christina gibney full sociology thesis pdf finished

Christina Gibney

13333206

Sociology (SO303)

“I am five years Cancer free but it wouldn’t take much for it to become active again”

The Side Effects of Cancer - A Rare Case of Hodgkin’s

Lymphoma Cancer

Project supervisor: Niall Gilmartin

29th April 2016

THE SIDE EFFECTS OF CANCER - A RARE CASE OF HODGKIN’S LYMPHOMA CANCER

ii Christina Gibney 13333206 2016

Abstract

The vast majority of people who battle cancer experience consequential side effects at some

point. Ireland’s biggest cancer research organisation, the Irish Cancer Society has invested

€30 million since 1963 into hundreds of research projects. However, there is a limited

number of research projects implemented on a rare case of Hodgkin’s Lymphoma Cancer.

This dissertation is an exploratory research project into a specific case of Hodgkin’s

Lymphoma Cancer. Hodgkin’s Lymphoma Cancer was specifically chosen as it has little

research done on it. The exploration sheds light on the physical and mental side effects of

such a cancer to enlighten further possible research on this rare case of cancer. The findings

that were collected from this research project add to the sociological field of research. The

findings were based on the side effects of a rare case of Hodgkin’s Lymphoma Cancer. It was

concluded that cancer could have both positive and negative impacts for both the individual

with cancer and for the immediate family.

Key words: Cancer, Hodgkin’s Lymphoma, Physical, Mental, Experience, Consequence


iii Christina Gibney 13333206 2016

Acknowledgments:

Completing this dissertation has been a challenging but rewarding experience. I would like to

extend my appreciation to my family for their assistance and on- going support and in

particular my mother who has battled the disease.

I would also like to thank my close friends who have supported me and assisted me with this

project. My family and friend’s loyalty and support has been greatly appreciated.

I would also like to take this opportunity to thank my supervisor, Dr. Niall Gilmartin.

Through Niall’s expertise, this project was successfully conducted. I would also like to thank

Dr. Jane Grey who supported my thesis at the early stages. Lastly, I would like to thank all of

my lecturers who contributed and assisted me in conducting this dissertation.


iv Christina Gibney 13333206 2016

Table of Contents

Abstract ................................................................................................................................................... ii

Acknowledgments: ................................................................................................................................ iii

Table of Contents ............................................................................................................................... iv

Chapter 1 ................................................................................................................................................. 1

Introduction ............................................................................................................................................. 1

1.0 Introduction ................................................................................................................................... 2

1.1 Research Question ........................................................................................................................ 2

1.2 Aims and Objectives ..................................................................................................................... 2

1.3 What is Cancer? ............................................................................................................................ 3

1.4 Hodgkin’s Lymphoma Cancer ...................................................................................................... 4

1.5 Specific contribution to sociological research .............................................................................. 4

1.6 Scopes and Limitations ................................................................................................................. 4

1.7 Refinement of proposal ................................................................................................................. 5

Chapter 2 ................................................................................................................................................. 6

The Literature Review ............................................................................................................................ 6

2.0 Literature Review .............................................................................................................................. 7

2.1 Introduction ................................................................................................................................... 7

2.2 The Illness Experience as Socially Constructed ........................................................................... 7

2.2.1 Socially Constructed Name .................................................................................................... 8

2.3 The Sick Role ................................................................................................................................ 9

2.4 The Struggle of Time .................................................................................................................. 10

2.4.1 Cancer as a disruption of life and time; ............................................................................... 11

2.4.2 Increased awareness of time; ............................................................................................... 11

2.4.3 Appropriating time: .............................................................................................................. 12

2.5 Physical appearance .................................................................................................................... 13

2.6 Emotional effect .......................................................................................................................... 13

Chapter 3 ............................................................................................................................................... 16

The Methodology .................................................................................................................................. 16

3.0 Methodology ................................................................................................................................... 17

3.1 Introduction ................................................................................................................................. 17

3.2 Theoretical Approach .................................................................................................................. 17

3.3 Study Design ............................................................................................................................... 17

3.4 Description of Research Procedure ............................................................................................. 18

5.5 Ethical Considerations ................................................................................................................ 19

5.6 Conclusion .................................................................................................................................. 21


v Christina Gibney 13333206 2016

Chapter 4 ............................................................................................................................................... 22

The Findings ......................................................................................................................................... 22

4.0 Findings........................................................................................................................................... 23

4.1 Introduction ................................................................................................................................. 23

4.2 Mothers Life Story introduction ................................................................................................. 24

4.3 Emotional Effects ........................................................................................................................ 25

4.4 Physical Appearance ................................................................................................................... 27

4.5 A New Socially Constructed Name - A Cancer Survivor ........................................................... 29

4.6 Life five years cancer free ........................................................................................................... 30

Chapter 5 ............................................................................................................................................... 32

Conclusion ............................................................................................................................................ 32

5.0 Conclusion ...................................................................................................................................... 33

5.1 Introduction ................................................................................................................................. 33

5.2 Data Conclusion .......................................................................................................................... 33

5.2 Recommendations ....................................................................................................................... 34

5.3 Experience and Further Research ............................................................................................... 34

5.4 Concluding Comments ................................................................................................................ 35

6.0 Bibliography ................................................................................................................................... 36

7.0 Appendices ...................................................................................................................................... 38

Chapter 1

Introduction


2 Christina Gibney 13333206 2016

1.0 Introduction

1.1 Research Question

In a recent 2014 study, over 122,000 people who contracted cancer in the past 20 years are

alive today, and 94,000 of these have survived at least 10 years with the disease (Cullen

2014). With the increasing survival rates in Ireland, there has to be increasing side effects and

negative consequences that occur during their survival. The research question intended to be

explored was to discover the consequences of being diagnosed with cancer – a rare case of

Hodgkin’s Lymphoma Cancer that was experienced by a middle-aged woman in recent years.

To what extent that the day-to-day activities were affected along with the physical and mental

consequential effects.

Bury (1988, 1991), distinguished between two aspects of the impact of chronic illness in

suggesting that there are two types of meaning … First, there is ‘meaning as consequence’,

that is, the effects on the practical aspects of everyday life following the onset symptoms,

such as disruption to work and domestic routines, the management of symptoms, and so on.

Secondly, there is ‘meaning as significance’, which refers to the connotations and imaginary

associated with given conditions (Nettleton 2013). The sociological framework in which this

research project is based on is Bury’s (1988, 1991) ‘meaning of chronic illness as

consequence’. Researching based on the consequences will evolve the hidden disruption of

daily lives of a person who has a chronic illness. It will contribute to the little research that

has been done on this specific rare case of Hodgkin’s Lymphoma Cancer.

1.2 Aims and Objectives

The primary aim of this research project was to explore the consequences of being diagnosed

with cancer - to what extent having a rare case of Hodgkin’s Lymphoma Cancer affects the

psychological and physical state of a middle-aged woman. This dissertation was proposed to

add to the narrow research that is done on Hodgkin’s Lymphoma Cancer of middle-aged

women. There were two principal objectives for this dissertation. The first objective was to

explore the consequential side effects of being diagnosed with cancer. Through literature this

objective was achieved through having a sociological imagination and reviewing existing

sociological literature based on cancer consequences such as mental and physical

experiences.



The second objective was to shed a deeper light on a specific cancer case, Hodgkin’s

Lymphoma Cancer that a woman of middle age experienced numerous consequences and

Bury’s, (1988, 1991), meaning as significance. This specific cancer was explored for two

reasons. Firstly because it is very rare for a middle aged woman to get this type of cancer

because according to the medical assumptions, it is either a very young person’s cancer (20-

24) or a very old person’s cancer (70-74). It is very rare for a middle-aged woman to get it.

