Article: Cancer Rehabilitation in Denmark – The Growth of a New Narrative

By Helle Ploug Hansen and Tine Tjørnhøj-Thomsen

https://doi.org/10.1111/j.1548-1387.2008.00035.x

Abstract: A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation and a growth in residential cancer rehabilitation initiatives in Denmark (Danish Cancer Society 1999: Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this discourse has challenged the dominant illness narrative, “sick-helped-cured”, producing a new narrative, “sick-helped-as if cured,” and that this new narrative is produced and reproduced through technologies of power and the self.

This article discusses shift in the ways that the biomedical establishment deals with the disconnect between being “cured” and being “well. The article points out out that the dearth of rehabilitation care can be attributed in part to increased survivor rates; the treatment paradigm is no longer just preparing patients for the possibility of death but providing care post treatment. The “cancer establishment” has begun to address that need through rehabilitation programs, which help patients navigate the difficulties of post treatment side effects. The article also discusses patient anxieties over relapse, social stigmas, and the moral value society attaches to patients participation in rehabilitation programs. Hanson points out that rehabilitation still brings up issues of normality vs deviance, assuming normality can be achieved through participation in the program. We see underlying this model the same assumptions about willpower and personal responsibility that are embedded in mainstream narratives about cancer treatment and survivorship.

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The Undying

By Anne Boyer

The Undying is a cancer narrative in the form of creative nonfiction. The text has a dreamy quality, with vignettes from Boyer’s personal experiences interwoven with pieces of historical and biomedical information for context.

 Boyer deals heavily with paradoxical wellness, though from a slightly different angle. While most works on this site describe the pre-diagnosis states of either being anticipated patients or being ill without knowing it, Boyer deals with the dissonance of having been diagnosed, and knowing one is gravely ill, but still feeling alright.

She also deals with the tensions of prognosis, both in the instrumentalization of others’ lived experiences with cancer in order to generate statistical reports as well as her own difficulty in translating her symptoms into something easily digested by the medical system. Boyer also addresses the disconnect she feels between her prognosis and the direction her illness is taking, metaphorically linking it to the prophecies of ancient oracles rather than a scientifically backed prediction.

She also addresses the paradox of chemotherapy– though it is a cure for cancer, its side effects are grievous and sometimes deadly:

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After The Cure: The Untold Stories of Breast Cancer Survivors

After The Cure jacket blurb

After the Cure is focused on a single issue: chemotherapy. As Lochlann Jain noted in Malignant, chemo is inherently oxymoronic: it is a poison that cures, and it is sometimes unclear whether patients have died from chemo or from cancer. Chemotherapy can also have serious, long lasting side effects, yet post chemo ailments such as brain fog, fatigue, infertility, secondary neoplasms, etc. are virtually unspoken of within any mainstream cancer narratives. Breast cancer tends to be especially subject to overwhelmingly optimistic patient narratives which cause many patients to do not fit that model to feel excluded, inadequate, or marginalized. After the Cure is a conscious and pointed intervention into mainstream breast cancer narratives, an archive of the stories of people who are “cured” but not “well”.

Key quotes:

Pg. 1

This quote perfectly encapsulates both the phenomenon of lingering unwellness after being “cured” as well as the exclusion of these issues from the popular narrative. When the lingering effects of chemotherapy and the threat of relapse are not acknowledged, patients feel frustrated and lied to.

Quote from Annie Briggs, Pg. 31

This quote addresses a woman’s struggles with cognitive dysfunction resulting from chemotherapy, colloquially known as “chemobrain”. It can last at least ten years, and is extremely frustrating for those who suffer from it.

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