"I Have Both Lost and Gained." Norwegian Survivors' Experiences of Coping 9 Years After Primary Breast Cancer Surgery.

BACKGROUND: Increased breast cancer survival means that many women live with long-term consequences of their cancer and treatment. Knowledge about their coping is important.

OBJECTIVE: This qualitative follow-up study describes survivors' coping experiences 9 years after primary breast cancer surgery.

METHODS: Seventeen of the 21 women interviewed 9 years earlier were invited to participate. Fifteen agreed and were interviewed individually between January and June 2015. Qualitative meaning condensation analysis was used.

RESULTS: Three themes emerged: (1) Changed life: some felt healthy and beyond cancer; others suffered from reduced energy, joy of life, and self-esteem. Being affected by a life-threatening illness made their fundamental values clearer. Using cancer experiences to help others was emphasized. (2) Positive thinking, distancing the negative: striving to maintain positive thinking and distancing themselves from insecurity and fear of recurrence. A step-by-step strategy was important to cope with their new life situation. (3) Need for understanding and recognition: support was experienced as necessary and challenging. Recognition of posttreatment ailments was emphasized. Being more socially selective and preferring positive people were essential.

CONCLUSIONS: Cancer experiences changed the women's lives. Their coping varied. Fewer but selected supporters were preferred. Understanding and recognition from others for the women's changed life situation was essential.

IMPLICATIONS FOR PRACTICE: Healthcare professionals should prepare women for a changed life situation because of illness experiences and the adverse effects of treatments. The support and information offered must be adjusted to each woman's individual needs, coping capacity, and life situation. Further clinical intervention studies are needed.