Secondly, this cancer was explored because the middle-aged woman who got it is a blood

relative of the author of this dissertation. The author used this to their advantage for primary

source, in-depth data collection for the optimal dissertation project.

1.3 What is Cancer?

“Cancer comes in many shapes and sizes, and how it affects the body varies greatly. Cancer

is a term used to describe a group of illnesses all having certain common characteristics.

These characteristics include an over-growth of cells that forms a tumour”

(Irish Cancer Society 2015).

In 2015 Healthy Irelands general health report highlighted that 85% of the Irish population

aged 15 and over report their general health as being good or very good (Healthy Ireland

2015). The question lies within that 15% of the Irish population were chronic diseases are

killing people every day. This research is an exploratory study to identify the consequences

and experiences that are faced by cancer sufferers during their diagnosis of cancer and in

some cases persist beyond the diagnosis. To understand how a disease can affect our body in

such a way that it does, we must consider how cancer is formed. Our body’s cells multiply

and repair cells every second of every day. It is when our cells multiply to the extent that our

body cannot control the multiplication that is when our organs become overly controlled by

cells and as a result a tumour forms. This tumour can cause health problems by blocking

internal ducts, or by pressing against other organs, preventing them from working properly

(Irish Cancer Society 2015), sometimes leading to an earlier than expected mortality. The

fear of losing the cancer victim not only affects the physical and mental body of the ill body

but it also has major implications on family members and close friends. However, when a

cancer patient gets the ‘all clear’ from cancer, it is a long road to recovery for the sick, family

and close friends. According to the NCSI, studies have shown that 60% of cancer survivors

have unmet physical or psychological needs; over 33% have problems with close

relationships, careers or have difficulty preforming household duties; and over 90% have



suffered financial losses (Initiative, 2014). Depending on the type of cancer, where it affected

the body and in what form, all cancer effects the body differently

1.4 Hodgkin’s Lymphoma Cancer

Hodgkin’s disease (Hodgkin’s Lymphoma) is a type of lymphoma, a cancer that starts in

white blood cells called lymphocytes. Lymphocytes are part of the immune system (American

Cancer Society 2016). The disease is most common to start in the upper part of the body,

particularly affecting the lymph nodes in the neck, chest or under arm. According to a study

conducted by the Cancer Research UK organisation, Hodgkin lymphoma is a rare cancer, in

women it occurs more commonly between the ages of 20 to 24 and 70 to 74 (2015). It is an

example of a cancer that in most cases would involve chemotherapy treatment. The peak ages

to get this type of cancer are as outlines above, 20 to 24 and 70 to 74. Rates then decrease

until middle age before rising again in late adulthood (Cancer Research UK 2015).

1.5 Specific contribution to sociological research

This project will be an exploratory study into the consequences of cancer that affects daily

routines and socialization. When the human body is disturbed in how it functions, it can have

great consequences. There is a lot of literature on the consequences of cancer already,

however, there is little research on this specific cancer to this specific stage of human life.

Taking into consideration these ages, there is a gap in cancer research on people who get

Hodgkin’s Lymphoma Cancer that are not in these age categories. Taking this into

consideration, this research project will fill the gap of little research that has been done on the

cases of Hodgkin’s Lymphoma Cancer that occurred in the middle stage of life. It is a great

advantage to be able to write up the project based on a blood relative who is one of the very

few people to get such a cancer. It will hopefully encourage further research on this specific

age group of Hodgkin’s Lymphoma Cancer.

1.6 Scopes and Limitations

The research project was based on a particular middle aged woman who experienced stage

four Hodgkin’s Lymphoma Cancer in recent years. Fortunately, for the case of the project,

this individual was the mother of the author who carried out this research project. This

resulted in easy access to primary source information whenever it was needed during the

course of the project write up. However, when it came to doing the findings, an interview was

conducted with the woman. Unfortunately, some information could not be given for the



project. This did not affect the findings very much as a lot of relevant information was

gathered.

Secondly, data collected from the mother’s mother (81) interview was not an in-depth

interview. A few questions that were asked were short answers or not elaborated on. This

slightly effected the reliability of the findings chapter.

1.7 Refinement of proposal

The topic of research slightly changed since the proposal was completed. The proposal was

an exploration of general cancer consequences for the individual and immediate family.

However, since further research and thought went into the dissertation a new idea based on

the same topic of cancer was considered. This new idea was to explore a specific case of

cancer (Hodgkin’s Lymphoma Cancer). Research gathered that it was a rare case if a person

got this cancer in the middle age of life so from this, it was gathered that it would be a great

benefit to contribute to the low level of research on such a rare case of cancer. This topic was

chosen to be studied in detail as it was a big interest as Hodgkin’s Lymphoma Cancer played

a huge role for both the individual affected by cancer and the author of this dissertation. It

was also chosen as there was primary data almost guaranteed thus creating an in-depth

interesting dissertation.



Chapter 2

The Literature Review



2.0 Literature Review

2.1 Introduction

This chapter is a review of existing literature that provided a sociological framework for this

research project. The research question is to explore a rare case of Hodgkin’s Lymphoma

Cancer. To answer this research question, the literature review provided in-depth existing

research that explored four main sociological topics. These topics are 1) Illness as socially

constructed 2) The sick role 3) The struggle of time 4) The physical and emotional effects of

illness. Through using these four topics, the consequential side effects of having such an

illness was explored, particularly how society reacts to a diagnosis of an illness and what

meanings attribute to a person becoming ill. These sub questions were the underpinning to

possibly unravelling the theory behind a rare case of Hodgkin’s Lymphoma Cancer of a

woman of her genre. To possibly get a deeper appreciation of how the theories that illness is

socially constructed, the theory of the sick role, the struggle of time, and the physical and

emotional upshots had affected her behaviours and rational for the duration of the illness

2.2 The Illness Experience as Socially Constructed

Over the last quarter of a century, research on the illness experience has thrived, interests in

studying the meanings and experiences of chronic illness has grown, especially in British

circles (Pierret 2003). For example there has been research conducted by Pierret (2003),

Thorne (2000), Conrad (1990), and Kleinman (1992). They are amongst many sociological

researchers who conducted research on the illness experience.

Illness is thought to be socially constructed. This assertion is grounded in the strong

pragmatist underpinnings of symbolic interactionism which suggest that reality does not just

exist out there in the world waiting to be discovered, but rather is created by individuals who

act in and toward their world, applied to illness, people enact their illness and endow it with

meaning (Baker 2010). This perspective of illness as socially constructed is the beginning for

many sociology researchers in exploring the constructed experiences of illness in everyday

life. In the 1960’s a study was conducted on patient’s perspective of illness. The study was

done by Glaser and Strauss 1965 and Goffman 1961. These researchers were among the first

to recognize that the patient experience is not the same as the illness experience; after all,

people with illnesses spend very little time in the patient role (Baker 2010). The illness



experience can be lived with for many years after a diagnosis with cancer, does this mean a

person is a patient for the duration of the illness experience? This important step laid a

foundation for a more developed approach to the experience of illness (Baker 2010).

To use this starting point for a more developed approach to the experience of illness, research

of Charmaz (1991), is a well-developed example. This perspective is well positioned to

examine how individuals construct and manage their illness, and with what consequences

(Baker 2010). Charmaz’ (1991) primary argument of chronic illness is that a person suffering

with an illness loses the control of day-to-day living thus becoming increasingly cut off from

the routines of conventional life—unable to work, spend time with family, socialize with

friends, or move about freely (Baker 2010). A chronically ill person has difficulties to find

the power and energy in their body to live a way that society expects of them. The daily

norms of work, house chores, looking after kids, and socializing become a major struggle for

many people with cancer. However, how does the loss in control over day-to-day living affect

an individual with cancer? This research also describes how people struggle to make sense of

their illness and reclaim a sense of self; people endeavour to endow their illness with

meaning within the context of their personal and social relationships, employment status,

health insurance coverage, religious and cultural beliefs (Baker 2010).

