Journal of Cancer Survivorship

, Volume 10, Issue 3, pp 457–466 | Cite as

The salience of cancer and the “survivor” identity for people who have completed acute cancer treatment: a qualitative study

  • Katherine Clegg SmithEmail author
  • Ann C. Klassen
  • Kisha I. Coa
  • Susan M. Hannum



Globally, there are nearly 33 million persons who have survived 5 or more years after a diagnosis of cancer [1]. We explore the salience of cancer in such people’s self-concept as an important element for creating patient-centered care for those living with a cancer history.


Our data are responses to a free-listing exercise and subsequent qualitative interviews with 53 individuals aged between 45 and 74 who were diagnosed with non-Hodgkin’s lymphoma or breast or prostate cancer at least 3 years prior and had completed acute treatment. Participants lived in the Baltimore-Washington region of the USA.


Cancer was not necessarily salient to participants’ current self-concept, and espousal of a “survivor” identity is complex. We construct a typology of seven contrasting meanings of “survivor” based upon participants’ narratives (factual, beaten, functional, temporary, adversity, passage of time, and lucky or blessed) and present interviewees’ rationales as to why they did or did not adopt a survivorship identity.


We examine the complexity of “survivorship” as an identity and people’s affiliation with it, as well as how this relates to other salient and fluid elements of people’s sense of self within a life course perspective.

Implications for cancer survivors

Understanding how cancer factors into people’s self-concept throughout the life course is important for designing effective, patient-centered programs that acknowledge diverse experiences and expectations and possible changes with the passage of time.


Cancer Survivorship Identity Qualitative methods Phenomenology 



We would like to thank all of the members of the “Eating For Life” research team for their assistance in the conceptualization and implementation of this research. We are grateful to all of our research participants for the time and insights that made this analysis possible. This research is funded by National Cancer Institute-National Institutes of Health Office of Behavioral and Social Sciences Research Grant #1R21CA152789 (Smith). Dr. Kisha I. Coa was supported during her doctoral training by the National Institutes of Health, National Research Service Award T32 CA009314. Dr. Susan M. Hannum was supported during her postdoctoral training by the National Institutes of Health, National Research Service Award T32 CA009314.

Compliance with ethics guidelines

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all individual participants included in this study.

Supplementary material

11764_2015_489_MOESM1_ESM.doc (38 kb)
ESM 1 (DOC 37 kb)
11764_2015_489_MOESM2_ESM.doc (36 kb)
ESM 2 (DOC 35 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Katherine Clegg Smith
    • 1
    Email author
  • Ann C. Klassen
    • 2
  • Kisha I. Coa
    • 1
  • Susan M. Hannum
    • 1
  1. 1.Department of Health, Behavior and SocietyJohns Hopkins Bloomberg of Public HealthBaltimoreUSA
  2. 2.Department of Community Health and PreventionDrexel University School of Public HealthPhiladelphiaUSA

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