The lived experience of existential distress among older Iranian adults with colorectal cancer: a qualitative study

With population aging and rising colorectal cancer (CRC), existential distress, defined as a profound psychological suffering associated with threats to meaning, identity, and purpose, has emerged as a critical yet underexplored aspect of older adults' cancer experience. This study explored the lived experience of existential distress among older Iranian adults with CRC.

A qualitative descriptive phenomenological design was employed. Seventeen adults (≥65 years) with confirmed CRC were purposively recruited from a cancer center in northern Iran. Data were obtained through in-depth semi-structured interviews and analyzed with Colaizzi's seven-step method.

Participants included 10 men and 7 women with a mean age of 68.94 ± 3.78 years, with diverse education, occupation, illness duration, and treatment. Three themes emerged: Inadequate Self-Realization, Confronting Uncertainty and Death, and Disruption of Meaningful Relationships. Inadequate self-realization involved diminished inner value and guilt for perceived family burdens. Confronting Uncertainty and Death encompassed being lost, fear of the unknown, and pervasive death presence. Disruption of Meaningful Relationships reflected stigma, social humiliation, and self-imposed isolation.

Older Iranians with CRC endure layered existential suffering shaped by personal beliefs and sociocultural values. Findings guide supportive cancer care addressing existential and spiritual needs, alongside physical care, highlighting psychosocial dimensions for culturally informed interventions.