2.2.1 Socially Constructed Name

Many chronic illness survivors are given a socially constructed name. According to Park,

living through cancer often involves developing new identities, which may strongly influence

well-being and relationships with care providers, yet little is currently known about these

post-cancer identities (2009). Chronic illness can prompt a re-evaluation of one’s former life

and identity, and, in some cases, the creation of a new illness identity (e.g., cancer survivor)

(Baker 2010). To be categorized under a new identity such as a cancer survivor may be very

rewarding for survivors of this disease but it also shadows over the persons former identity.

The foundation on which a sense of self is based can be lost, there is nothing to look forward

to, and nothing to do; time is experienced as unchanging (Charmaz 1991).

According to Parks study (2009), the research found that in recent years, one particular

identity, “survivor”, has been actively promoted and widely and prominently used (2009).

The terminology survivorship is a term that is used to identify an individual who has had

cancer and is surviving and living after the diagnosis and treatment. The term is used by

many practitioners, including medical professions to identify a person who had survived the



disease. It may be an achievement to say a person is now a cancer survivor and proud to have

beat cancer, however, according to Park some may be reluctant to adopt the

label survivor because, to them, it carries connotations of cure, survivor may imply that the

danger has passed (2009). The results of the study showed that despite some people who are

reluctant to be known as a cancer survivor, the study indicated that at least somewhat, 83%

endorsed survivor identity (2009). This result from the study has been helpful in the findings

chapter of this dissertation. The significance of this project is the use of three-generational

interviews which are unique to sociological research that gave a broad perspective of

Hodgkin’s Lymphoma cancer. Within the interviews a discussion on a socially constructed

name as a cancer survivor is discussed.

2.3 The Sick Role

When a person is ill, that person does not deliberately give up normal social roles, one

substitutes a new role - the sick role

(Lonnquist 2006).

The sick role was first introduced by Talcott Parsons in 1948 in a book called ‘The Social

System’. Parsons theory argues that illness is not simply a biological or psychological

condition, and it is not simply an unstructured state of free social norms and regulation

(Lonnquist 2006). A person who becomes ill cannot change the fact that they are ill, one must

allow the social changes to occur. Fox argues that the sick role is “a social role, characterized

by certain exemptions, rights, and obligations, and shaped by the society, groups, and cultural

tradition to which the sick person belongs (1989:17). Fox’s theory is grounded in a

sociological perspective that when a person becomes ill, the inability to fulfil societal norms

such as going to work, is acknowledged by society as a whole and their family. The

individual becomes vulnerable to a new alternative role in society, the sick role.

Parsons identifies that the sick role belongs in two categories; a passive alienative category

and a confirmative motivational orientation. Acquiring the sick role also acquires an element

of dependency which can be characterized into the confirmative motivational orientation

category. Illness is predominantly a withdrawal into a dependent relation, it is asking to be

“taken care of.” It uses disability as the basis of legitimation of this claim (Parsons 1951). To

be granted care sacrifices many other roles for the family. Parsons and other functionalists

viewed sickness as a type of deviant behaviour in that it is a violation of role expectations;

“Illness, in our society, is undoubtedly motivated to a high degree and therefore may



legitimately be regarded as a type of deviant behaviour” (Parsons 1951). Parsons argues that

sickness is assessed as being dysfunctional for the family because when one member is sick

and relinquishes normal responsibilities, other members are required to pick up the slack –

and may become overburdened in so doing (Lonnquist 2006). This overburden on family

members can have significant effects on their daily routine for example, school, college or

work may become more of a hassle. The dependency may not only affect their routine but it

may also affect family member’s education as he/she may not be able to attend school or

college as much in order to look after the ill person in the family. When a person becomes

disabled to fulfil societal norms, society characterises them within the sick role. To become

disabled can trigger burdens for other family members as the ill person, as theorised by

Parsons (1951) withdraws to a dependant state, a state that demands to be taken care of by

family members. This effects daily norms and routines of family members. On the other

hand, how does an unexpected rare case of Hodgkin’s Lymphoma Cancer burden the family

and interfere with daily tasks?

The dependency that burdens a family as a result of a person being diagnosed with cancer has

significant impacts. It affects the social norms and routines of family members. However

there is a lack of research on the effects that this has on family members. This dissertation

contributes to the lack of attention that family members experience with their loved one being

diagnosed with cancer. The three-generation interviews allowed the author to explore the

feelings and emotions that family members hide away during a loved one’s battle. It also

allowed to explore family members views about the burden that associates with the sick role.

2.4 The Struggle of Time

The number of cancer survivors is increasing rapidly, however there still is not much research

implemented on cancer survivors’ experience and management of time (Elverdam 2007).

After a person has been diagnosed with cancer, immediately time becomes a crucial element

of life. Time with family and friends, time to reflect on one’s life and the time to appreciate

the things they were given in their life time, become essential meanings for a chronically ill

person. In a study done by Elverdam, interviews are conducted with cancer effected

participants. Elverdam concludes a paper based on the answers given by these participants

about what time means to them, their experience with time and how they control their time.



In the study three key findings were unfolded; cancer as a disruption of life and time;

increased awareness of time; appropriation of time (Elverdam 2007).

2.4.1 Cancer as a disruption of life and time;

As mentioned in the introduction chapter of this project, Burys’s (1988, 1991), theory on the

meaning of chronic illness, ‘meaning as consequence’ can contribute greatly to cancer as a

disruption of life and time. However, some argue that biographical disruption can also have

positive consequences (Nettleton 2013: 84). It can oftentimes signal a new view about life. It

can initiate a rethinking about the direction of a person’s life; it can mean that the sufferer

may become a more insightful person; and it may result in new opportunities never before

imagined (Nettleton 2013: 84). However, in most chronic illness cases, cancer diagnosis can

be a shock and a fright, evolving many mixed emotions and thoughts. Informants in this

study perceive a disruption in their experience of time, which means time becomes essential –

a primary focus of living – and contains different visible components: It is definitely a new

time. There is the time before I became ill and the time after. It is if one has been given life,

one feels that it is possible to feel life much more intensely. Because it was either or

(Elverdam 2007).

After a person becomes diagnosed with cancer time is split. Time becomes the before and

after diagnosis. Cancer becomes a symbol of disruption of life and time, and the harmony of

ordinary life disappears … several informants describe how the dates of diagnosis and

conclusion of treatment (and the resulting survivorship) become special, participants keel

turning back to these dates as indicators of a shift in time, how the time of cure becomes a

starting point for a new life and a point from which to measure new time (Elverdam 2007).

2.4.2 Increased awareness of time;

Time becomes one of the most valued elements of life when one’s future becomes uncertain.

Cancer could mean the end of life for cancer patients. To respond to this a lot of the

informants talk about their time and experience of life. Cancer patients also talk about the

‘end of time’ as an increased awareness of time.

I. The end of time: The informants that participated in this study are survivors, but

despite this, cancer means that they have been confronted with death, death is

confronted because: (1) Informants experience or have experienced others dying from

cancer; (2) Treatment may be ineffective; (3) The general discourse of cancer sees it

as unruly, unpredictable and at times mystical (Sontag 1991). To experience a person



dying from cancer is frightening for a person to be diagnosed with the same disease as

they do not know when their time will come. Also to have a great amount of trust in

nurses and doctors to do what it best for their survival can be difficult as their life is in

the hands of the medical professions. Lastly, life discourse can become unpredictable

and uncertain which could mean the end of time is closer than expected.

