The meaning-making process in the re-entry phase: A qualitative focus group study with patients treated for breast cancer or melanoma

Purpose: After completion of curative cancer treatment patients enter the re-entry phase, which is characterized by the task to pick up life again. While having to resume their former roles, patients experience the loss of normality and face existential concerns. A sense of meaning and purpose may help in dealing with changes in life and existential concerns. The aim of this study is to gain insight in the meaning-making process of patients treated for breast cancer or melanoma in the re-entry phase in order to develop an intervention to support picking up life after a long treatment process including systemic treatment. Methods: We conducted six focus groups with 16 patients (11 breast cancer and five melanoma) to explore their experiences, challenges, and sources of meaning during the re-entry phase. The re-entry phase was defined as the point from completion of surgical and systemic treatment (except for hormonal therapy) up to 18 months in remission. A thematic content analysis was performed by two researchers. Results: We identified four themes pertaining to patients’ use of sources of meaning in the meaning-making process: (1) use of existing, helpful sources; (2) distress due to impacted sources; (3) search for new sources; and (4) use of adapted or new sources. When patients drew upon existing sources of meaning that had been impacted by cancer and the aftermath of treatment, they experienced distress. This could instigate a search resulting in adapted, strengthened, or new sources of meaning. Conclusions: Meaning-making in the re-entry phase is a versatile process involving the use of existing sources of meaning, and a search for, or use of new, strengthened, or adapted sources of meaning. An intervention increasing patients’ awareness of their sources of meaning might strengthen the meaning-making process of patients treated for breast cancer or melanoma.