Abstract
BACKGROUND: Psychological distress increases after a cancer diagnosis. However, patients who identify as Hispanic/Latino are less likely than their White counterparts to receive mental health care after being diagnosed, placing them at risk of poor psychological adjustment. The parent research objective aimed to characterize the treatment experiences of rectal cancer patients who identify as Hispanic/Latino. This qualitative secondary analysis specifically explored patients' emotional and psychological experiences. METHODS: We partnered with local community health workers to recruit rectal cancer patients who identified as Hispanic/Latino and their caregivers from California's Bay Area and Central Valley. Semi-structured interviews (n = 21) were conducted in either Spanish or English based on patient preference. Initial themes were identified using reflexive analysis. Experiences of distress were found in nearly all interviews, motivating this qualitative secondary analysis using directed content analysis. RESULTS: We identified three main themes: (1) emotional reactions to the initial diagnosis, (2) perspectives and emotions experienced throughout treatment, and (3) coping strategies and advice for others. Participants reported shock and incongruence with their diagnosis. The treatment journey caused feelings of embarrassment and frustration from difficulties such as racial profiling and insurance. Patients coped through faith and support from trusted individuals. CONCLUSIONS: Rectal cancer patients who identify as Hispanic/Latino endure emotional distress at multiple stages of their cancer journey, including from sources that are unique to this population. Culturally and linguistically tailored interventions are needed to help mitigate this psychological burden and to provide active, coordinated support throughout the treatment phase in order to better prepare patients for survivorship.