Cancer-related loneliness context and mechanisms: A qualitative interview study of British adults

Background

Throughout Europe, one in three of the population will receive a cancer diagnosis during their lifetime. In the UK, it is almost 50%. Advances in early detection and treatment means people live longer with, or survive it. However, many experience loneliness at a prevalence exceeding level of the general population. Whilst well-documented, cancer-related loneliness is not well understood. This study examined context and mechanisms of cancer-related loneliness.

Methods

Qualitative interviews of adult participants with cancer (n = 18) were conducted. Participants were recruited within a region served by one English NHS trust. Participants were aged 27-80 years, 56% were female. Interviews were conducted between 2024-2025. Of participants, 3 reported that they had never been lonely, whilst 11 were lonely at the time of interview. Data were analysed using Framework Method.

Results

Participants described a desire to return to a life unimpeded by life‑threatening illness but sensed no opportunity of return. Life was described as fragmented and making sense of the experience was a priority. Cancer was perceived to constrain close relationships, and participants often reported a preference for being alone. Peer relationships with others who had cancer were regarded as essential sources of information and support.

Conclusions

Cancer represents an existential and ontological threat to the individual, constraining relationships. Contextual complexity exacerbates the experience of loneliness; internal resources, the social environment, and structural conditions interact to shape identity, agency, cognitive processing, and future orientation. Moderating factors, including recent diagnosis, poor prognosis, chronic symptoms, lacking support of a life partner, or experiencing additional life stressors influence loneliness.

Key messages

• A central mechanism of loneliness is deficit of self and relationally constrained meaning making, explaining how loneliness co-exists within family relationships and alongside apparent active coping.

• Facilitated opportunities that target making meaning from, or sense of, the experience may be important to prevent or recover from loneliness.