Active aging—spunky survivorship? Discourses and experiences of the years beyond breast cancer

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Abstract

Recent critical gerontology has drawn attention to the origins, functions and consequences for elders of the ‘successful aging’ discourse. In this paper we describe parallels between successful aging and what we are calling ‘spunky survivorship,’ the contemporary subject position made available to women in the years after a breast cancer diagnosis. The central focus of the paper is a study about the intersections between a dominant discourse of breast cancer survivorship, and the perceptions and experiences of women living the years beyond breast cancer. It is our hope that the analysis presented here will suggest new pathways for exploring the relationship between discourses of successful aging and people's ideas and feelings about growing older.

Section snippets

Discourses of cancer and cancer survivorship

Cancer, whatever else it might merit or claim, does not lack for public profile. Images of the human encounter with cancer illness permeate media accounts and popular discourse. Critical commentary on cancer images is similarly abundant (see for instance Clarke, 1986, Del Vecchio Good et al., 1994, DiGiacomo, 1988, Martindale, 1994, Seale, 2001, Sontag, 1990). Less well rehearsed, however, are representations of cancer survivorship, of life in the years beyond the acute phase of diagnosis and

Survivorship discourse: parallels with ‘successful aging’

Both the image of the cancer survivor as someone “made normal,” and the image of the cancer survivor as someone transformed in a positive way by the encounter with illness, find echoes in the discourse on successful aging.

Biggs (2001) notes that contemporary policy narratives foreground the social value of work or near-work situations, solving the problem of aging by assuming that older people are the same as everyone else. Extended periods of formal work, and activities like volunteering and

Creating ladies in waiting?

The inspiration and foundation of Ladies in Waiting? A Play About Life After Breast Cancer was a series of focus groups conducted across the province of Ontario, Canada in 1997 to explore the information needs of longer-term breast cancer survivors, women who were at least 4 years disease-free. Results of this study are reported in (Gray et al., 1998). Buoyed by the success of two previous research-based dramas, Handle with Care? Women Living with Metastatic Breast Cancer (Ivonoffski, 1998) and

Exploring survivorship discourse

This paper draws from multiple sources linked to the Ladies in Waiting? project: a written record of dialogue amongst the group as the drama was created, taken by a member of the research team using a laptop computer; journals kept by the 10 cancer survivors involved in script development; and images in the drama itself. It focuses centrally on the written record of the drama's creation.

The SDT included nine breast cancer survivors and one cervical cancer survivor. Seven participants are active

Images and prescriptions of survivorship: women's perspectives

Over the course of meetings to create Ladies in Waiting?, members of the SDT described the social images and messages that they perceive to surround cancer survivorship. Central among these was the message that cancer is or should be over. Also salient were images of cancer survivorship as achievement, and an assignment of responsibility for cancer.

Lived experiences of survivorship

For most members of the SDT, lived experience—the experience of a changed body and lingering consequences of treatment, alongside felt vulnerability to cancer returning—counters, at least part of the time, popular image of cancer survivorship. Getting through diagnosis and treatment is not an achievement in the ways it is popularly constructed; and, years beyond diagnosis, the disease is not over.

Consequences of ‘spunky survivorship’

As is clear from the commentary above, most women on the SDT perceived a public discourse around survivorship at odds, at least some of the time, with their personal experience of life after a cancer diagnosis. The relationships women in the group had with public images and messages about their experience were, however, complex. For the most part meetings of the SDT identified problematic social and personal consequences for women who have had cancer, of contemporary survivorship discourse:

Implications for the study of ‘successful aging’

Themes from the study reported here hold relevance for the analysis of aging discourses, and particularly for research that considers the relationship of ‘successful aging’ to older people's perceptions and experiences. Cross cutting themes include the particular consequences of the dominant discourse; the relative salience of some images over others; the complex relationship between personal narratives and preferred vocabularies; and sites and sources of resistance. As well, of course, theory

Conclusion

The current study allows us to speak about the effect of contemporary survivorship discourse on individual women who have had cancer. The study attends to a small and arguably particular set of women. Yet, critically, it furthers the nuanced approach to the interface between dominant discourses and individual experience that critical gerontology is pursuing. Findings from this study compel us to ask: Which aspects of ‘active aging’ matter most to people who are growing old, and what about them

Acknowledgements

Our appreciation is extended to the women whose experiences and insights were the foundation for Ladies in Waiting? and to Vrenia Ivonoffski, writer and director of the drama. We are grateful for comments from Jane Aronson, Ann Wray Hampson and an anonymous reviewer on an earlier version of this paper. The Ladies in Waiting? project, and the research presented here, was supported by the Canadian Breast Cancer Foundation, Ontario Chapter.

References (31)

  • Barbara Ehrenreich

    Welcome to Cancerland: A mammogram leads to a cult of pink kitsch

    Harper's Magazine

    (2001)
  • Kathleen Ell et al.

    Coping with cancer: A comparison of older and younger patients

    Journal of Gerontological Social Work

    (1992)
  • M. Featherstone

    Post-bodies, aging and virtual reality

  • Arthur Frank

    The wounded storyteller: Body, illness and ethics

    (1995)
  • J.F. Gubrium et al.

    Narrative practice and the coherence of personal stories

    Sociological Quarterly

    (1998)
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