‘More stressful than cancer’: treatment experiences lived during Hurricane Maria among breast and colorectal cancer patients in Puerto Rico

Abstract

Background: In September 2017, Hurricane Maria, a Category 4 storm, struck Puerto Rico, causing widespread structural damage, prolonged power outages, and severe flooding. The devastation profoundly affected the island’s infrastructure and population. Patients with chronic diseases, particularly cancer, face distinct challenges and healthcare needs during and after disasters. This study examined and documented the narratives of breast and colorectal cancer patients regarding their experiences with cancer care and treatment disruptions during Hurricanes Irma and Maria in Puerto Rico diagnosed six months before September 2017. Methods: A total of three focus groups were conducted in San Juan and Ponce. Colorectal and breast cancer patients were recruited in collaboration with the Puerto Rico Central Cancer Registry. The interviews were coded using a grounded theory approach. Results: 40% of the participants interviewed reported that their treatment was interrupted due to hurricane Maria. Focus groups narratives indicated that the most prevalent themes were (a) barriers and facilitators related to their cancer treatment, (b) experiences in treatment, and (c) stressors related to the hurricane. Participants discussed their struggles regarding their treatment experience, access to care during and after the hurricane and describe household challenges due to lack of electricity and water, which deter their intention to continue their treatment. Conclusion: Stressors directly linked with the disaster were most challenging to cope with. Our data highlights the impending need to address cancer patients in future emergency plans to minimize the delay in continuing cancer care.