| Summary: | Cancer is mainly a disease of older people; older people with cancer experience complex symptoms, which may include pain. Pain is also a significant concern for many people living and dying with cancer, and may be particularly difficult for people with co-morbidities of ageing. Pain which is unrecognised and untreated may significantly affect quality of life and function. In particular, there is limited knowledge of how older people experience cancer pain and how this affects their daily lives. This study aimed to capture the experiences of pain of older people with cancer, consider how older people construct the experience of cancer pain and how this is informed by their expectations and experiences. The methodological approach of Interpretative Phenomenological Analysis informed a qualitative diary-interview study which was conducted with purposively selected older people, diagnosed with cancer and in receipt of specialist palliative care. Nine older people with cancer (aged 67-88) living independently were interviewed either in the hospice day centre or their domestic home. Major themes identified were: 'Better to be old than to be dying with cancer', 'Maintaining control and independence', 'Loss of identity - grieving for a former self', 'Dislike of analgesia' and 'Dismissal or denial of pain'. Collecting data about cancer pain, from older people who may be vulnerable and in receipt of specialist palliative care, proved ethically and practically challenging. Clinical pain assessment alone, without listening to people's pain stories, does not always identify pain or problems with daily living. Understanding the communication needs of older people is an important precursor to understanding their health care needs. Appreciation of the individuality of the lived experience of cancer may advance our understanding of pain and end of life care. This study adds to the existing body of knowledge about the needs of older people with cancer pain and offers unique theoretical, methodological and practical contributions to support the body of evidence about older people's needs.
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