Reconfiguring time: optimisation and authenticity in accounts of people surviving with advanced cancer

ABSTRACT

Increasingly, people live longer with advanced cancer, despite having no prospect of full recovery. Ongoing survival is owed to early detection and effective disease management, yet experienced as highly precarious. In this article we explore how cancer chronicity brings into effect a pre-occupation with time, what time is to people with advanced cancer, and what socio-cultural norms inflect everyday practices. We analyse 20 interviews conducted in Queensland, Australia with 11 participants with advanced cancer, to trace the intersections of what time means, what people do with time, and what time feels like. Drawing on scholarship on the moralities around ill health, we discuss how awareness of time emerges in cancer chronicity and raises moral questions on how to live well. Here, imperatives of optimisation (urging people with advanced cancer to make the most of limited time) intersect with imperatives of authenticity (marked by emphasis on how to live one’s own best life). These dynamics reveal expressions of living with advanced cancer in morally viable ways. Such ontological processes have implications for the lived experience of people with advanced cancer, their families and oncological care.

KEYWORDS:

• Advanced cancer
• narratives
• lived experience
• qualitative interviews
• Australia
• time

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

We would like to acknowledge Australian Research Council (DP150100414) Chief Investigators Prof Alex Broom and Dr Katherine Kenny, as well as the clinical collaborators A/ Profs Zarnie Lwin and David Wyld at the Royal Brisbane and Women's Hospital. We also thank all participants of this study for telling their stories.

Additional information

Funding

This work was supported by the Australian Research Council under a Discovery Project [grant number DP150100414]; an Australian Government Research Training Program Scholarship, and a Life Course Centre Fellowship [Australian Research Council Centre of Excellence for Children and Families over the Life Course, grant number CE200100025]..