Living with locally advanced rectal cancer: an exploration of the everydayness of living with rectal cancer

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Description/Abstract

Advances in treatment and prolonged survival times mean that increasingly individuals are living with advanced cancer, yet services remain disease orientated. This thesis has documented the process of undertaking a longitudinal qualitative study to explore the everydayness of living with locally advanced rectal cancer. The study has identified how this can influence individual’s day to day lives when the focus of care moves away from cure, but prior to the transition to ‘end of life’ care. The aim was to obtain data in which to situate local service development based on those aspects which were accorded primacy by the participants.

This interpretive study used a longitudinal qualitative approach which was informed by phenomenology. The philosophical works of Heidegger, Merleau Ponty and Van Manen were influential in this work which involved ten participants, with locally advanced rectal cancer. Successive interviews with ten individuals were undertaken over a two year period. The 38 interviews were analysed using a combination of frameworks offered by Miles and Huberman and Saldana.

Individuals during much of this time concentrated on maintaining normality in their everyday lives. The drive for stasis and focus on day to day living allowed the individual to remain in the present and distance a future which was associated with illness and annihilation. Crucial to this was the ability to self-manage. This allowed space to create a self-definition of health. Uncertainty during this time was life affirming. Avoiding those who may challenge this, was desirable for as long as possible. As illness progressed there was an inverse relationship between the ‘boundness’ of the body and the ‘boundness’ of the individual.
Insights from this study raise the need for further research and exploration of alternative models of supportive care whilst focusing on the wellness of individuals and self-management within their daily lives.