II. Losing the future: During one of the interviews with one particular cancer survivor

about the confrontation with death being closer than expected;

“To life in the present means that it is today I am here. It is today I may be able to go

to work, or bake a scone. It is today I may read little, if I am able. It is today I can go

to church, or listen to some tapes that interest just me. I can call my children today, or

walk in the garden. I am able to watch the flowers grow today, I have time for them,

because I have today. That is how it is. Tomorrow has not been promised to me”

(Elverdam 2007).

This quotation is an example that highlights the consequences of cancer, not knowing

whether you will be here tomorrow or not. A person with cancer cherishes the past and the

present but cannot cherish the future. It is characteristics for many informants that at the start

of their survivorship, shortly after treatment, they live in the present, feeling unable to

imagine what life will be, if at all, in 5-year time, they raise questions about starting a family

or reaching retirement (Elverdam 2007). In this case, cancer is already winning the battle

against survivorship as the cancer victims question their future goals and wants.

2.4.3 Appropriating time:

Appropriating time is the last of the key findings from this study. Time cannot be altered or

changed. Time is a continuous cycle of life. Time becomes much more noticed for an ill

person as they count down the last few days, months, or years that they may have to live.

Time controls human action, in this study, the informants however, showed that, instead of

being controlled by time in relation to what is to happen and when, they take control and

appropriate time (Elverdam 2007). In other words the informants attempt to forget about what

might happen and when the uncertain time may be, and instead, take control and appropriate

the present day.

The struggle of time can yes be one of the major difficulties that cancer patients have while

battling their illness. The uncertain thoughts of whether or not they have enough time to

spend with family and reflect on one’s life. It is almost as though the battle has been won to



the illness already. However, it is wrong to say that the struggle of time, time to spend with

family and time to appreciate the life they had, holds true for all cancer patients. Results in

the following findings chapter supports this assertion.

2.5 Physical appearance

Very little research has focused specifically on the stress of an altered appearance during

cancer treatment (Williamson 2010). In a study done by Williamson (2010), interviews of

cancer sufferers were conducted. One of the biggest fears that many cancer patients have

during this time, is the distinctive change in their physical appearance, however not every

person with cancer has the same side effects. The side effects of radiation, chemotherapy and

surgery bring about many physical changes to the appearance including hair loss, weight

change, and skin change. The small amount of research on this topic has concluded that

appearance changes during cancer treatment can hugely interrupt quality of life and identity.

These include abuse, taunting, reduced self-esteem, increased self-consciousness, problems

with social interactions and relationships with peers, body image concerns, and a sense of

social isolation (Williamson 2010). To have an appearance that reflected cancer can highlight

personal factors to the outside world that many people want to keep to themselves. For these

girls that were interviewed, their physical changes were a symbol of cancer, strongly

associated with illness and fear: “wellness and health was gone, it’s such a potent, frightening

symbol” (Williamson 2010).

In a recent study done by the American Cancer Society (2013), research about how

chemotherapy changes your appearance can affect the individual so much that it stops them

thinking positively about life. A person can lose all their confidence and self-esteem through

changes in their physical appearance. Despite this, does physical appearance changes affect

middle aged women of Lymphoma Cancer?

2.6 Emotional effect

A survey of more than 21,000 patients in Scotland found rates of clinical depression ranging

from 6% to 13% among cancer patients, compared with a prevalence of just 2% in the

general population (Irish Examiner 2014). Depression is a mental health issue that can be an

experience that a lot of cancer survivors experience after their illness. Research has indicated

that between 25 and 40 per cent of people may go through some depression after cancer (Mail

2011). According to a study conducted by Moscoso et al (2012) research concluded that

emotional distress is a neglected side of cancer care. The aggressive treatments that follow



with a diagnosis with cancer have major impacts on the psychological state of mind. The

study found that the occurrence of significantly elevated levels of anxiety as compared to a

normal population has been reported to be as high as 85% for newly diagnosed cancer

patients (Moscoso et al 2012). With mental health being a huge issue that associates cancer,

the report shows that emotional distress is a neglected area of cancer research. Despite this

increased attention to control these troublesome symptoms in patients with cancer, there have

been no concerted efforts to address the assessment of emotional distress based on

psychometric measures particularly developed for cancer patients (Moscoco et al 2012).

Despite this, an objective of this dissertation is to contribute to the lack of research on the

emotional effects of cancer. More information needs to be given to the primary oncologist

and his/her staff about the recognition of significantly high levels of emotional distress; how

to query the patient to elicit adequate information about their feelings, and how to identify

appropriate resources to which they could be referred for psychological counselling and

support (Moscoco et al 2012).

Conclusion

Through reviewing existing literature a sociological framework was formed that this

dissertation could be supported by. From reviewing literature on cancer experience and

impacts it is concluded that cancer has many affects on the human body mentally and

physically. It was gathered that the illness experience is socially constructed. As illustrated

by Charmaz (1991) and Baker (2010). The literature review also shed light on the creation of

a socially constructed name as theorized by Baker (2010). Baker argues that chronic illness

can prompt a re-evaluation of one’s former life and identity (2010). Fox’s theory discusses

the formation of a new role, the sick role when one becomes chronically ill. He argues that

the sick role is s social role, characterized by certain exemptions, rights and is shaped by

society (1989: 17). The literature review also discussed the problem with time. As supported

by Elverdam (2007). Elverdam’s study unfolded three key findings: cancer as a disruption of

life and time; increased awareness of time; and appropriating time. These highlight the

impacts that cancer has the issue of time. The literature review shed light on the physical and

emotional side of cancer. There is plenty of research conducted on the experiences that

associate cancer. Notwithstanding this body of research is informative and proven however

none of the research that this literature reviews is based on a three-generation method of data

collection. This research project is based on three-generation life history interviews. This is

beneficial as contrasting views and meanings of cancer were gathered through an exploration



of the participants life history. Lastly, very little research has been conducted on the stress of

an altered appearance during cancer treatment (Williamson 2010). This research project

contributed to the gap in sociological research on the physical appearance changes during

cancer treatment.



Chapter 3

The Methodology



3.0 Methodology

3.1 Introduction

This dissertation is fundamentally concerned with the experience of a woman with Hodgkin’s

Lymphoma cancer. This section is a discussion about the methods used to answer the

research question. The method used was three generational life history interviews. This

method is best suited to answer the research question for two reasons. Firstly, the interviews

being based on different generations gives a broader perspective of the meaning of cancer

thus creating different experiences and emotions about the effects of cancer. Secondly, the

life history aspect gives a synapsis of the interviewee’s life before cancer interrupted. It is

important to explore the lives before cancer interrupted them. This will unravel how much

cancer has affected them individually. As mentioned in the literature review chapter, cancer

survival rates are increasing dramatically. Generational life history interviews allowed for a

broader exploration of the impacts of Hodgkin’s Lymphoma Cancer and thus contributing to

the sociological research on the human experience of illness. The methodology chapter

consists of four sections. Firstly, there a discussion of the theoretical approach followed by

the study design, a description of the research procedure, and lastly the ethical considerations

are discussed.

3.2 Theoretical Approach

Relevant theoretical approaches that are highlighted in the literature chapter were used to

drag out similar experiences and thoughts that were gathered during the study. Theoretical

frameworks that were used during the study are Elverdams (2007) theory of the struggle with

time, Williamson’s (2010) study on a cancer survivor’s physical appearance changes and

Pierret’s (2003) theory of cancer as socially constructed. These approaches helped to develop

a theoretical perspective that broadened this issue of cancer in the sociological imagination.

