, UK. Email firstname.lastname@example.org. Twitter @CizCG