Disrupted lives and a threat to identity? Exploring illness narratives after chemotherapy as adjuvant treatment for colorectal cancer

Abstract

The aims of this study are a) to explore the lived experiences of individuals requiring an emergency attendance due to an acute disease during their cancer trajectory; b) to understand the composite nature of cancer as an acute and a chronic disease. In order to explore the acute and chronic sides of cancer, this study draws upon theories of time and temporality, health literacy and embodiment, biographical disruption and the social construction of illness. A purposeful sampling technique was used as qualitative research methodology. Semi-structured open-ended interviews were conducted with ten patients at different phases of cancer illness. The participants were three men and seven women, aged between 34 and 82 years, undergoing chemotherapy and who attended the Emergency Department at least once during their chemotherapy period. A thematic analysis with continuous comparative method between acute and chronic characteristics of illness was conducted. Several key concepts emerged from the data. Primarily, patients with cancer live their illness trajectory as a journey, during which they describe multiple smaller journeys. Their coping idea is to live life day-by-day. The porosity of the acute and the chronic phases in cancer is also evident. Secondly, the contoured nature of time affects the process of learning and forming relevant formal and informal information networks. Finally, the re-temporalisation of time in cancer as a chronic illness creates a sense of immediacy and compression of time in the present, making space for the acute experience of illness. This conflation of the acute and the chronic gives rise to differences in biographical disruptions, embodiment and social constructionism. This dissertation problematises the perception that cancer is only a chronic illness and questions the facile distinction between its chronic and acute aspects. This study concludes that cancer is not just a chronic illness, but its nature is intertwined with multiple acute episodes, making the lived experience of cancer a dynamic and complex experience.