3.3 Study Design

This study was based on a qualitative methods approach. Semi-structured interviews were the

most effective for this research question as it would give precise, relevant detailed

information about participants experience during and after cancer. It would also signal non-

verbal signs and emotions that would be visible to the eye. These interviews were based on a

three-generation structure. This type of interview structure is not one that is used a lot in



sociological research. Using a three-generational structure is the most beneficial method of

data collection as a wide range of thoughts and expressions are collected from separate

generations who view things completely different, this will give me optimal data collection

on what cancer means to each of these separate generations. It is also a benefit because

conducting for example three interviews from the same generation in today’s society is a

snapshot whereby conducting three generation interviews gives a much broader history of the

meanings and mass social changes associated with the generations.

3.4 Description of Research Procedure

Choosing the correct research setting and participants was not a hard task, as it was already

there all along. I had always planned on concentrating on my mother as the primary focus for

the research findings. This is because she had Hodgkin’s lymphoma cancer five years ago. To

make my mother as comfortable talking about such a difficult experience, the setting in

which the interview took place was her home over a cup of tea. The questions were read over

and the tape recorder was checked before starting. The second interview took place also in

her home. We were going to go to the local coffee shop but she rather stay in her home and

have tea. Again the questions were read over and the tape recorder was checked before

starting the interview. After the interview I stayed with her and watched television for an

hour so that I wasn’t leaving her upset or lonely too quickly. A consent form was given to

each interviewee in advance. This explained the reason behind the research and it made them

aware that the participant is completely on a voluntary basis, which meant that they could

withdraw at any time with no given reason. This is also an ethical consideration that is

discussed later in the ethics section.

To gather the optimal standard of data, there were a number of procedures that was important

as a researcher to carry out during each interview.

Each interview were tape recorded. Recording each interview meant that more

concentration on the interviewee could commence as there is an ease of mind that all

information will be able to be played back. It also meant that notes could be taken.

Notes were taken in each interview. Notes on how the interviewee portrayed himself

or herself just before the interview, were they nervous? Notes on non-verbal language

could be taken during the interview such as sadness during specific topics or constant

moving or fidgeting. Notes were taken after the interview. This can be quite important



to note because a lot of the time as a researcher it is important to look out for signs of

relief that it is over or signs of melancholy.

It is also important that as a researcher, I mostly controlled the power relation. This is

an important step that can quite often be forgotten about. It is important to ensure that

the interview does not go off course that it does not go onto something that would be

irrelevant and non-worthy for my research. To ensure this does not happen, a clear

structure of questions or themes should be jotted down as a guide to follow to ensure

that all themes or topics are covered.

Lastly the interviewee’s agreed to participating in this study on a voluntary basis. To

ease any nerves that the interviewees may have, we had tea before their interview.

This made each interviewee more relaxed and willing to open up more. This is a

benefit for an increase in optimal research findings. Each interview was conducted

late in the evening, between 6pm-8pm. This meant as a researcher, I did not interfere

with their daily routines and it also gave them time to prepare throughout the day.

To analyse the data from the interviews, firstly each interview was transcribed. A method of

coding referencing was carried out to identify themes and topics that were continually

mentioned or that were of significance to the project that I would not have spotted during the

interview. The coding method used was colour coding. This worked best as the themes and

vital data jumped out of the page.

5.5 Ethical Considerations

As a researcher there is unconditional responsibilities for the integrity of the research process

(O’Leary 2014). Ethics are self‐regulatory guidelines for making decisions and defining

professions (CliffsNotes 2016). Guidelines such as ensuring the correct preparation before

conducting the interviews and a professional approach during the interviews i.e. no

disagreements with any given answer are huge ethical considerations in sociological research.

There were a lot of ethical considerations with conducting successful interviews. The ethical

considerations need to be revised by the researcher to ensure the dignity and well-being of the

researched (O’Leary 2014).



This section will discuss the ethical considerations that had to be considered during the

qualitative method of gathering information for this research project.

Responsibility for the researched

Responsibility for the dignity, respect, and welfare of respondents, both mentally and

physically, is central to research ethics (O’Leary 2014). Respecting and obeying by the

rights of each interviewee regardless of any given information was crucial during the data

collection. As a researcher, respecting the participant’s answers was an essential element

of ethical obligations. To ensure this consideration was obeyed, no interference or

disagreements with the participant’s answers were said.

Signed consent form

The purpose of giving all interviewee’s a consent form is to inform them of the nature and

objectives of the research that is being carried out. According to O’Leary, Participants

can only give informed consent if they have a full understanding of their requested

involvement in a research project, including time commitment, type of activity, topics

that will be covered, and all physical and emotional risks potentially involved (2014). A

consent form was given to all three participants to inform them of the study and to outline

that the study is done on a voluntary basis with no unnecessary pressure.

Ensuring there is no harm towards participants

The concept of harm in social science research generally refers to emotional or

psychological harm, rather than physical harm (O’Leary 2014). This is a major

consideration during this research as three interviews were conducted on a topic that is

deemed powerful and emotional to confront with. Regardless of any potential benefits to

society, or even informed consent, risks of any type of harm, including damage to self-

esteem or self-respect, should be ethically and/or morally unacceptable (O’Leary 2014).

To ensure there was no harm during these interviews, an instruction was given before the

interviews started that they are free to withdraw the interview at any stage without

reasoning to ensure there would be no emotional harm.

Ensuring confidentiality and possibly anonymity

Ensuring that the participants that voluntarily engaged with this study, were free from

personal identity from members of the public, however not from the researcher.



Protection of confidentiality may involve secure storage of data; restricting access to raw

data; and obtaining permission for subsequent use of data (O’Leary 2014). To ensure

confidentiality was obeyed, any given information was stored behind a password based

computer.

Anonymity takes a step further with privacy. Anonymity refers to privacy from both the

public and researcher. In this study, anonymity was not used. Confidentiality was the

agreed privacy method that was agreed by all interviewee’s.

Development of expertise and experience

As a researcher in this particular field, it is appropriate to have clear knowledge in the

research landscape before going about conducting appropriate interviews. This was done by

reviewing existent literature on my topic on cancer experiences. There is an implicit

obligation for researchers to know about: their topic; previous research; and commonly used

methods, including their shortcomings (O’Leary 2014).

5.6 Conclusion

The methodological section was an overview of the procedures and ethical considerations. It

is important in sociological research to prepare for data collection. This will increase the

chances of optimal findings and it will ensure that there is no harm to any participant. The

methodology contained six main sections. The introduction, the theoretical approach, the

study design, a description of the research procedure, the ethical considerations and lastly the

conclusion.



Chapter 4

The Findings



4.0 Findings

4.1 Introduction

The literature review chapter discussed the different experiences and consequences that

cancer can bring. Using the literature review, an in-depth individual cancer experience was

carried out. To carry out this task, a qualitative data collection method was used, this

involved semi-structured interviews that were conducted on the basis of three inter-

generational structures. The interviews were based on a two generational basis as discussed in

the methodology which is a unique research technique in the sociological research field that

allow for more in-depth and precis findings that formulate across the different generations for

a more generalizable finding. The wide gaps within the generations were deliberately chosen

as there is an increased chance of their experiences and thoughts and expressions about

cancer being completely different as they have lived through completely different periods of

time.

The three interviewees were relatives; two of them were mother and daughter. The

interviewee generations that were interviewed were; the author’s mother who had Hodgkin’s

lymphoma cancer (53), the cancer survivors mother (81) and lastly the daughter (21). This

chapter will be supported by the literature review for an optimal understanding of the

research purpose. The cancer survivor lived all her life in Cabra West in her mother’s house

who still lives there today. Before the woman got cancer her face was always glowing with

healthy shiny red hair and a bright smile.

