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

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

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.

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Correspondence to Katherine Clegg Smith.

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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.

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The authors declare that they have no conflicts of interest.

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

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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). https://doi.org/10.1007/s11764-015-0489-0

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Keywords

  • Cancer
  • Survivorship
  • Identity
  • Qualitative methods
  • Phenomenology