Discursive Representations of the Meaning of Finitude in 'Cancer Survivorship'

Background/Significance. Phenomenological investigations surrounding illness and illness behavior are often rooted in a health beliefs model and are thus described according to personal interpretations of disease, and about life and death. In this paper, we evaluate how older cancer patients describe survivorship in everyday language and discuss implications for initiation of care and self-management behaviors, as guided by one’s long-term evaluations of health.

Methods. This work draws on data from the Eating for Life study, which included informants with cancers of the breast and prostate, as well as Non-Hodgkin’s lymphoma (n=53). Informants were recruited to participate in a semi-structured interview pertaining to experiences and conceptualizations of cancer survivorship and dietary behavior, following acute periods of care. Interview transcripts from those aged 60-74 years (n=29) were used for this sub-analysis and were evaluated using techniques of discourse and narrative analyses to focus on survivorship beliefs within the aging context.

Findings. Analyses revealed the importance of age and time, as reflected in beliefs about cancer, its experience, and the potential for recurrence. Cancer illness and survivorship were thus often seen as deeply implicated in disruptions to biography, but also to one’s ability to engage in future planning.

Conclusions. How older persons conceptualize the future seems to bear deeply on decisions made in reaction to cancer therapies, but also uptake of self-care and overall health management. We suggest that notions of time and cancer survivorship be integrated in care models, with an appreciation of how older persons approach decisions relevant to care.