Medicine, Health Care and Philosophy

, Volume 17, Issue 3, pp 437–446 | Cite as

Alcohol abuse in cancer patients: a shadow side in the oncological field and research

  • Stinne GlasdamEmail author
  • Christine Øye
Scientific Contribution


This article aims to foreground alcohol abuse by cancer patients and explore how alcohol abuse functions as a biographic master motive and at the same time is a shadow side in the oncological field and research. The research is based on a single case study which draws on empirical material from interviews, field notes and staff policy, with analysis using Bourdieu’s concepts of trajectory of life and habitus. The findings show that the cancer patient’s alcohol abuse is an important part of the trajectory of his private life and spare time. In social life with family and friends alcohol is given and normal and acts as a socialisator. Alcohol abuse provides both stability and instability in the cancer patient’s life. When cancer results in work breaks and retirement, and spare time often is used as drinking time, then all daily life becomes drinking time for the cancer patient. Alcohol is often a hidden abuse at the working place and in the oncological field. In meetings with healthcare professionals, the patient chooses not to speak about his alcohol abuse to avoid further medicalisation. The challenge for the healthcare professionals is to see and accept alcohol abusers with cancer and their social lives without always trying to change their ‘unhealthy’ lifestyles.


Cancer Alcohol abuse Life history Bourdieu Case study Medicalisation 



Thanks to all the informants and the collaborative oncological clinic. Thanks to Lise Bjerrum Thisted for clinical assistance. Thanks to Sidsel-Marie Glasdam for transcriptions. Thanks to Penny Bayer (UK) for proof reading. This work was partly supported by the Danish Nurses’ Organisation and Institute of Nursing, Metropolitan University College.