The interview introductory stages firstly explored their life stories and then explored their

individual experiences and thoughts about their relationship with cancer. Particular interest is

the cancer survivors experience with cancer as there is very little research on Hodgkin’s

Lymphoma Cancer in the age category that she is in. It is uncommon to get this type of

cancer at her age. The emotional and physical effects that result from cancer were explored,

and the gradual changes of dominant roles in the family were explored in relation to the

change of role to the sick role as theorised by Lonnquist (2006). The three inter-generational

interviews will be discussed on the basis of these topics in detail with support from existing

literature to give optimal discussions.



4.2 Mothers Life Story introduction

Four sections of the mothers experience with cancer were explored in detail. 1. Emotional

effect 2. Physical effect 3. Socially constructed name 4. Life five years cancer free. The

interview began in the woman’s house over a cup of tea to calm any nerves. The “C” word is

the dreaded, stomach turning word that most people find to be one of the most difficult topics

to talk about over the course of their lifetime, particularly when that person was fighting for

their life in a constant battle with the disease.

The first conversation with the mother most definitely did not jump straight into a depressing

conversation about their fight with cancer. It began at her youth, reflecting on living a healthy

life were she was optimistic about her future achievements and goals.

I loved going out with my friends, we only really went out on the weekends. I

remember one conversation that has stuck with me to this day, we were sitting around

the fire with a bottle of wine talking about our future wants and plans. I said that I

wanted to travel the world with the man that I would be married to (smile), but I

didn’t want to do this during my youth because I just couldn’t afford it at the time, I

planned to do it when my kids had all grown up and could look after themselves for a

while, but that one future plan to travel the world didn’t seem so clear anymore

(sigh).

The beginning of the interview highlighted a sense of identity and stigma. The interviewee

talked about her youth stage and the socialization of herself and her friends. Life for the

interviewee was coming across as a typical young woman’s life. The beginning of the

interview also indicates a sense of want, a sense of determination of life goals. However, it

was also the starting point of melancholy. Already as a researcher this was the first indication

that this interview was going to be an emotional conversation. Without any emphasis, the

want for kids and the one man to travel the world with are indications of the importance of

family to this woman. Number one; to be talking to friends about future plans to create a

family and number two; to continue to talk about when her kids were all grown up in a

melancholy tone, identifies the close relationship the mother had with the illusion of a

possible family.

In most cases, cancer diagnosis can be a shock and a fright, evolving many mixed emotions

and thoughts (Elverdam 2007). For this participant, cancer was a huge shock to her nobody

thinks it will ever happen to them, until it does.



I was surprised I got it, very surprised, because the one that I got is either a very

young persons or a very old persons cancer and I’m kind of mid-life so they were

surprised that I would have gotten that kind of cancer but (pause) I just saw it as a

battle.

The shock that the medical professions and this woman got when this cancer was diagnosed

to a woman middle-aged, highlights the possibility of a lack of attention of the disease on

middle aged women who were affected by Hodgkin’s Lymphoma Cancer. Yes, cancer can be

a shock to any person who is diagnosed with the disease however from the data that was

gathered through this interview it was concluded that it was a rare case of Hodgkin’s

Lymphoma cancer. The analysis indicates that more research needs to be implemented on

woman or men who get this type of cancer in their middle age. According to research done on

Hodgkin’s Lymphoma cancer statistics indicate that Hodgkin’s Lymphoma cancer is most

common in early adulthood (ages 15 to 40, especially in a person’s twenties), and in late

adulthood (after age 55) (American Cancer Society 2016).

4.3 Emotional Effects

It was not long before the sadness had already derived from the interview, the first signs of

melancholy had already appeared by the introductory stage. It was already clear that cancer

had a huge impact on her emotional state of mind, as identified firstly from shattering her

future plans to go travelling.

The emotional effects that associate cancer are very difficult to research. Many cancer

victims tend to hide their emotions as they don’t want to frighten or upset loved ones. For

example, 7 years ago when the mother told her daughter, the author, of the cancer, she had no

emotion. Nothing was said other than, ‘I’ve something to tell you, I’ve got cancer’. The

atmosphere was unbearable to the extent that, the conversation had ended she had left the

room. Tendencies toward withdrawal is common in reaction to deeply felt emotional pain

(Seltzer 2011). It was obvious that there was a huge struggle for both parties to remain strong

and impractical of their emotions.

However, from conducting this interview, information gathered that the emotional side

effects of cancer was not the biggest consequence for this woman. Emotionally, cancer did

not affect her as much as other side effects did.



It didn’t really affect me too much. I remained quite positive about it all. I just took it

day-by-day.

This is a key finding that cancer did not affect the emotional state of the woman. The

literature highlighted that the aggressive treatment that follow with a diagnosis with cancer

have major impacts on the psychological state of mind, the study found that the occurrence of

significantly elevated levels of anxiety as compared to a normal population has been reported

to be as high as 85% for newly diagnosed cancer patients (Moscoso et al 2012). Through

discussing the emotional effects of her cancer, even though the introductory section may have

been an indication of sadness and emotional distress, data collected on this topic proved the

previous analysis wrong. Data gathered that emotions can be restrained and controlled by the

correct supports and love from friends and family. Psychologically, the participant deemed

that she was in the correct state of mind for fighting her cancer mentally. This is a significant

finding as cancer is associated with poor mental health and an unstable emotional state.

When talking to the cancer survivors mother (81) during the interview, she got very upset in

her tone of voice when her daughter having cancer was brought up. Cancer seemed to affect

the mother (81) more so than the cancer survivor.

It was very depressing, your grandad was very depressed with it too. It was hard to sit

back and see your daughter get cancer after her always looking after myself and your

grandad so well. Always coming to visit, cooking for us, having us over for Christmas

and allowing us to stay the night. All of these memories came back and it was very

depressing to think about. It was almost like guilt of all the times she looked after us

and I felt like it should have been us looking after her the whole time. It was very

depressing

The analysis here indicates that there is a contrasting sense of emotion between the two

generations. The significance is that the person who battled cancer remained strong and

positive about their illness. There was no indications of anxiety or depression from the cancer

survivor. There was no medications involved in her treatment for mental health. However, the

mother found it very difficult to adhere. There is one particular underlying theory behind the

cancer patient’s positive attitude towards her illness. It is illustrated by Bury (1991). Bury

theorizes how a person adapts and copes with their illness through discussing the differences

between coping, strategy and style. The positivity illustrated by the data collection indicates

Bury’s (1991) theory on coping and style. Coping refers to ‘the cognitive processes whereby



the individual learns how to tolerate or put up with the effects of illness (Nettleton 2013: 87).

Secondly, the positive response to her illness can also be illustrated by Bury’s theory on style.

Style incorporates the cultural circumstances and connotations of an illness, and refers to ‘the

way people respond to, and present, important features of their illnesses or treatment

regimens’ (Bury, 1991: 462). The positive response to her illness indicates a sense of hope

and calmness however, that does not indicate that behind Bury’s response mechanism that

there was not a sense of fear and uncertainty. Bury’s coping and style theories are

interrelated, and what is common to them is that they are compounded by uncertainty and

unpredictability (Nettleton 2013: 88). This is a significant contrast with the cancer survivors

mother and fathers depression during her cancer. As we can see from the quote from the

elderly woman, the word depression was repeated in those few lines four times and negative

words such as very hard and guilt repeated themselves over and over again. The analysis of

this indicates severe struggle and severe pain from the immediate family. This contrasting

emotional state also highlights the significance of carrying out inter-generational interviews

as the data collection method. Without the inter-generational interviews the analysis would

not have represented this key finding about the emotional effects of cancer. It allowed for a

more holistic and comprehensive finding.

4.4 Physical Appearance

Physical changes during cancer treatment occurs for only some patients, depending on the

type of treatment they are getting. This participant had chemotherapy for a total of one and a

half years. Physical changes during cancer is one of the hardest experiences of cancer for

many people. In a study done by Williamson, one of the biggest fears that many cancer

patients have during this time, is the distinctive change in their physical appearance (2010).

