Characterizing the patient experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma: A qualitative study

Table 1 Participant characteristics (n = 12)

Variable
Age [mean (range), yr]	67 (52 – 81)
Gender
Male	8 (67)
Female	4 (33)
Race
White	9 (75)
Black	3 (25)
Marital status
Married	7 (58)
Single	4 (33)
Divorced	1 (8)
Stage of cancer
PR	2 (17)
BR	7 (58)
LA	3 (25)
Location of tumor
Head	9 (75)
Body	2 (17)
Neck	1 (8)
Type of NT
Chemo	5 (42)
Chemo + XRT	7 (58)
Length of NT1
< 3 mo	1 (10)
3-6 mo	6 (60)
> 6 mo	3 (30)
Type of chemo
FOLFIRINOX	4 (33)
Gemcitabine/nab-paclitaxel	2 (17)
Other/both	6 (50)
Major complications during NT2
Hospitalization	2 (50)
ER visit, no admission	1 (25)
Other	1 (25)
Travel distance
< 15 miles	4 (33)
15 – 30 miles	1 (8)
31 – 50 miles	2 (17)
51 – 100 miles	3 (25)
100+ miles	2 (17)
Surgical resection
Yes	8 (67)
No	2 (17)
Not scheduled yet	2 (17)
Insurance status
Government	9 (75)
Private	3 (25)
Psychosocial or palliative care counseling
Yes	2 (17)
No	10 (83)

¹Values reflect the length of neoadjuvant therapy (NT) for n = 10 patients that have completed NT.

²Values for n = 4 patients that had major complications during NT.

All values are expressed as n (%) unless otherwise stated. PR: Potentially resectable; BR: Borderline resectable; LA: Locally advanced; NT: Neoadjuvant therapy.

Table 2 Representative quotes describing patient experience during neoadjuvant therapy

Physical symptoms
Quote No. 1	“After getting chemo for the next 5 d I’m sick as a dog, weak, losing weight, lost about 40 lbs.”
Quote No. 2	“Side effects of course. You’re gonna be queasy, you’re gonna be lightheaded. Definitely, I ate, but food didn’t taste good, even water didn’t taste good and I didn’t expect that.”
Quote No. 3	“I’m tired all the time. No energy. I sleep a lot. A little diarrhea. Pretty mild, never threw up yet. Only real bad thing is my appetite. Lost it about completely I have to force myself to eat until I start gagging”
Emotional symptoms
Quote No. 1	“Most times I don’t care, I really just don’t want to think about it. I just want to watch a good movie. You know what I mean. Not dwell on it all the time. I love my wife and I want to be around for her. It’s hard.”
Quote No. 2	“There are days that I get a little depressed. Because…I am used to movement. And I just don’t have the stamina, nor the willpower.”
Coping and support mechanisms
Quote No. 1	“…my wife and I, we are Christians and we know it’s up to him, the Lord.”
Quote No. 2	“I have good support from my family and friends. And prayer circles. Getting financial gifts to help us with gas money and things like that. So, they’ve all been very supportive.”
Access to care
Quote No. 1	“And I have had a lot of friends that make sure that I get to my treatments. So, I don’t have any problems there.”
Quote No. 2	“But it got to be a little bit much for [my sister-in-law] so, I had to withdraw money to get me through this [to ride the bus] that was an extra expense, as I am a senior. And I’m on a fixed income. So, I hadn’t counted on that.”
Quote No. 3	“I have no problem with transportation. My wife was always there to give me a ride.”
Life factors
Quote No. 1	“I have help with paying my bills, [grocery store], cleaning my house, things like that, doing laundry. So, I am very lucky.”
Quote No. 2	“I worry about all the damn bills”
Quote No. 3	“I’m retired so really the work thing didn’t come into play, but I have chores around the house that I’m limited in doing”