Research seeks to understand and assess loneliness in people with cancer

A PhD student at the University of Dundee has developed an index for measuring loneliness in cancer patients which she hopes will form the basis of better care and even improved outcomes for people with the disease.

Kathryn Cunningham’s thesis aims to enhance understanding of loneliness in cancer in order to provide a basis for future assessment and intervention. Kathryn used questionnaires and interviews to explore the nature of and degree to which patients with cancer experience loneliness after treatment finishes. She spoke to 107 people diagnosed with cancer and compared their responses to a similar-sized group from the general population. She then carried out in-depth research with those patients who reported the strongest feelings of loneliness to enhance understanding of their experience.

This work helped to inform the development of her Cancer-Related Loneliness Measure, which identifies the patients who are most likely to be adversely affected by feelings of loneliness. The measure, which has undergone initial cognitive testing, was developed for use in clinical practice and also to aid in the development and evaluation of interventions to address cancer-related loneliness. 

Kathryn’s research comes just a month after Macmillan Cancer Support published a report showing that 22 per cent of people living with cancer in the UK (31 per cent in Scotland) suffer loneliness as a result of their illness and are much more likely to experience further problems as a result.

The report shows the detrimental impact of being lonely on the lives of cancer patients. Those who reported feeling lonely, or more lonely than they did before  were three times more likely to drink more alcohol than usual, almost five times more likely to not have left the house for days, three times more likely to have problems sleeping, five times more likely to skip meals and almost eight times more likely to eat a poor diet. 

Macmillan CEO Ciarán Devane warned that with the number of people diagnosed with cancer set to double by 2030 there is an urgent need for “the NHS, policy makers and local authorities to wake up to this looming loneliness epidemic”.

Kathryn believes her PhD will enhance the bank of evidence available to help public health officials, healthcare professionals and policymakers understand the links between cancer and loneliness.

“The Macmillan report was very timely as it highlighted what we were looking at and I think my research builds on this with some robust evidence of the nature of loneliness in people with cancer as well as with a practical way of measuring loneliness, which patients who would most benefit from interventions to address this problem,” she said.

“Loneliness is an unpleasant and distressing experience that carries a stigma due to being seen as some sort of failure on the part of the person. The experience of psychosocial loneliness appears to supersede the boundaries of cancer diagnosis, stage of disease, tumour site and treatment, with participants varying in these terms experiencing loneliness.”

Kathryn’s PhD studies were supervised by Professor Thilo Kroll, from the University’s School of Nursing and Midwifery, and Professor Mary Wells, now of the University of Stirling. She intends to continue work in this area and to use the Cancer-Related Loneliness Measure on a wider scale and to develop effective interventions to support people experiencing loneliness following a cancer diagnosis.

Kathryn has spoken to other researchers working in the field about possible collaborations going forward, and says the next stage is to develop an evidence base on the most effective interventions to address loneliness in cancer patients and prevent it having a negative impact on outcomes.

Notes to editors:
About Macmillan Cancer Support
When you have cancer, you don’t just worry about what will happen to your body, you worry about what will happen to your life. Whether it’s concerns about who you can talk to, planning for the extra costs or what to do about work, at Macmillan we understand how a cancer diagnosis can take over everything.

That’s why we’re here. We provide support that helps people take back control of their lives. But right now, we can’t reach everyone who needs us. We need your help to make sure that people affected by cancer get the support they need to face the toughest fight of their life. No one should face cancer alone, and with your support no one will.

To get involved, call 0300 1000 200 today. And please remember, we’re here for you too. If you’d like support, information or just to chat, call us free on 0808 808 00 00 (Monday to Friday, 9am–8pm) or visit

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