Homeworld/Alienworld: a qualitative study about existential experiences after cancer treatment

Abstract

Background As a group, cancer survivors experience significant vulnerability and existential challenges. The biomedical approach dominating health care is insufficient to meet such existential challenges in an individualistic, holistic way. Objective This study aimed to explore the existential experiences of those treated for different cancers. Methods An exploratory phenomenological–hermeneutical design was used to obtain an understanding of existential experiences after cancer treatment. Data were collected through in‐depth interviews with 21 individuals who represented a purposive sample and were recruited from a cancer organisation. Results Three overriding themes emerged from the phenomenological–hermeneutical analysis are as follows: Experiencing an unfamiliar tiredness; Experiencing not being fully oneself; and Experiencing a feeling of being alone. Conclusions Existential suffering after cancer treatment involves living on the edge of the old homeworld and the experience of a new alienworld. Individuals undergoing such suffering need a transformational process, from the alienworld to the homeworld, which must be supported by the healthcare system. Implications for practice To facilitate the transformational process, healthcare professionals should communicate with patients throughout their cancer journey about how their existential experiences have been integrated into their lifeworld, allowing them to tell their own story from the perspective of lifeworld brokenness.

Cancer survivorship: existential suffering

“…In our study, there seems to be a brokenness experienced by the participants because they feel unable to live fully in the familiar homeworld, as alienworld is foreign and different from their homeworld. They seem to be striving to interweave and unite these two worlds (Ueland, Dysvik et al, 2020 ). Receiving a cancer diagnosis and undergoing cancer treatment can be such a “break,” with the result that one no longer feels at home in life (Ueland, Dysvik et al, 2020 ).…”

“…People want to return to the life they had before being affected by cancer, but many people find this experience difficult because their life power is limited (Hvidt, 2017 ; see also Ellingson, 2017 ). Earlier studies have highlighted the need to fill the gap in the current health-care approach to cancer survivors by focusing on survivors’ existential burden and ways to support the transition process towards becoming more whole as a person (Ueland, Dysvik et al, 2020 ; Ueland, Rørtveit et al, 2020 ).…”

“…Previous research has emphasized that different types of damage affect a range of everyday life activities such as social life, working life, finances, and relationships. Particularly pronounced are the symptoms of fatigue, exhaustion, and lack of concentration (Ellingson, 2017 ; Ellingson & Borofka, 2020 ; see also Fitch et al, 2019 ; Ueland, Dysvik et al, 2020 ). As such, the areas of life affected impose various limitations on everyday life (Hvidt, 2017 ; see also Knox, 2020a ).…”

“…Existential challenges point to an experience of several losses, such as “not feeling like oneself” anymore, with an impact on living the ordinary life as before (Ueland, Dysvik et al, 2020 ; Ueland, Rørtveit et al, 2020 ; see also Hvidt, 2017 ; Tindle et al, 2019 ; Ellingson & Borofka, 2020 ; Knox, 2020a ). Further existential challenges in patients with cancer could be described as escaping or remaining in the cage of inauthentic self (Khoshnood et al, 2018 ).…”

“…Furthermore, little has been done towards understanding survivors’ fundamental sense of being in life “as having a palpable sense of temporality and mortality awakened in oneself” (Knox, 2020b ). Lives of those affected by cancer are about so much more than having survived cancer, which suggests there is a need for more attention to be paid to the challenges that people may face when they have finished cancer treatment (Hvidt, 2013 ; see also Ueland, Dysvik et al, 2020 ).…”