Poster Presentation 2025 National Cancer Survivorship Conference

“I was waiting for the sky to fall in”: A qualitative exploration of experiences of immunotherapy for melanoma (#143)

Sarah C. Marvin 1 , Haryana Dhillon 2 , Kate Edwards 1 3 , Georgina V. Long 1 3 4 5 6 , Alexander M. Menzies 1 4 5 6 , Jia (Jenny) Liu 7 8 , Jasmine Yee 1 2
  1. Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
  2. Psycho-Oncology Cooperative Research Group, School of Psychology, The University of Sydney, Camperdown, NSW, Australia
  3. Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
  4. Melanoma Institute Australia, Wollstonecraft, NSW, Australia
  5. Mater Hospital, North Sydney, NSW, Australia
  6. Royal North Shore Hospital, St Leonards, NSW, Australia
  7. The Kinghorn Cancer Centre, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
  8. St Vincent's Clinical School, University of NSW, Darlinghurst, NSW, Australia

Aims: Prognosis of people with metastatic melanoma has dramatically improved with the introduction of immunotherapy. Immunotherapy is now also used as adjuvant therapy following melanoma excision to reduce the risk of recurrence. Immunotherapy has been associated with a number of side-effects which impact day-to-day life. Patient experiences of the treatment process are understood to be unique, varied and at times unpredictable. We aimed to explore experiences of immunotherapy in this population.

Methods: Adults (ECOG 0-2) receiving immunotherapy as adjuvant therapy or treatment of metastatic melanoma, participating in a 12-month observational study capturing physical activity and symptoms, were invited to participate in this qualitative study following four cycles of immunotherapy. Semi-structured interviews explored their experiences with immunotherapy and support received. Interviews were transcribed and analysed thematically.

Results: Thirteen participants participated (median age 64-years, 62% male, 46% metastatic). Three key themes were extracted in this preliminary analysis: 1) impact of immunotherapy; 2) factors impacting immunotherapy experience; and, 3) treatment support systems. The impact of immunotherapy varied from minimal side-effects and minor disruptions in daily life, to severe side-effects leading to treatment cessation. Initial fears and expectations of immunotherapy often differed from experiences, which were generally more positive than anticipated. Factors influencing the immunotherapy experience included ongoing effects from other melanoma treatments, management of comorbid conditions, and financial stress. Participants praised the professionalism and support provided by their healthcare team. Some expressed a desire for more holistic care, including diet and exercise advice.

Conclusions: Our results highlight the diverse impact of immunotherapy among the cohort. While many found the experience to be more positive than expected, factors beyond immunotherapy itself played a significant role. Support from the healthcare team was highly valued, though participants indicated a need for additional supportive care from Allied Health Practitioners.