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



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.

This is a preview of subscription content, log in to check access.


  1. 1.

    Centers for Disease Control and Prevention, Division of Cancer Prevention and Control (2015) Global cancer statistics. In: International Cancer Control. 2015. Retrieved March 3, 2015.

  2. 2.

    Phillips JM, Cohen MZ, Moses G. Breast cancer screening and African American women: fear, fatalism, and silence. Oncol Nurs Forum. 1999;26:561–71.

    CAS  PubMed  Google Scholar 

  3. 3.

    Clarke JN, Everest MM. Cancer in the mass print media: fear, uncertainty and the medical model. Soc Sci Med. 2006;62:2591–600.

    Article  PubMed  Google Scholar 

  4. 4.

    Miles A, Voorwinden S, Chapman S, Wardle J. Psychologic predictors of cancer information avoidance among older adults: the role of cancer fear and fatalism. Cancer Epidem Biomar. 2008;17:1872–9.

    Article  Google Scholar 

  5. 5.

    Muzzin LJ, Anderson NJ, Figueredo AT, Gudelis SO. The experience of cancer. Soc Sci Med. 1994;38:1201–8.

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Else-Quest NM, LoConte NK, Schiller JH, Shibley HJ. Perceived stigma, self-blame, and adjustment among lung, breast and prostate cancer patients. Psychol Health. 2009;24(8):949–64.

    Article  PubMed  Google Scholar 

  7. 7.

    Bellizzi K, Blank T. Cancer-related identity and positive affect in survivors of prostate cancer. J Cancer Surviv. 2007;1:44–8.

    Article  PubMed  Google Scholar 

  8. 8.

    Zebrack B. Cancer survivor identity and quality of life. Cancer Pract. 2000;8:238–42.

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Park CL, Zlateva I, Blank TO. Self-Identity after cancer: “survivor”, “victim”, “patient”, and “person with cancer”. J Gen Intern Med. 2009;24(Suppl2):S430–5.

    Article  PubMed  Google Scholar 

  10. 10.

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

    Article  PubMed  Google Scholar 

  11. 11.

    Mullan F. Seasons of survival: reflections of a physician with cancer. N Engl J Med. 1985;313(40):270–3.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Kaiser K. The meaning of the survivor identity for women with breast cancer. Soc Sci Med. 2008;67:79–87.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Chambers SK, Baade P, Meng X, Youl P, Aitken J, Dunn J. Survivor identity after colorectal cancer: antecedents, prevalence and outcomes. Psychooncology. 2011;21:962–9.

    Article  PubMed  Google Scholar 

  14. 14.

    Khan NF, Harrison S, Rose PW, Ward A, Evans J. Interpretation and acceptance of the term ‘cancer survivor’: a United Kingdom-based qualitative study. Eur J Cancer Care. 2012;21:177–86.

    CAS  Article  Google Scholar 

  15. 15.

    Kelly KM, Shah N, Shedlosky-Shoemaker R, Porter K, Agnese D. Living post treatment: definitions of those with history and no history of cancer. J Cancer Surviv. 2011;5:158–66.

    Article  PubMed  Google Scholar 

  16. 16.

    Jagielski CH, Hawley ST, Corbin K, Weiss MC, Griggs JJ. Phoenix rising: who considers herself a “survivor” after a diagnosis of breast cancer? J Cancer Surviv. 2012;6:541–457.

    Article  Google Scholar 

  17. 17.

    Morris BA, Lepor SJ, Wilson B, Lieberman MA, Dunn J, Chambers SK. Adopting a survivor identity after cancer in a peer support context. J Cancer Surviv. 2014;8:427–36.

    Article  PubMed  Google Scholar 

  18. 18.

    Bell K, Ristovski-Slijepcevic S. Cancer survivorship: why labels matter. J Clin Oncol. 2013;31:409–11.

    Article  PubMed  Google Scholar 

  19. 19.

    Glaser B. The constant comparative method of qualitative analysis. Soc Probl. 1965;12:436–45.

    Article  Google Scholar 

Download references


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.

Author information



Corresponding author

Correspondence to Katherine Clegg Smith.

Ethics declarations

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.

Electronic supplementary material

Below is the link to the electronic supplementary material.


(DOC 37 kb)


(DOC 35 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Smith, K.C., Klassen, A.C., Coa, K.I. et al. The salience of cancer and the “survivor” identity for people who have completed acute cancer treatment: a qualitative study. J Cancer Surviv 10, 457–466 (2016).

Download citation


  • Cancer
  • Survivorship
  • Identity
  • Qualitative methods
  • Phenomenology