Liminality: a major category of the experience of cancer illness

Little, Miles; Jordens, Christopher F. C.; Kim, Paul; Montgomery, Kathleen; Philipson, B. M.

doi:10.1016/s0277-9536(98)00248-2

Cited by 318 publications

(381 citation statements)

References 17 publications

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“…21 This study supports the concept that a diagnosis of cancer sets a person on an existential quest, emphasizing the dynamic process fluctuating throughout the illness, rather than achieving existential adjustment as an outcome. 6 Our results showing that patients developed a greater appreciation for friendships and the natural world were consistent with the re-evaluation necessary to find meaning in changing circumstances. 22 Expressions of peace with oneself and pantheism were signs of positive transitions, as were moments of despair as patients struggled to maintain their positivity.…”

Section: Comparison With Other Studiessupporting

confidence: 81%

Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study

Cavers

Hacking

Erridge

et al. 2012

CMAJ

110

106

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Section: Comparison With Other Studiessupporting

confidence: 81%

Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study

Cavers

Hacking

Erridge

et al. 2012

CMAJ

110

106

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“…A diagnosis of cancer tends to undermine a patient's trust in her own body (Little, Jordens, Paul, Montgomery & Philipson, 1998). Thus the body is commonly experienced as "a house of suspicion" (Breaden, 1997), and this trope was clearly evident in the illness narratives collected in this study:…”

Section: Resultsmentioning

confidence: 78%

Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer

Jordens

Morrell

Harnett

et al. 2010

Social Science & Medicine

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Post-treatment surveillance of advanced ovarian cancer involves regular testing of asymptomatic patients using the CA125 test. This practice is based on a rationale that is not supported by evidence from clinical trials. This paper aims to stimulate critical reflection concerning the effect of investigative tests on clinical decisions and interactions, and the experience of illness, particularly in the context of advanced malignant disease. Drawing on the idea of the "medical gaze", and building on previous health communication research, we present an analysis of in-depth interviews and psychometric tests collected in a prospective study of 20 Australian women with advanced ovarian cancer conducted between 2006 and 2009. We describe the demands placed on patients by the use of the CA125 test, some hazards it creates for decision-making, and some of the test's subjective benefits. It is widely believed that the CA125 test generates anxiety among patients, and the proposed solution is to educate women more about the test. We found no evidence that anxiety was a problem requiring a response over and above existing services. We conclude that the current debate is simplistic and limited. Focussing on patient anxiety does not account for other important effects of post-treatment surveillance, and educating patients about the test is unlikely to mitigate anxiety because testing is part of a wider process by which patients become aware of a disease that -once it has relapsed -will certainly kill them in the near future.

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“…Participants strived to maintain their sense of self through diagnosis, as they deteriorated, and through death. Consistent with the findings of other studies, at diagnosis, participants tried to make sense of, and accommodate the cancer in their lives (Ramfelt et al., 2002) and maintain a semblance of normality (Taylor, Richardson, & Cowley, 2010), but over time became increasingly isolated and their social world contracted (Little et al., 1998; Taylor, 2001). …”

Section: Discussionmentioning

confidence: 99%

“…Fluctuations in psycho‐social and spiritual wellbeing also occur as patients suffer gradual social decline and seek meaning and purpose in their distress (Murray et al., 2007). Patients may also reflect on life's value as the illness progresses (Houldin & Lewis, 2006; Sjovall, Gunnars, Olsson, & Thome, 2011) and their sense of self is compromised, which can result in social isolation and existential distress (Hubbard, Kidd, & Kearney, 2010; Kidd, Kearney, O'Carroll, & Hubbard, 2008; Little, Jordens, Paul, Montgomery, & Philipson, 1998; Rozmovits & Ziebland, 2004; Taylor, 2001). …”

Section: Introductionmentioning

confidence: 99%

Living and dying with metastatic bowel cancer: Serial in-depth interviews with patients

2017

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Colorectal cancer is the second highest cause of cancer deaths. There are significant physical and psycho‐social effects on quality of life with advanced disease. Despite this, there are few accounts of the patient experience from advanced illness through to dying. We elicited the longitudinal experiences of living and dying with incurable metastatic colorectal cancer by conducting serial interviews with patients for 12 months or until they died. The interviews were analysed, using a narrative approach, longitudinally as case studies and then together. Thirty‐six interviews with 16 patients were conducted. Patients experience metastatic colorectal cancer in three phases; (1) Diagnosis and initial treatment; (2) Deterioration and social isolation and (3) Death and dying. Many patients initially said they hoped to survive, but, as “private” and in‐depth accounts of the experience emerged in further interviews, so did the understanding that this hope co‐existed with the knowledge that death was near. Palliative chemotherapy and the challenge of accessing private accounts of patient experience can inhibit care planning and prevent patients benefitting from an active holistic palliative care approach earlier in the disease trajectory. This study has immediate clinical relevance for health care professionals in oncology, palliative care and primary care.

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Liminality: a major category of the experience of cancer illness

Cited by 318 publications

References 17 publications

Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study

Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study

Cancergazing? CA125 and post-treatment surveillance in advanced ovarian cancer

Living and dying with metastatic bowel cancer: Serial in-depth interviews with patients

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