title: The salience of cancer and the "survivor" identity for people who have completed acute cancer treatment: a qualitative study.
abstract: Globally, there are nearly 33 million persons who have survived 5 or more years after a diagnosis of cancer [1]. We explore the salience of cancer in such people's self-concept as an important element for creating patient-centered care for those living with a cancer history.
  
  
  
  Our data are responses to a free-listing exercise and subsequent qualitative interviews with 53 individuals aged between 45 and 74 who were diagnosed with non-Hodgkin's lymphoma or breast or prostate cancer at least 3 years prior and had completed acute treatment. Participants lived in the Baltimore-Washington region of the USA.
  
  
  
  Cancer was not necessarily salient to participants' current self-concept, and espousal of a "survivor" identity is complex. We construct a typology of seven contrasting meanings of "survivor" based upon participants' narratives (factual, beaten, functional, temporary, adversity, passage of time, and lucky or blessed) and present interviewees' rationales as to why they did or did not adopt a survivorship identity.
  
  
  
  We examine the complexity of "survivorship" as an identity and people's affiliation with it, as well as how this relates to other salient and fluid elements of people's sense of self within a life course perspective.
  
  
  
  Understanding how cancer factors into people's self-concept throughout the life course is important for designing effective, patient-centered programs that acknowledge diverse experiences and expectations and possible changes with the passage of time.
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA. katecsmith@jhu.edu.
authors.forename: Katherine Clegg
authors.initials: KC
authors.lastname: Smith
authors.affiliation: Department of Community Health and Prevention, Drexel University School of Public Health, Philadelphia, USA.
authors.forename: Ann C
authors.initials: AC
authors.lastname: Klassen
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
authors.forename: Kisha I
authors.initials: KI
authors.lastname: Coa
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Hannum
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy*; D018802:Patient-Centered Care; D036301:Qualitative Research; D012649:Self Concept; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*
keywords: Cancer; Identity; Phenomenology; Qualitative methods; Survivorship