‘Take ownership of your condition’: Australian women’s health and risk talk in relation to their experiences of breast cancer

Abstract

Western understandings of breast cancer are primarily shaped both by neo-liberal, individual-oriented approaches to health and illness and by 'consumer-led' health movements. In this 'healthist' context, diagnosis of breast cancer typically marks a crisis in women's lives, which may prompt them to account for the development of the illness and reposition themselves as self-governing individuals who have control over their health and who can manage future 'risks'. We present a thematic discourse analysis of interviews conducted in 2012 with 27 women across Australia who have had breast cancer. Using the lenses of 'healthism' and 'risk management' in this analysis, we identified a cultural discourse of 'individual responsibility and empowerment'. Women utilised this discourse while 'accounting' for their illness by engaging in 'health talk' and 'risk talk'. While many women emphasised the shock of the diagnosis in light of having been 'always healthy', others expressed the inevitability of 'risk' on the basis of individual behaviours or genetic history. This discourse provided women one way to explain and make sense of their illness, potentially enabling them to cope with the fear and uncertainty of breast cancer. Drawing on this discourse, women could also position themselves in socially desirable and empowered ways as responsible health consumers, as self-governing and as taking responsibility in dealing with the illness and remaining vigilant for recurrence. We discuss how this neo-liberal approach can be empowering, but also has the effect of positioning women as primarily responsible for managing their health and their illness.

The Lived Experience of Australian Women Living with Breast Cancer: A Meta-Synthesis

“…Fear of recurrence and death were evident in multiple studies (Oxlad et al, 2008;Mackenzie, 2014;Keesing et al, 2016;Connell et al, 2006;Thewes et al, 2016;Elmir et al, 2010;Kwok and White, 2014;Coyne et al, 2012;Coyne and Borbasi, 2014;Connell et al, 2006;Fisher and Connor, 2012;Kwok and White, 2013;Gibson et al, 2015;Ives et al, 2012;Halkett et al, 2006;Beatty et al, 2008;Powers et al, 2014). In particular, mothers expressed their fear and concern over their children's future in the event of their death (excerpts 2.1.1).…”

“…Younger women, on the other hand, found the informational support provided by breast care nurses during treatment was calibrated more for older women and hence, some women sought additional internet support which was more calibrated to their age (Keesing et al, 2016;Lawler et al, 2010;Fisher and Connor, 2012;Gibson et al, 2015;Halkett et al, 2006;Anderson et al, 2011).…”

The sociology of cancer: a decade of research

“…Sociology has a long tradition of qualitative research into the experiences of illness, from the early work in the social constructivist tradition (Blaxter and Paterson 1982), to recent studies of chronic illness and the body from a more Foucauldian perspective (Armstrong 2003, Gibson et al 2015. This work is notable for its emphasis on the lived experience of disease, not just in terms of its physical manifestations and tribulations, but also with respect to identity work and caring practices.…”

“…Cancer charities turn over millions of pounds annually (for example, Cancer Research UK had a revenue of £537 million in 2013 (Cancer Research UK 2014)). High profile cancers like breast cancer have also become associated with strong discourses of patient and citizen empowerment (Bell 2014, Gibson et al 2015. Cancer is also at the forefront of efforts to enhance diagnosis and prognosis via targeted treatments and therapies, with participation in research, especially clinical trials, becoming a much more routine part of the cancer experience Cambrosio 2007, 2012).…”

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors

“…), lifestyle changes, information seeking, and trying to control side effects from treatment [ 26 ]. Acts such as these are reported to be a method of empowerment in women living with breast cancer [ 27 ]. Participants in the current study described the workbook as a way of making them aware of their transition from being a patient to someone who is able to make an active difference in their life.…”