This study proved correct when this participant admitted to losing her hair as one of the

biggest difficulties associated with her cancer.

I know I was going to lose my hair, so before I lost it I decided to cut it all off so I

shaved it off. After that I felt better, I felt refreshed. When you have no hair you then

have a wig, you can go out and still nobody would know any different

The analysis of the physical appearance of this cancer patient represents acts of agency. ‘So

before I lost it I decided to cut it all off’. This is a deliberate act of agency which includes an

action to intentionally cut off her hair before cancer could slowly destroy her identity. There



is a significant key result of this act of agency. ‘I felt better, I felt refreshed’. This was the

outcome to her act of agency which made her feel more positive about her battle. It made her

feel as if she is winning, which she was. A person’s identity can be completely disrupted.

Losing a sense of identity can affect a person’s confidence and self-esteem particularly being

in public. Enskar et al found that appearance changes during cancer treatment can hugely

interrupt quality of life and identity. These include reduced self-esteem, increased self-

consciousness, and body image concerns (Williamson 2010). When talking to the participant

about whether her confidence and self-esteem dropped when she lost her hair, the findings

came back that her confidence was hugely affected by her disease.

Yeah it did. It affected the confidence only when I went back to work. I had no hair at

that stage so I went back a wee bit too soon and it is difficult to go into an office with

a wig, when people know you so well so you lose your confidence quite easily in your

appearance

Hodgkin’s Lymphoma Cancer has many other physical appearance changes associated with

it. According to the National Cancer Institute, chemotherapy may damage fast growing skin

and nail cells, this can cause problems such as skin that is dry, itchy, red and/or that peels.

Nail changes may include dark, yellow, or cracked nails (2015). Although physical changes

in skin or nails may not be the most daunting change, it still contributes to an extra

unnecessary burden that effects self-confidence.

Yeah, my nails went black, especially my toe nails but my hand nails stuck it out and

they weren’t damaged at all. My skin was dry, my teeth were sore, my skin was flaky.

My teeth are still a problem, I still have to get a lot of treatment on my teeth

The significance of these changes to the human body as illustrated by the interviewee, have

major implications on confidence and social interactions. This refers to Bury’s (1988, 1991)

theory ‘meanings as risk’: that is, people who are chronically ill constantly have to risk the

fact that their interpretations of a situation might not be shared by others (Nettleton 2013: 82).

For example calls for sympathy may be rejected, or attempts to ‘carry on’ may be regarded

by significant others an inappropriate in the light of a deterioration of symptom’s (Nettleton

2013: 82). The issue regarding rejection of sympathy or in-appropriation of ‘carrying on’ that

is portrayed by the social world around us highlights the want factor to avoid the annotations

of the world’s leading disease, cancer.



4.5 A New Socially Constructed Name - A Cancer Survivor

Bury’s (1999, 1991) theory, ‘meaning as significance’, provides a framework for

understanding the loss of identity that is experiences through chronic illness. Meaning of

significance refers to the connotations and imagery associated with given conditions … it is

the meaning as significance which affects individuals’ sense of self (Nettleton 2013: 82).

Chronic diseases can prompt new identifications and overshadow personal identities. As the

literature review explored Parks theory of survivorship as a socially constructed name, it is

proven through this study that a person has encountered a socially constructed name as a

cancer survivor. The results of Parks study showed that despite some people who are

reluctant to be known as a cancer survivor, the study indicated that at least somewhat, 83%

endors ed survivor identity (2009). Included in that 83% is the participant of this new study

that has followed up on that.

Yeah, I suppose you are given a socially constructed name when you have cancer,

then you are always a survivor of cancer. I suppose it hangs over you always too like

a bit of a black cloud

To get to the depths of her thoughts about her new identity a question was asked to expand on

her loss of identity experience.

Personally, yes I would say that I would like to get my personal identity back and not

always to be known by everyone as the woman who bet Hodgkin’s Lymphoma Cancer.

I think that giving me back my real identity would help me to forget about the illness,

forget that I ever had it and it would therefore boost my confidence and self-esteem

that I once had

Even though the illness has subsided, the illness still shapes her life. This woman is defined

primarily through the illness even though she has gotten the all clear. However, according to

Charmaz (1987), this ‘loss of self’ is not necessarily a permanent feature and Charmaz (1987)

also illustrates ways in which people move beyond this state and are able to create new

‘reconstituted identities’ (Nettleton 2013: 83). How cancer survivors respond to their

experience of the disease impacts on the name given to them. Referring back to the literature

review, chronic illness can prompt a re-evaluation of one’s former life and identity, and, in

some cases, the creation of a new illness identity (e.g., cancer survivor) (Baker 2010). The

study concluded that despite some people who are reluctant to be known as a cancer survivor,



the study indicated that at least somewhat, 83% endorsed survivor identity (2009).

Unfortunately, for this particular woman, the study proved correct as her experience with her

disease added to the number who endorsed survivor identity.

4.6 Life five years cancer free

I am five years cancer free now, which is a bit of a milestone. I celebrated recently

over a bottle of wine and a meal out in a restaurant with my mother, sister, and

daughter. Unfortunately, my dad wasn’t there as he recently had passed away from

cancer so it was a huge celebration to have been lucky to beat it after watching my

father die from it 3 years later

According to Pesmen, the ‘five-year survival’ is a term doctors and researchers use as a

benchmark … it relates to the percentage of people in research studies who were still alive

five years after diagnosis (2007). It is considered a milestone. To reach the five-year cancer

free stage is a huge achievement to both doctors and the cancer survivor. The five-year

survival rates were introduced in the 1930’s not to point patients toward notions of a cure, but

because cancer specialists back then considered five-year survival a nearly unattainable goal

(Pesmen 2007).

(SEER 18 2005-2011)

Figure 1: Stages of Hodgkin's Lymphoma Cancer.

I had stage four cancer which is pretty serious, and I had chemo for first for about six

months and then I had mini chemo for two years after that. It is a lighter version of

chemo



Stage four Hodgkin’s Lymphoma Cancer means that the cancer had distanced from its

origins. According to a study done by Cancer.Net, stage four refers to the cancer spreading

throughout the body and beyond the lymph nodes Stage, lymphoma most often spreads to the

liver, bone marrow, or lungs (2014). This woman had stage four Lymphoma Cancer, which

on the figure above, it is at the distant level. The five-year survival for distant Hodgkin’s

Lymphoma is 76.9%. This is considered a milestone to cancer researchers and doctors.

However, it does not mean to leave the illness in the past. As there is chances of it returning

as quickly as it had started.

Any little problem I have I can’t ignore it no matter how insignificant I think it is, I

have to go about it. The cancer is inactive at the moment, but it wouldn’t take much

for it to become active again. If that was the case I would have very harsh treatment

and probably stem cell replacement which is quite evasive, so I have to keep a very

close eye on things, something you have to live with….

This cancer survivor could speak for many cancer survivors here. Cancer survivors and in

particular this cancer survivor is critically aware that the illness my return. Unfortunately, the

illness never completely diminishes. There is always a fear for the cancer survivor and the

family of it returning. Life five years cancer free does not mean life is back to normality.

Cancer survivors are often battling with physical and practical challenges, anything from

huge financial losses, to the side effects of medication profound fatigue, a confused-feeling

known as “chemo-brain”, or lymphoedima (swelling) (Atkins 2012). Rates of depression and

anxiety are very high when treatment ends (Atkins 2012). These side effects must be kept a

close eye on as the data gathered indicates that the body and mind is as vulnerable after

treatment as it is during treatment.



