BACKGROUND:
Lung cancer is a leading cause of cancer deaths globally, especially in low- and middle-income countries like South Africa. Late diagnoses are common due to limited public awareness, poor healthcare access, socio-cultural barriers, and unequal healthcare infrastructure. This study explores how patients’ health information and health literacy shape their cancer care health journeys in the Western Cape, South Africa.

METHODS:
Using patient journey mapping and semi-structured interviews, lung cancer patients and their families and caregivers were recruited from a tertiary and secondary hospitals in the Western Cape, South Africa. Data from patient medical records was used to assess patient diagnosis and staging information. We recruited 50 patients and their families and/or caregivers. Data were analysed using thematic analysis.

RESULTS:
The preliminary analysis of data suggests there is a considerable variation in participants’ understanding of their health conditions, treatment plans, and care pathways. Differences in health literacy appeared to shape patients’ sense of autonomy, agency, and participation in decision-making. Participants with limited understanding of health information often reported confusion, reliance on informal support networks, a reduced confidence in navigating the health system, and passive acceptance of the health care they received. Health worker communication practices, including the use of technical language and limited opportunities for clarification, strongly influenced patients’ comprehension and engagement with care.

CONCLUSIONS:
This study highlights the central role of health information and communication in shaping patient cancer care journeys in South Africa. Understanding how health literacy interacts with health system practices may inform interventions aimed at improving patient engagement, shared decision-making, and equity in health care delivery in resource-constrained settings.