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Self-identity After Cancer: “Survivor”, “Victim”, “Patient”, and “Person with Cancer”

Abstract

Background

Living through cancer often involves developing new identities which may strongly influence well-being and relationships with care providers, yet little is currently known about these post-cancer identities.

Objectives

To examine (1) the extent to which four post-cancer identities (patient, person who has had cancer, victim, and survivor) are adopted, (2) relations between each identity and involvement in cancer-related activities and mental and physical well-being, and (3) correlates of these identities.

Design

Cross-sectional questionnaire-based study.

Participants

168 young to middle-aged adults who had previously experienced cancer.

Measurements

Cancer identifications, background variables, psychological functioning, cancer risk appraisals and coping, cancer-related activities, and mental and physical well-being.

Results

At least somewhat, 83% endorsed survivor identity, 81% identity of “person who has had cancer”, 58% “patient”, and 18% “victim”. Identities were minimally correlated with one another and differentially associated with involvement in cancer-related activities. Survivor and person who has had cancer identities correlated with involvement in most cancer-related activities such as wearing cancer-related items and talking about prevention (ps <  0.5). Survivor identity correlated with better psychological well-being and post-traumatic growth, victim identity with poorer well-being (ps <  0.5); neither identifying as a patient nor a person with cancer was related to well-being. Through regression analyses, identities were shown to be explained by unique combination of background, functioning, appraisal and coping variables.

Conclusions

Survivor identity appears most common and most associated with active involvement and better psychological well-being, but other identifications are also common and simultaneously held. Adoption of specific cancer identities is likely to impact interactions with health care providers, including those in general internal medicine, and health behavior changes.

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References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ. Cancer statistics 2008. CA: Cancer J Clinicians. 2009;58:71–96. doi:10.3322/CA.2007.0010.

    Article  Google Scholar 

  2. Hewitt M, Greenfield S, Stovall E. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: National Academies Press; 2008.

    Google Scholar 

  3. Epstein RM, Street RL. Patient-centered communication in cancer care. Bethesda, MD: NCI NIH Publication No. 07-6225; 2007.

  4. Zapka JG, Lemon SC. Interventions for patients, providers, and health care organizations. Cancer. 2004;101:1165–87.

    Article  PubMed  Google Scholar 

  5. Ganz PA, Hahn EE. Implementing a Survivorship Care Plan for patients with breast cancer. J Clin Oncol. 2008;26:759–67.

    Article  PubMed  Google Scholar 

  6. Mathieson CM, Stam HJ. Renegotiating identity: cancer narratives. Sociol Health Illn. 1995;17:283–306.

    Article  Google Scholar 

  7. Zebrack BJ. Cancer survivor identity and quality of life. Cancer Pract. 2000;8(5):238–42.

    Article  CAS  PubMed  Google Scholar 

  8. Brennan J. Adjustment to cancer: coping or personal transition? Psycho-Oncol. 2001;10(1):1–18.

    Article  CAS  Google Scholar 

  9. Bellizzi KM, Blank TO. Cancer-related identity and positive affect in survivors of prostate cancer. J Cancer Surviv. 2007;1(1):44–8.

    Article  PubMed  Google Scholar 

  10. Harwood J, Sparks L. Social identity and health: an intergroup communication approach to cancer. Health Commun. 2003;15(2):145–59.

    Article  PubMed  Google Scholar 

  11. Twombly R. What’s in a name: who is a cancer survivor? J Natl Cancer Inst. 2004;96(19):1414–5.

    PubMed  Google Scholar 

  12. National Cancer Institute website. (Accessed 4/10/2009) http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=445089

  13. Deimling G, Kahana B, Schumacher J. Life threatening illness: the transition from victim to survivor. J Aging Identity. 1997;2(3):165–86.

    Google Scholar 

  14. Bower JE, Meyerowitz BE, Desmond KA, Bernaards CA, Rowland JH, Ganz PA. Perceptions of positive meaning and vulnerability following breast cancer: predictors and outcomes among long-term breast cancer survivors. Ann Behav Med. 2005;29(3):236–45.