  1. Barzelay, M. 1993. The single case study as intellectually ambitious inquiry. Journal of Public Administration Research and Theory 3: 305–318.Google Scholar
  2. Bourdieu, P. 1984. Distinction: A social critique of the judgement of taste. Massachusetts: Harvard University Press.Google Scholar
  3. Bourdieu, P. 1995. Den biografiske illusion [The biographical illusion]. Social Kritik 36:33–38.Google Scholar
  4. Bourdieu, P. et al. 1999. The weight of the world. Social suffering in contemporary society. Cambridge: Polity Press.Google Scholar
  5. Casswell, S., R.Q. You, and T. Huckle. 2011. Alcohol’s harm to others: Reduced wellbeing and health status for those with heavy drinkers in their lives. Addiction 106(6): 1087–1094.CrossRefGoogle Scholar
  6. Christensen, A.I., M. Severin, T. Holmberg, L. Eriksen, M. Toftager, A. Zachariassen, O. Ekholm, J.S. Tolstrup, M. Grønbæk, and T. Curtis. 2009. KRAM-undersøgelsen i tal og billeder [The KRAM-study in numbers and pictures]. Copenhagen: Ministeriet for Sundhed og Forebyggelsen & Trygfonden.Google Scholar
  7. Danish Health and Medicines Authority. 2008. Alkoholpolitik og alkoholproblemer på arbejdspladsen [Alcohol policy and alcohol problems at the workplace]. Copenhagen: Danish Health and Medicines Authority.Google Scholar
  8. Danish Health and Medicines Authority. 2009. Pakkeforløb for hoved- og halskræft [Diagnosis and treatment courses for head and neck cancer]. Copenhagen: Danish Health and Medicines Authority.Google Scholar
  9. Ekholm, O., M. Kjoeller, M. Davidsen, U. Hesse, L. Eriksen, A.I. Christensen, and M. Groenbaek. 2006. Sundhed og Sygelighed i Danmark -og udviklingen siden 1987 [Health and Morbidity in Denmark—and development since 1987]. Copenhagen: Statens Institut for Folkesundhed.Google Scholar
  10. Emslie, C., and R. Mitchell. 2009. Are there gender differences in the geography of alcohol-related mortality in Scotland? An ecological study. BMC Public Health 9(58). doi: 10.1186/1471-2458-9-58.
  11. Emslie, C., K. Hunt, and R. Lyons. 2012. Older and wiser? Men’s and women’s accounts of drinking in early mid-life. Sociology of Health & Illness 34(4): 481–496.CrossRefGoogle Scholar
  12. Flyvbjerg, B. 2006. Five misunderstandings about case-study research. Qualitative Inquiry 12(2): 219–245.CrossRefGoogle Scholar
  13. Gerring, J. 2004. What is a case study and what is it good for? American Political Science Review 98(2): 341–354.CrossRefGoogle Scholar
  14. Glasdam, S. 2003. Inklusion og eksklusion af kræftpatienters pårørende i en onkologisk klinik. [Inclusion and exclusion of relatives to cancer patients in an oncological clinic] Ph.d. Dissertation. Viborg: Forlaget PUC.Google Scholar
  15. Glasdam, S. 2011. Klemt mellem sygdom og job—om kræftpatienters møde med jobcenters krav om jobaktivitet [Sandwiched between disease and job—on cancer patients’ meetings with the requirements of job center in relation to job activity]. Klinisk Sygepleje 25(4): 25–35.Google Scholar
  16. Glasdam, S., and L.B. Thisted. 2010. Metodiske udfordringer ved rekruttering af patienter til sociologisk studie—Med udgangspunkt i et projekt om arbejdslivets betydning for mennesker med kræft [Methodic challenges for recruitment of patients to a sociological study—Based on a research project on the meaning of work for cancer patients]. Klinisk Sygepleje 2: 4–15.Google Scholar
  17. Glasdam, S., N. Henriksen, L. Kjær, and J. Præstegaard. 2013a. Involvement of the client in home care practice—A relational sociological perspective. Nursing Inquiry 20(4): 329–340.CrossRefGoogle Scholar
  18. Glasdam, S., P. Præstegaard, and N. Henriksen. 2013b. Placed in home care: Living an everyday life restricted by dependence and monitoring. Nordic Journal of Social Research 4: 83–89. Google Scholar
  19. Groenbaek, M.N. 2004. Alkoholforbrug i Danmark—Folkesundhedsmæssige udfordringer og videnskabelige spørgsmål [Alcohol consumption in Denmark—public health challenges and scientific issues]. Ugeskrift for Laeger 166: 1573–1576.Google Scholar
  20. Groenbaek, M. 2009. The positive and negative health effects of alcohol- and the public health implications. Journal of Internal Medicine 265(4): 407–420.CrossRefGoogle Scholar
  21. Groenkjaer, M., T. Curtis, C. de Crespigny, and C. Delmar. 2011. Acceptance and expectance: Cultural norms for alcohol use in Denmark. International Journal of Qualitative Study Health Well-being 6(4). doi: 10.3402/qhw.v614-8461.
  22. Gutjahr, E., G. Gmel, and J. Rehm. 2001. Relation between average alcohol consumption and disease: An overview. European Addiction Research 7(3): 117–127.CrossRefGoogle Scholar
  23. Horsdal, M. 2012. Telling Lives: Exploring dimensions of narratives. Oxon: Routledge.Google Scholar
