Table 2 Patient interviews: additional quotes

Awareness of SPC

“Interviewer: Did anybody ever mention to you about the risk of a second primary cancer or was it ever on your mind…?

P16: Never, no, no, I didn’t think at all. “P13

“I just completely forgot. […], It’s because of having no problems with the...after the first one that I just forgot all about it, I really did.” P14

Symptom appraisal and help-seeking

“…Very tired, […] I’m sitting at nine o’clock sleeping, and I thought this is not normal. So, I went to see my GP and they took blood tests and then sent me for an X-ray, and that’s when they discovered that I had a tumour in my lung.” P1

“I’m probably less inclined to just sit on

something and not go to the GP, as a result.”

P18

Pathways to diagnosis of SPC

“I will be absolutely frank, I never thought, oh goodness, that’s the second time I’ve had cancer […].[…]. That wasn’t the first thing that came to my mind. I would say it took me quite a long time to kind of clock that actually, that means I’ve had cancer twice. It just wasn’t top of my list of priorities to be perfectly honest.” P5

Navigating the healthcare system

“I go to that urology clinic, it’s packed, it’s absolutely mobbed. It’s a really busy place […]. When I went to the kidney clinic, when I first got it, there was only me, you know, there wasn’t a big queue or nothing.” P4

Impact of SPC

“Interviewer: Have they ever mentioned your first cancer, the melanoma or was that kind of never discussed?

P5: Not really discussed, I mean they knew, but it wasn’t linked and nobody kind of majored on it.” P5

Cumulative burden of SPC

“I thought, oh, no, here we go again.” P8