    Article  PubMed  Google Scholar 

  15. Beanlands HJ, Lipton JH, McCay EA, Schimmer AD, Elliott ME, Messner HA, et al. Self-concept as a “BMT patient", illness intrusiveness, and engulfment in allogeneic bone marrow transplant recipients. J Psychosom Res. 2003;55(5):419–25.

    Article  PubMed  Google Scholar 

  16. Charmaz K. Loss of self: a fundamental form of suffering in the chronically ill. Sociol Health Illn. 1983;5(2):168–95.

    Article  CAS  PubMed  Google Scholar 

  17. Dunn JL. “Victims” and “Survivors”: emerging vocabularies of motive for “Battered women who stay”. Sociol Inq. 2005;75(1):1–30.

    Article  Google Scholar 

  18. Young SL, Maguire KC. Talking about sexual violence. Women Lang. 2003;26:40–52.

    Google Scholar 

  19. Deimling GT, Bowman KF, Wagner LJ. Cancer survivorship and identity among long-term survivors. Cancer Invest. 2007;25(8):758–65.

    Article  PubMed  Google Scholar 

  20. Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol. 1989;57:1069–81.

    Article  Google Scholar 

  21. Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002;24(1):49–58.

    Article  PubMed  Google Scholar 

  22. Mullens AB, McCaul KD, Erickson SC, Sandgren AK. Coping after cancer: Risk perceptions, worry, and health behaviors among colorectal cancer survivors. Psycho-Oncol. 2004;13:367–76.

    Article  Google Scholar 

  23. Carver CS. You want to measure coping but your protocol is too long: consider the brief COPE. Int J Behav Med. 1997;4:92–100.

    Article  CAS  PubMed  Google Scholar 

  24. Boehmer S, Luszczynska A, Schwarzer R. Coping and quality of life after tumor surgery: personal and social resources promote different domains of quality of life. Anxiety Stress Coping. 2007;20(1):61–75.

    Article  PubMed  Google Scholar 

  25. Park CL, Adler NE. Stress in the first year of medical school: a study of the effects of coping on physical and psychological health. Health Psychol. 2003;22:627–31.

    Article  PubMed  Google Scholar 

  26. Ware J Jr., Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.

    Article  PubMed  Google Scholar 

  27. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54(6):1063–70.

    Article  CAS  PubMed  Google Scholar 

  28. Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18.

    CAS  PubMed  Google Scholar 

  29. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–5.

    Article  CAS  PubMed  Google Scholar 

  30. Tomich PL, Helgeson VS. Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychol. 2004;23(1):16–23.

    Article  PubMed  Google Scholar 

  31. Bellizzi KM, Miller MF, Arora NK, Rowland JH. Positive and negative life changes experienced by survivors of non-Hodgkin’s lymphoma. Ann Behav Med. 2007;34:188–99.

    Article  PubMed  Google Scholar 

  32. Kaiser K. The meaning of the survivor identity for women with breast cancer. Social Sci Med. 2008;79–87.

  33. Mao JJ, Bowman MA, Stricker CT, et al. Delivery of survivorship care by primary care physicians: The perspective of breast cancer patients. J Clin Oncol. 2009;27:933–8.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by a Scientific Research Grant from the Lance Armstrong Foundation to the first author. We are indebted to Dr. Andrew Salner and the Helen and Harry Gray Cancer Center at Hartford Hospital for their help in conducting the study, and to the survivors who were willing to share their experiences with us.

Conflict of Interest

None disclosed.

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Correspondence to Crystal L. Park PhD.

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Park, C.L., Zlateva, I. & Blank, T.O. Self-identity After Cancer: “Survivor”, “Victim”, “Patient”, and “Person with Cancer”. J GEN INTERN MED 24 (Suppl 2), 430 (2009). https://doi.org/10.1007/s11606-009-0993-x

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  • DOI: https://doi.org/10.1007/s11606-009-0993-x

KEY WORDS

  • cancer
  • survivorship
  • identification
  • well-being
  • post-traumatic growth