From diagnosis to survivorship: Mapping the lived experience of patients with cancer in the Philippines.

Abstract

e13619 Background: Cancer is now the Philippines’ second leading cause of death, yet the day-to-day realities of care remain poorly documented. Mapping the patients' cancer journey is a valuable tool in cancer care, providing a deep understanding of the patient's perspective and using that knowledge to drive improvements across the healthcare system. Despite the legislation and continuing implementation of the National Integrated Cancer Control Act (NICCA), a landmark policy designed to enhance access, equity, and quality of cancer care in the Philippines, there is a gap between the law's intended impact and the actual experiences of Filipino cancer patients. Methods: We conducted a multicenter qualitative study that combined focus-group discussions with real-time patient-journey mapping among 24 adults with diverse cancers from five Philippine regions. We independently applied inductive coding and developed an initial codebook that the entire team reviewed by consensus. Codes were aggregated into higher-order themes within and across regions, and matrix tables were created showing barriers and facilitators to care according to cancer phase and care setting. The team then generated a composite patient-journey map that visually represented these themes. Results: Twenty-four adults (15 females and 9 males), with a mean age of 52.5 years, participated in five regional journey-mapping sessions. Most patients had breast, lung, or rectal cancers. Eight patients (32%) had metastatic disease, while the rest had early or locally advanced cancers. Eight participants (32%) received treatment in private hospitals, 7 (28%) received concurrent mixed private-public hospital care, 5 (20%) received treatment in government hospitals only, and 4 participants (16%) switched from private to public hospitals. Thirteen (13) participants were able to receive treatment in a CSPMAP (Cancer and Supportive-Palliative Medicines Access Program)-enabled government facility. Four care trajectories surfaced: exclusive private care, public-to-private switching, concurrent mixed-sector use, and exclusive public care. Regardless of the care trajectory, five themes shaped experience: the navigational power of family, faith, and social capital; financial and geographic hurdles that magnify distress; the decisive impact of empathic clinicians; life-course disruption and anxiety during survivorship; and persistent recourse to alternative therapies. These insights pinpoint several touch-points that could be mitigated by strengthening the implementation of the NICCA: the need for early diagnostic access, more streamlined subsidy processes, and the impact of compassionate communication. Conclusions: Patient-journey mapping thus offers a practical lens for designing Filipino-centered cancer services in a resource-limited setting.