Promoting healthy diet among long-term cancer survivors: Examining cancer salience and identity

There are currently 13.7 million cancer survivors in the United States, approximately two-thirds of whom are surviving 5 or more years post-diagnosis.  Cancer survivors face the risk of recurrence as well as heightened risks for new cancers and co-morbid conditions. The effects of lifestyle behaviors on key health outcomes for cancer survivors are not yet well understood. The majority of cancer survivors do not meet dietary guidelines, and effective dietary change interventions may promote optimal health for this growing population. Our study is intended to identify intervention opportunities and salient messages and strategies to promote sustainable dietary change where needed, and protect healthy diet where it already exists.

We present data from a thematic analysis of pairs of qualitative interviews with 53 individuals who completed acute treatment for non-Hodgkin’s lymphoma, breast and prostate cancer at least two years prior. We focus on the salience of cancer in how people conceptualize themselves, and the importance one’s cancer experience in the years following acute treatment. From a phenomenological perspective, we describe ways in which people either adopt or reject the label of ‘cancer survivor’ and suggest implications of the complexities of identity, and sense of self and community for health promotion. Interviews also yielded descriptions of dietary changes undertaken alongside rationales for such attempts, accounts of successes and explanations for setbacks. The analysis will consider the relevance of self concept and cancer experiences for current dietary behaviors and attempts to improve diet with a goal of guiding future intervention efforts.