# “…it is not the sickness itself that kills. It is the emotional trauma”: a qualitative study of the lived experience and systemic barriers of women with breast cancer in Nigeria

## TL;DR

This study explores the emotional and systemic challenges faced by Nigerian women with breast cancer, highlighting the need for better support systems.

## Contribution

The study provides new qualitative insights into the lived experiences and coping strategies of Nigerian breast cancer patients.

## Key findings

- Women face emotional, physical, economic, and social upheaval after diagnosis.
- Participants rely on personal, spiritual, and peer-based coping strategies.
- Structural barriers like financial costs and fragmented care pathways are significant issues.

## Abstract

Breast cancer is the leading cancer among Nigerian women and is commonly diagnosed at an advanced stage; yet the everyday realities that influence patient outcomes and well-being remain underexplored. Understanding the lived experiences of Nigerian breast cancer patients is critical for developing culturally appropriate, supportive, and palliative care services.

To explore the lived experiences, needs and coping strategies of women living with and beyond breast cancer in Nigeria.

Qualitative study using a constructivist–interpretivist paradigm. Semi-structured, in-depth interviews were conducted online via Microsoft Teams, audio and/or video-recorded, and transcribed verbatim. Data were analysed inductively using the Framework Method, with double coding to ensure rigour.

Twenty-eight women (aged 29–63 years; mean 42 years) receiving care at two oncology centres were purposively sampled between June 2024 and March 2025. Most had stage II or III disease and had lived with cancer for at least 6–12 months.

Four inter-linked themes described the women’s experiences: (1) “For several months, I saw myself like a ghost amongst people”—emotional, physical, economic and social upheaval following diagnosis; (2) “But I have to talk to myself, I need to encourage myself to keep going”—personal, spiritual and peer-based coping resources; (3) “I just know that there should be a lot more awareness” of the care continuum—structural, financial and informational barriers, including catastrophic out-of-pocket costs and fragmented care pathways; (4) “It is the emotional trauma”—reframing illness, personal growth and an expressed desire to support other patients. Across the themes, women stressed unmet psychosocial needs, reliance on faith communities, and the paucity of formal peer-support or counselling services.

Participants reported navigating a complex interplay of financial toxicity, systemic delays, and profound psychosocial distress, and many described drawing on spiritual practices, self-encouragement, and peer connections to cope; several also expressed a desire to support other women by sharing advice or lived experience while going through the care pathway. Strengthening palliative and supportive care in Nigeria should prioritise: (1) financial-protection mechanisms to reduce treatment abandonment; (2) streamlined referral/navigation systems; and (3) integrated psychosocial and peer-support interventions that acknowledge spiritual coping. Further research should investigate survivor-led support models and assess the effectiveness of culturally tailored communication training for oncology teams.

The online version contains supplementary material available at 10.1007/s00520-026-10377-8.