A legacy of lingering uncertainty: the experience of long-term cancer survivorship: a multiple-case study

Scott, Emma Joanne (2014) A legacy of lingering uncertainty: the experience of long-term cancer survivorship: a multiple-case study. PhD thesis, University of Nottingham.

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Abstract

More people are surviving cancer, and for longer. As a result, ‘cancer survivorship’ is a key policy and research issue. This exploratory study aimed to describe, and further understanding of, the cancer experience of individuals living five years or more post-treatment.

A multiple-case study design was adopted. A narrative interview and semi-structured follow-up interview were held with thirteen participants and their ‘significant others’. ‘Restorying’ of narratives was followed by a cross-case analysis to explore similarities and differences across cases. The utility of liminality as a framework for understanding cancer survivorship was then explored. Little et al. (1998) argue individuals live in a state of ‘sustained’ liminality that persists until end-of-life. However, some individuals may ‘transcend’ the liminal phase.

Individuals diagnosed with breast, gynaecological, prostate, testicular and colorectal cancer, five to sixteen years post-treatment, took part. A legacy of lingering uncertainty was evident across cases. The most common manifestation was fear of recurrence. A typology of the place of cancer was developed. Cancer was situated in the past, past-present or present-future. However, the place of cancer is not static; it oscillates between the past, present and future, and foreground and background of participants’ lives as a result of the lingering uncertainty and various ‘reality checks’ experienced.

Most, but not all, participants live in a state of ‘sustained’ liminality. Perceiving the five-year survival marker as a ‘milestone’ is key to transitioning out of the liminal state. Some participants have put cancer (the disease) in the past, but consequences of treatment result in them living in an on-going state of physical liminality. Others perceive they are living with cancer within them and experience liminality existentially. However, whilst liminality is often construed negatively, it can be a catalyst for positive change to self.

Implications for practice are positioned within the context of new models of ‘aftercare’ implemented in England. Holistic needs assessments at key transition points along the survivorship trajectory are crucial to providing tailored care within the context of individuals’ wider lives.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Cox, K.
Seymour, J.E.
Subjects: QS-QZ Preclinical sciences (NLM Classification) > QZ Pathology
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Health Sciences
Item ID: 13955
Depositing User: EP, Services
Date Deposited: 08 Oct 2014 14:14
Last Modified: 15 Sep 2016 01:12
URI: http://eprints.nottingham.ac.uk/id/eprint/13955

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