  24. Hvidtfeldt, U.A., A.B.G. Hansen, M. Groenbaek, and J.S. Tolstrup. 2008. Alkoholforbrug i DanmarkKvantificering og karakteristik af storforbrugere og afhængige. [Alcohol consumption in Denmark—Quantification and characterization of heavy users and addicts.]. Copenhagen: Statens Institut for folkesundhed, Syddansk Universitet.Google Scholar
  25. Hydén, L.-C. 2010. Identity, self, narrative. In Beyond narrative coherence, ed. Hyvärinen, M., and M. Tamboukou, 33–48. Amsterdam: John Benjamins Publishing Company.Google Scholar
  26. Illich, I. 1979. Limits to medicine. Medical nemesis: The expropriation of health. Penguin: Harmondsworth.Google Scholar
  27. Järvinen, M. 1998. Det dårlige selskab. Misbrug, behandling, omsorg [The bad company. Abuse, treatment, care]. Holte: Forlaget SOCPOL.Google Scholar
  28. Järvinen, M. 2000. The biographical illusion: Construction meaning in qualitative interviews. Qualitative Inquiry 6: 370–391.CrossRefGoogle Scholar
  29. Leibing, A. 2007. The hidden side of the moon, or, “lifting out” in ethnographies. In The shadow side of fieldwork. Explorig the blurred borders between etnography and life, ed. A. Leibing, and A. McLean, 138–156. Oxford: Blackwell Publising.CrossRefGoogle Scholar
  30. Leyland, A., R. Dundas, P. McLoone, and F.A. Boddy. 2007. Cause-specific inequalities in mortality in Scotland: Two decades of change. A population-based study. BMC Public Health 7: 172. doi: 10.1186/1471-2458-7-172.CrossRefGoogle Scholar
  31. McLean, A. 2007. When the borders of research and personal life become burred: Thorny issues in onducting dementia research. In The shadow side of fieldwork. Explorig the blurred borders between etnography and life, ed. A. Leibing, and A. McLean, 262–287. Oxford: Blackwell Publising.CrossRefGoogle Scholar
  32. McLean, A., and A. Leibing. 2007. “Learn to value your shadow!” An introduction to the margins of fieldwork. In The shadow side of fieldwork. Explorig the blurred borders between etnography and life, ed. A. Leibing, and A. McLean, 1–28. Oxford: Blackwell Publising.CrossRefGoogle Scholar
  33. Office for National Statistics. 2011. Alcohol-related death rates in the UK 19912009. Accessed 03 July 2013.
  34. Peled, E., and I. Sacks. 2008. The self-perception of women who live with an alcoholic partner: Dialoging with deviance, strength, and self-fulfilment. Family Relations 57(3): 390–403.CrossRefGoogle Scholar
  35. Rehm, J., D. Baliunas, G.L. Borges, K. Graham, H. Irving, T. Kehoe, et al. 2010. The relation between different dimensions of alcohol consumption and burden of disease: an overview. Addiction 105(5): 817–843.CrossRefGoogle Scholar
  36. Room, J., J. Ferris, A.M. Laslatt, M. Livingston, J. Mugavin, and C. Wilkinson. 2010. The drinker’s effect on the social environment: a conceptual framework for studying alcohol’s harm to others. International Journal of Environmental Research and Public Health 7(4): 1855–1871.CrossRefGoogle Scholar
  37. Saukko, P. 2000. Between voice and discourse: Quiting interviews on anorexia. Qualitative Inquiry 6(3): 299–317.CrossRefGoogle Scholar
  38. Sayer, A. 2000. Method in social science. A realist approach, 2nd ed. London: Routledge.Google Scholar
  39. Terp, M.Ø., and S. Glasdam. 2010. Et liv med indre stemmer[A life with inner voices]. Klinisk Sygepleje 2: 26–36.Google Scholar
  40. The Scottish Government. 2008. Changing Scotland’s relationship with alcohol: A paper on our strategic approach. Edinburgh: The Scottish Government.Google Scholar
  41. Thomas, G. 2011. A typology for the case study in social science following a review of definition, discourse and structure. Qualitative Inquiry 17(6): 511–521.CrossRefGoogle Scholar
  42. Thygesen, L.C., N. Keiding, C. Johansen, and M. Groenbaek. 2007. Changes in alcohol intake and risk of upper digestive tract cancer. Acta Oncologica 46(8): 1085–1089.CrossRefGoogle Scholar
  43. Thygesen, L.C., C. Johansen, N. Keiding, E. Giovannucci, and M. Groenbaek. 2008. Effects of sample attrition in a longitudinal study of the association between alcohol intake and all-cause mortality. Addiction 103(7): 1149–1159.CrossRefGoogle Scholar
  44. Thygesen, L.C., P. Mikkelsen, T.V. Andersen, H. Tønnesen, K. Juel, U. Becker, and M. Groenbaek. 2009. Cancer incidence among patients with alcohol use disorders—long-term follow-up. Alcohol and Alcoholism 44(4): 387–391.CrossRefGoogle Scholar
  45. Williams, G. 1984. The genesis of chronic illness: Narrative re-construction. Sociology of Health & Illness 6(2): 175–200.CrossRefGoogle Scholar
  46. World Health Organization. 2002. The world health report 2002Reducing risks, promoting healthy life. Geneva: World Health Organization.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Division of Nursing, Health Sciences CentreLund UniversityLundSweden
  2. 2.Division of HealthStord/Haugesund University CollegeStordNorway
  3. 3.Centre for Care ResearchBergen University CollegeBergenNorway

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