Experience of long-term cancer survivorship: a multiple-case study

Project Duration

October 2009 - September 2012

Funder

ESRC-CASE Studentship (Macmillan Cancer Support)

Aims

This study aims to:

• describe the experience of long-term cancer survivorship
• examining how the concept of survivorship has been constructed in relation to cancer
• investigating the impact cancer has on an individual’s sense of self and relationships
• identifying strategies individuals employ to manage the impact of cancer on their daily lives

Findings will feed into national policy and research initiatives, facilitated by Macmillan Cancer Support, who part-fund the study and co-chair the National Cancer Survivorship Initiative. Service development recommendations will also be made.

Methods

• Qualitative
• Multiple-case study
• Narrative interviews

Outcomes and Findings

Thirteen participants, previously diagnosed with breast, gynaecological, prostate, testicular and colorectal cancer, ranging from five to sixteen years post-treatment, took part. Cancer has left a legacy of benefits and losses. In particular, a legacy of lingering uncertainty, which manifests itself in different ways, and to different extents, is evident across cases. The most common manifestation is fear of recurrence. A typology of the place of cancer is presented: cancer is in the past, past-present or present-future for long-term survivors. However, the place of cancer is not static. The legacy of lingering uncertainty, along with various 'reality checks' (reminders), means the place of cancer can oscillate between the past, present and future, and foreground and background of survivors' minds.

Implications for practice are positioned within the context of new survivorship care models being developed in the UK and North America. Key challenges are identifying long-term survivors who require ongoing information and support, and developing and implementing timely, effective interventions to meet their needs. Holistic needs assessments at key transition points within the survivorship trajectory are crucial. Assessments that identify the positive, as well as negative, implications of cancer will enable both specialists and primary care providers to tailor supportive care to the individual.