Patients’ Experiences of Navigating the Gynecologic Oncology Care Pathway from Diagnosis to Treatment: A Qualitative Study

Abstract

Gynecologic oncology care pathways are clinically complex and often require patients to move rapidly across diagnostic, surgical, medical oncology, radiotherapy, imaging, pathology, and supportive-care services. Although timely treatment is associated with better outcomes, the interval between diagnosis and treatment can also be experienced as an intense period of uncertainty, fragmented communication, and practical burden. This qualitative study explores how patients with different gynecologic cancer diagnoses experience navigation from confirmed diagnosis to initiation of treatment. Fifteen semi-structured interview narratives were analyzed using reflexive thematic analysis. Five themes were developed: (1) diagnosis as a rupture in ordinary life and an overload of information; (2) fragmented transitions and the experience of being passed between services; (3) waiting as an active psychological and practical burden; (4) family advocacy and self-navigation as informal safety nets; and (5) relational continuity and clear communication as sources of confidence. Across themes, navigation was not experienced as a simple sequence of appointments but as work undertaken by patients and families to connect information, people, decisions, and logistics. The findings suggest that high-quality gynecologic cancer care requires more than technical timeliness. Patients also need visible ownership of the pathway, anticipatory communication, reliable points of contact, and navigation support proportionate to individual complexity. The study contributes a patient-centred account of the diagnosis-to-treatment interval and identifies practical targets for gynecologic oncology services seeking to improve coordination, reduce avoidable uncertainty, and strengthen person-centred care.