“It’s just a flu or a death sentence”: A descriptive qualitative study on illness perceptions of cancer patients across four paradoxes

This descriptive qualitative study explored how individuals with cancer perceive their illness across different stages and contexts. Using a reflexive thematic analysis (RTA) framework, the study followed the Standards for Reporting Qualitative Research (SRQR) for transparency. Data were gathered through six semi-structured focus group discussions with 35 patients diagnosed with breast, lung, colorectal, or gastric cancer. Purposive sampling continued until sufficient information was obtained. Analysis yielded four overarching themes: (1) paradox of illness description, (2) paradox of disease causation, (3) paradox of treatment effects, and (4) paradox of life disruption. Participants expressed ambivalent understandings of cancer, some viewing it as a manageable, flu-like condition, while others experienced it as a life-threatening, identity-defining event. Similar tensions emerged regarding perceived causes, treatment responses, and the illness's broader impact. These paradoxes highlight the complexity of cancer perceptions and the need for individualised, psychosocially informed care across the illness trajectory.