'Finding Comfort in Discomfort': A Qualitative Study of Cancer Clinicians and Researchers' Experiences of Conducting a Cancer Rapid Autopsy Program.

Background: Rapid autopsy offers a tantalising opportunity to better characterise metastatic disease and determine how malignancies evade treatment. The CASCADE (CAncer tiSsue Collection After DEath) rapid autopsy program at the Peter MacCallum Cancer Centre, established in 2012, has conducted more than 100 autopsies. The experiences of clinicians and researchers who conduct this program can offer insight into how a unique program can be conducted sensitively and how their involvement impacts them personally and professionally.

Purpose: To explore experiences of the clinicians and researchers involved in the CASCADE cancer rapid autopsy program.

Materials and methods: A qualitative approach employing semi-structured interviews was used to collect data from clinicians and researchers working at the Peter MacCallum Cancer Centre. Inductive thematic analysis with team-based codebook development was used to generate findings.

Results: Participants (N = 20) described the benefits and burdens of involvement in a cancer rapid autopsy program, including strategies used to 'find comfort in discomfort'. Offering participation in CASCADE enhanced patient-clinician rapport. The goals of the CASCADE program helped participants overcome confronting experiences in the autopsy room and use of autopsy-derived tissue in the laboratory. Peer-support is essential to avoid burnout.

Conclusion: The benefits outweighed the burdens of delivering a cancer rapid autopsy program, however, it is important that staff are well supported in their roles.