Social determinants of health, diet changes, and treatment-related symptom experiences in patients with colorectal cancer who are receiving chemotherapy: A qualitative study

Abstract

Purpose: Patients with colorectal cancer (CRC) undergoing chemotherapy often face symptoms that significantly diminish their quality of life. Dietary intake is one factor that affects both physical and psychological CRC symptom management; however, notable inequities in CRC symptom experiences exist due to social determinants of health (SDOH). This study aimed to explore the challenges and adaptative behaviors related to dietary management and treatment-related symptom experiences among patients with CRC undergoing chemotherapy, with a particular focus on the influence of SDOH.

Methods: Eighteen participants, representing diverse racial and ethnic backgrounds, with a diagnosis of CRC who had received chemotherapy within the past three months were included in the study. One-time, semi-structured interviews were conducted via video call, and the data were analyzed using conventional qualitative content analysis.

Results: Six primary themes were identified: (1) the multidimensional impact of cancer treatment, (2) overcoming SDOH barriers along the cancer continuum, (3) adaptation to new dietary needs, (4) use of proactive self-management strategies and cultural resilience to overcome cancer, (5) multifaceted support systems that enhance cancer care, and (6) nurturing positivity and hope.

Conclusions: These findings highlight complex and interconnected factors that shape the treatment-related symptoms and dietary challenges of patients with CRC undergoing chemotherapy. Understanding of these influences can inform targeted interventions and ongoing support systems to enhance quality of life and optimize care for cancer survivors.

Keywords: Chemotherapy; Colorectal cancer; Dietary changes; Social determinants of health; Treatment-related symptoms.