Understanding fear of cancer recurrence in terms of damage to ‘everyday health competence’

Abstract

Advances in clinical treatments are resulting in cancer patients living longer, but with the threat of the disease returning at some later date. Anxiety associated with this fear of recurrence, which seems widespread among patients, can lead to an enhanced bodily awareness and a pronounced tendency to interpret mundane sensations as symptoms of pathology. Relatively little sociological work has been done to systematically document, understand, and find ways of addressing, this syndrome and its impact on the quality of patients' lives. It is argued that this syndrome is best understood not in cognitive terms, as a form of irrationality, but rather as resulting from damage to certain aspects of social competence, namely one's 'everyday health competence'. In investigating this issue, the author draws upon his personal experience of breast cancer diagnosis, surgery and adjuvant therapy; and on a broadly phenomenological approach to examining the relationship between bodily sensations and practical reasoning about experience. The implications for clinical practice are considered briefly.

Transient ischaemic attack: a qualitative study of the long term consequences for patients

“…These findings reflect those of Salter et al who explored risk in relation to osteoporosis screening [25]. Horlick Jones suggests that patients suffer damage to their ‘everyday health competence’ following a negative health event which they failed to anticipate [26]. Everyday health competence is the ability to review bodily sensations and to react in an appropriate manner, that is, to recognise when symptoms can be ignored and when action is needed.…”

“…In this sample many participants were highly motivated to make lifestyle changes to address their risk of stroke but were unable to access the detailed personal information and support they felt they needed to do so successfully. Where patients are motivated to be proactive about reducing their stroke risk, support to negotiate individual goals with patients, for example, setting targets for blood pressure, blood cholesterol levels and weight, along with regular monitoring to review progress towards these targets, will promote effective self-management and the restoration of ‘everyday health competence’ [26]. …”

Sharing or not sharing? Balancing uncertainties after cancer in urban Norway

“…Our analysis of the ways in which the study participants talk about their experiences and interactions after cancer indicate that they struggle with existential uncertainties and confirm the findings of other studies (for example Horlick-Jones, 2011;Lee-Jones et al, 1997;Muzzin, Anderson, Figueredo, & Gudelis, 1994;Stoller, 2004). The participants talked about how they had come to appreciate and value aspects of life differently, and in this way had modified their 'experience and life world' as the unthematised horizon of knowledge that we as human beings experience and act upon in relation to our culture and society (Gullestad, 1989).…”

“…Sickness in particular and crisis in general pose questions of our very sense of existence and non-existence, and thus raise questions about how to deal with the uncertainties of living and the means with which we try to maneuver when the waters of life are troubled. (2005, p. 9) 5 While researchers have recognised how uncertainty is ever present in peoples' lives after cancer, and how managing uncertainty becomes a part of their new life (Horlick-Jones, 2011;Jain, 2013;Lee-Jones et al, 1997), in this article we aim to develop considerations of uncertainty further by emphasising the importance of social relationships, arguing that the management of uncertainty is inherently a social process, and simultaneously the management is aiming at maintaining and protecting social relations and everyday life. Moreover, empirically departing within the ideological and cultural contexts of the Norwegian welfare state which emphasise security and access to health, in this article we argue that the way social others are involved in the managing of uncertainty reflects the manner by which careand treatment practices are highly institutionalised by biomedicine.…”

Evaluation of a Breast and Colon Cancer Survivorship Program

“…If left unaddressed, these behaviors ultimately result in poor decision making, inadequate psychological adjustment, and post-traumatic stresslike responses in cancer survivors (Mishel, 1988). The state of emotional distress is associated with fear and anxiety, and often can lead to enhanced bodily awareness that produces a tendency to interpret ordinary sensations as symptoms of possible pathology indicating cancer recurrence for many survivors (Horlick-Jones, 2011). That combination of fear and anxiety is deeply ingrained within the aspects of uncertainty in illness and is a part of every cancer survivor's experience.…”