“Don’t be a hero, don’t keep it a secret” - Understanding the lived experience of Chinese American patients with cancer through their expressive writing entries

Sep 22, 2026

Cancer is the leading cause of death for Chinese Americans, yet psychosocial intervention research remains limited. This qualitative study examines patient narratives from an Expressive Helping intervention to clarify how Chinese American patients understand and make meaning of cancer diagnosis and treatment journeys. Thirty-one participants completed four 20-minute writing sessions; iterative blended coding and thematic analysis were used to assess illness perception, meaning making, and peer-helping recommendations across intrapersonal, interpersonal, and organizational levels.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Purpose

Methods

Results

Conclusion

Background

Cancer burden and mental health

Psychosocial interventions and immigrant needs

Cancer disparities among Asian Americans

Research gap for Chinese Americans

Supportive Care in Cancer (2026) 34:648 [https://doi.org/10.1007/s00520-026-10730-x](https://doi.org/10.1007/s00520-026-10730-x) “Don’t be a hero, don’t keep it a secret”: understanding the lived experience of Chinese American patients with cancer through their expressive writing entries Perla Chebli1 · Julie Kranick1 · Melissa Mazor2 · Weanne Myrrh Estrada3 · Angel Mui1 · Victoria Foster1 · Simona C. Kwon1 · Victoria Ngo3 · Chau Trinh‑Shevrin1 · William Tsai4 Received: 3 October 2025 / Accepted: 27 April 2026 / Published online: 12 June 2026 © The Author(s) 2026 Abstract Purpose Cancer is the leading cause of death for Chinese Americans, and research on optimal psychosocial interventions is scarce. Understanding the specific experiences of Chinese Americans with cancer is essential for developing supportive interventions. This study is a qualitative analysis of patient narratives collected from an Expressive Helping intervention, obtained from Chinese Americans with cancer to explore their experiences and meaning making of their cancer diagnosis and treatment journeys. Methods Thirty-one participants completed four 20-min writing sessions related to their cancer experiences. Informed by the Common-Sense Model of illness self-regulation, we used iterative, blended deductive-inductive coding and conducted a thematic analysis to explore meaning making, illness perception/narrative, and peer-helping recommendations. Results Significant themes were identified at the intrapersonal, interpersonal, and organizational/community levels. Participants felt initial disbelief and distress at the cancer diagnosis, which were attenuated through reframing of their experiencesand finding support from various sources. Participants were also worried about burdening their families with their diagnosis but subsequently came to appreciate their support. They described challenges with navigating the healthcare system but appreciated having access to trusted providers and modern medicine. Patients also provided advice to support other patients on their cancer journey. Conclusion Understanding the factors that influence the mental health of patients with cancer and survivors is key to informing responsive supportive strategies. Our analysis of expressive writing narratives by Chinese Americans with cancer illuminates their unique challenges and myriad ways they find resilience and acceptance. Keywords Cancer survivorship · Meaning making · Expressive writing · Peer helping · Chinese Americans * Perla Chebli [perla.chebli@nyulangone.org](perla.chebli@nyulangone.org) 1 NYU Grossman School of Medicine, Department of Population Health, New York City, NY, USA 2 ICahn School of Medicine at Mount Sinai, Division of General Internal Medicine, New York City, NY, USA 3 The City University of New York, Center for Systems and Community Design, New York City, USA, NY 4 New York University, Department of Applied Psychology, New York City, NY, USA Background More than two million new cancer cases were projected for 2025 in the United States of America (USA), with over 618,000 cancer-related deaths. Cancer disproportionately affects older adults, with nearly nine in ten diagnoses occurring among individuals aged 50 years and older, and almost 60% among those aged 65 years and above [1] . Cancer imposes significant burdens on the aging USA population, requiring patients to navigate the complexities of diagnosis, treatment, and survivorship [2] . This experience can amplify mental health challenges, often overlooked in traditional cancer care pathways [3] . Older adults with cancer frequently experience significant psychological distress, with one study reporting a 15% prevalence of depressive symptoms, which are linked to poorer physical functioning, reduced quality of life, and increased mortality [4] . Although psychosocial interventions, such as support groups, have demonstrated a positive impact on mental health outcomes [5, 6

FAQs

What was the purpose of this study?

To understand how Chinese American patients with cancer make meaning of their diagnosis and treatment journeys, enabling development of responsive supportive interventions.

How was the expressive writing intervention conducted?

Thirty-one participants completed four 20-minute writing sessions about their cancer experiences.

What key themes emerged from the narratives?

Participants reported intrapersonal, interpersonal, and organizational/community themes, including initial disbelief and distress, reframing their experiences, gaining support, and challenges navigating the healthcare system.

How do the findings relate to supportive care strategies?

By identifying factors influencing mental health among patients and survivors, the study informs responsive supportive strategies and highlights pathways to resilience and acceptance through expressive writing narratives.

Sep 22, 2026

Upload by McGucket