Support Care Cancer. 2026 Jul 8;34(8):746. doi: 10.1007/s00520-026-10978-3.
ABSTRACT
Recent theoretical and empirical advancements in well-being science can have meaningful implications for medical care when considering existential issues faced by people with incurable or life-limiting cancer diagnoses. We propose that certain elements of flourishing, such as meaning and purpose, deep personal relationships, and cultivating virtue, can be uniquely realized if targeted appropriately toward the end of life. Qualitative thematic analysis of semistructured interviews was conducted to explore the experiences and unmet psychological needs of people living with the blood cancer multiple myeloma and, precursor, smoldering myeloma to identify key themes related to the potential for flourishing at the end of life. Interview data was obtained from 25 participants (multiple myeloma n = 24, smoldering myeloma n = 4) and 10 health professionals with clinical expertise supporting or treating patients with multiple myeloma. Participants reported personal growth following their diagnosis through acceptance, meaning-making, and connection, yet reported the loneliness of dying with cancer with a desire to have discussions about death with their clinicians in addition to them maintaining treatment. On the contrary, health professionals were hesitant to discuss death with their patients, balancing hope in treatments with preparation for dying. We argue that the hesitation to discuss death thwarts the opportunity to flourish and that existing solutions such as dignity therapy, meaning-centered psychotherapy, early palliative care, and multidisciplinary support can close this gap without diminishing hope in treatments.
PMID:42420598 | DOI:10.1007/s00520-026-10978-3