Uncharted territory: Exploring Psychological Adjustment to Esophagectomy Surgery in Adults with Oesophageal Cancer

Hanton, Eleanor Rose (2026) Uncharted territory: Exploring Psychological Adjustment to Esophagectomy Surgery in Adults with Oesophageal Cancer. Doctoral thesis, University of East Anglia.

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Abstract

Background: Oesophageal cancer is a significant global health concern, with oesophagectomy being a key curative treatment for many patients. However, the procedure is physically demanding and can result in substantial changes to eating, bodily functioning and quality of life. Despite this, the psychological impact of the surgery remains comparatively under-researched, particularly in relation to longer-term adjustment and survivorship.

Method: This portfolio aimed to explore psychological distress and adjustment following oesophagectomy for oesophageal cancer. The systematic review synthesised quantitative evidence of the prevalence and trajectory of anxiety and depression post-oesophagectomy. The empirical paper explored the psychological experiences of adults living one to five years following oesophagectomy. Semi-structured interviews were conducted with 11 participants and analysed using reflexive thematic analysis.

Findings: Results from the systematic review suggest that psychological distress is a significant and non-linear concern, with anxiety and depression persisting or re-emerging for some individuals beyond the acute postoperative period. The results highlighted a predominantly biomedical focus within the literature, with less attention given to psychological mechanisms of adjustment.
In addition, five interrelated themes were generated from the empirical paper: (1) existential threat and emotional survival, (2) relational trust and safety underpinning engagement, (3) making sense of illness through knowledge and cognitive strategies, (4) negotiating acceptance, control, and autonomy, and (5) living with change: adaptation, loss and quality of life. Findings suggest that adjustment was an ongoing and non-linear process shaped by uncertainty, bodily changes, altered autonomy, identity disruption and relational support.

Conclusion: Together, the portfolio demonstrates that recovery following oesophagectomy extends beyond physical survival and surgical recovery. Psychological adjustment involves the ongoing reconstruction of life and self in the context of bodily and relational change. The area remains sparse with psychological research not keeping pace with advances in surgical procedures and improved prognosis. The findings highlight the need for a broader biopsychosocial survivorship approach, including routine psychological screening, staged information provision, relational continuity and further research into longer-term adjustment following oesophagectomy.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	12 Nov 2026 08:33
Last Modified:	12 Nov 2026 08:33
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105096
DOI:

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