A diagnosis of life-limiting cancer can be overwhelming and cause feelings of panic and anxiety. But for some people, it provides a license to live life differently, including quitting toxic jobs and becoming more adventurous.
Authors
Kevin Dew
Professor of Sociology, Te Herenga Waka — Victoria University of Wellington
Alex Broom
Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney
Chris Cunningham
Professor of Maori & Public Health, Te Kunenga ki Pūrehuroa – Massey University
Elizabeth Dennett
Associate Professor in Surgery, University of Otago
Kerry Chamberlain
Professor of Social and Health Psychology, Te Kunenga ki Pūrehuroa – Massey University
Richard Egan
Associate Professor in Health Promotion, University of Otago
In our recently published research, we sought to understand the impact of a cancer diagnosis and subsequent experiences for cancer survivors.
We talked with 81 New Zealanders (23 Māori and 58 non-Māori) who had lived longer than expected with a life-limiting or terminal diagnosis of cancer (four to 32 years since first diagnosis), and 25 people who were identified as their supporters.
We found there are vastly different ways in which people experience and respond to a cancer diagnosis, but for some it's a prompt to make significant changes. Of the 81 participants, 26 expressed the view, unsolicited, that cancer had some positive impact on their lives - without downplaying the negative impacts it could have as well.
A licence to change
Being told you only have limited time left to live can undoubtedly be a shock. But it can lead to profound change.
It's not uncommon for people who receive a serious diagnosis to draw up a "bucket list". Some people in our study took the opportunity to travel or move to a new home.
For others, the diagnosis provided a chance to rethink their lives and make more significant changes to the way they lived. They decided to be culturally more adventurous and to take up new skills.
Many of these people quit their jobs or changed to jobs that suited them better. Many changed their relationships with the people around them. One talked about showing more affection for his children, another was kinder and stopped fretting over small things.
Some decided to be more selective and no longer be around people who were negative. Others took up new hobbies or crafts which they felt were healing. For one person, the cancer diagnosis provided the impetus to look at things and people differently, which they thought would not have happened otherwise.
Individuals could also undergo a transformation to become what they felt they were meant to be in life. One person, given two months to live, embraced rongoā (Māori traditional healing), including its spiritual side. They now love their "journey" and feel this was what they were "supposed to do".
For many, a diagnosis of cancer gave them license to be different people and to resist conforming to social norms, including having a job, being thrifty or not taking risks.
Disrupting diagnoses
One person, given only months to live, moved out of her flat, gave away her possessions, quit her job that she described was toxic, and returned home to say goodbye to her family.
Most importantly for her, she worked on experiencing "joy" - after receiving the diagnosis, she realised she had lost it. But she continues to live many years later. After a while, she had to find a new flat, get a new job and the recovery of her joy was challenged:
I had to start working again. And, of course, with working again, joy goes down, time goes down, rest goes down, spirituality goes down.
But not everyone has the opportunity to change. Some peoples' lives were limited because of the physical effects of the cancer, its treatment, or because of their personal, social or financial resources.
Some go to great lengths to ensure their lives change as little as possible after diagnosis to maintain a sense of normality.
Why we need to know
Given the fear a cancer diagnosis can elicit, it is important to see there are different ways of responding.
It is also worth knowing there are people who live longer than expected. Many people in our study were given just months to live, but one woman was still alive 12 years after being told she had a year left.
Beyond that, this research documents how the disruption produced by a cancer diagnosis can prompt people to breach social norms. Where people have the capacity and resources to change, those around them and their health professionals can support them in taking opportunities to live life differently.
We heard people say they think of their cancer as a friend or an amazing opportunity. Some even felt thankful.
The possibility of cancer providing opportunities for some in no way diminishes the grief or a sense of loss, fear and anxiety that can accompany such diagnoses.
Our research supports a reframing of cancer narratives, to consider ways of tempering the negative impacts of a diagnosis - while remaining cognisant of the struggle that can follow such news, and the variability in people's capacity to engage with that struggle.
Kevin Dew receives funding from The Marsden Fund..
Alex Broom receives funding from the Australian Research Council.
Kerry Chamberlain receives funding from the Marsden Fund.
Chris Cunningham, Elizabeth Dennett, and Richard Egan do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