Chapter 5

Conclusion



5.0 Conclusion

5.1 Introduction

The conclusion chapter is a brief discussion of the key findings from this dissertation. The

primary aim of the dissertation was to explore the impacts of Hodgkin’s Lymphoma Cancer

for the individual and the immediate family. The dissertation had three main bodies, the

literature review, methodology and the findings. The literature review was a discussion of

existing literature on the topic of study. This provided a theoretical framework to support the

findings. The methodology section was a discussion on the preparation for the data

collection. It discussed the procedures of the data collection in detail and the ethical

considerations to ensure no harm was done to any participant. Lastly, the findings unravelled

the key answers that were gathered from the three inter-generational interviews. The findings

were based on each interviewee’s individual experience and relationship with cancer.

5.2 Data Conclusion

This study was fundamentally concerned with the impacts that cancer has on the human

body. The study concentrated on a rare case of Hodgkin’s Lymphoma Cancer as a primary

means of answering the research question. The research question shed light on the impacts

that cancer has on the mental and physical body. Through completing this study the findings

indicate that the disturbing annotations about cancer is the daunting side effects that it brings

to the individual. Even in cases where cancer is under medical control, cancer still brings

consequential side effects that effect the physical and mental body to some level. However, it

was concluded that cancer does bring positivity to the individual and the immediate family.

The findings suggest that when a person reaches the five-year survival rate it is a huge

celebratory experience. This dissertation shed a deeper light on the illness experience for the

individual with cancer, and exploring how cancer has the ability to affect the immediate

family more than the person with cancer. The dissertation was supported by sociological

literature. The evidence from the dissertation showed that cancer is such a powerful disease

that despite medical assumptions, cancer can destroy any body at any given age and can

create a number of concerns that affect the mind and the physical body.



The findings concluded that despite possible faulty scientific assumptions, a woman of

middle age who contracted a rare case of cancer regardless of her age. The biggest side

effects of Hodgkin’s Lymphoma Cancer was the physical appearance. Physical changes in

appearance during cancer can severely damage the psychological functioning. It can affect

self-confidence and it can create a socially constructed name and malfunction the identity to a

‘cancer survivor’ as explored through this dissertation.

However, cancer is not all as negative as we may think. The findings concluded that cancer

does not always mentally affect the individual as much as we may think. The data results

showed that in this case, cancer affected the immediate family more so than the woman

affected with Hodgkin’s Lymphoma Cancer. Lastly, the data concluded that individuals who

battle cancer tend to use all their energy to lead the battle. For this particular woman we seen

that she led the battle by participating in actions of agency. This gave her a sense of

positivity, determination and survivalship against her battle with the disease.

5.2 Recommendations

Based on the findings that were gathered from this project the assumptions indicate that there

is a need for more emphasis on research to be completed on rare cases of cancer for instance

Hodgkin’s Lymphoma Cancer of middle-aged woman, as an alternative of adding to the vast

amount of research done to date on common cancer cases in Ireland. This is not to say to

discontinue researching common cancer cases, it is a recommendation to explore cancer cases

like this, where there is not a lot of acknowledgement or research on the consequential side

effects for middle aged women of Hodgkin’s Lymphoma Cancer in contemporary society.

There is also more attention needed towards the affected family of a loved one with cancer.

We tent to place all our attention and energy on the person with cancer and almost ignore the

emotional family. The findings of this dissertation concluded that it is not always the person

with cancer that is affected with their illness as bad as their loved ones are affected by it.

5.3 Experience and Further Research

Completing this dissertation was a rewarding but very challenging experience. It was a

particular difficult topic to consider doing a detailed project on as my mother has never

discussed her cancer in such detail before. It was an educational dissertation, nevertheless it

was an exciting journey. I had great interest in the topic as it was a real life story from a

blood relative who recently had a rare case of Hodgkin’s Lymphoma Cancer. However, I

knew that by doing this topic it would add to the limited research that has been done by



cancer researchers on Hodgkin’s Lymphoma. Therefore, I used this opportunity to my

advantage to create awareness of Hodgkin’s Lymphoma Cancer that it can and does affect

individuals of all ages despite medical assumptions. I thoroughly enjoyed this project. I have

a particular interest in the topic as it is so relevant to my life. This dissertation has furthered

me onto being interested in doing a Masters in Sociology to expand on this topic.

5.4 Concluding Comments

To suggest that cancer only affects the individual is a false accusation. The participants in this

study conclude that Hodgkin’s Lymphoma Cancer affected the immediate family more than

the individual with cancer. The data gathered that it was depressing for the cancer survivors

mother and father to come to terms with their daughters illness. However, the woman with

Hodgkin’s Lymphoma Cancer had no signs of depression. There was signs of uncertainty and

fears of the illness returning nevertheless, the woman remained very strong and brave of her

illness. Cancer also has the talent to overshadow a person’s identity. This study revealed that

the woman that had Hodgkin’s Lymphoma Cancer fortunately was not hugely affected

emotionally however, the data showed that cancer did have the ability to interrupt her

identity. Before cancer could affect her identity and her physical appearance, the participant

partook in acts of agency. The woman shaving all of her hair off before cancer could destroy

her physical appearance and her identity showed the strength and determination of this

woman to confront with her illness and win. Another key finding from the data collection

presented that even though the illness is gone, cancer still shapes lives five years free of the

disease. This woman is still defined primarily through the illness even though she got the all

clear. The participant is still known as a cancer survivor, a socially constructed name that

cancer created. This contrasting illness experience of Hodgkin’s Lymphoma Cancer that

highlight both negative and positive impacts of the disease is just one experience of one case

of cancer in Ireland. The changes that a family experience with a diagnosis are uncontrollable

and unexplainable. This dissertation was concerned with the lack of knowledge of the illness

experience as assumptions are made every day of the experience. This project proved that the

assumptions are not always correct about the revolutionary illness experience.



6.0 Bibliography

American Cancer Society (2016) What are the key statistics about Hodgkin disease?

http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-key-statistics,

accessed April 1, 2016.

American Cancer Society (2016) What is Hodgkin’s Disease?

http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-what-is-

hodgkin-disease, accessed March 15, 2016.

CliffsNotes (2016) Ethics in Sociological Research, http://www.cliffsnotes.com/study-

guides/sociology/sociological-research-methods/ethics-in-sociological-research, accessed

February 19, 2016.

Irish Cancer Society (2015) what is Cancer? http://www.cancer.ie/cancer-information/what-

is-cancer#sthash.7lazXSSN.dpbs, accessed February 12, 2016.

Government of Ireland (2015) Healthy Ireland Survey 2015. Dublin: The Stationary Office.

Cancer.Net (2014) Lymphoma – Non-Hodgkins: Stages http://www.cancer.net/cancer-

types/lymphoma-non-hodgkin/stages, retrieved March 02, 2016.

Cancer survival rates higher than ever, says report (18 December 2014) The Irish Times.

Atkins, Lucy (2012) Life after Cancer

http://www.theguardian.com/lifeandstyle/2012/oct/07/life-after-cancer, accessed April 1,

2016.

Moscoco, Manolete S. Lengacher, Cecile A. and Reheiser, Eric C. 2012. “The assessment of the

perceived emotional distress: the neglected side of cancer care.” Psicooncologia. 9:2-2.

New treatment of depression in cancer patients has had promising results (28 August 2014)

Irish Examiner.

Nettleton, Sarah. 2013. The Sociology of Health and Illness. 3rd ed. Cambridge: Polity Press.

O’Leary, Zina. 2014. The Essential Guide to Doing Your Research Project. 2nd ed. London:

SAGE Publications Ltd.

American Cancer Society (2013) Chemotherapy changes the way you look,

http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffec

http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-key-statistics

http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-what-is-hodgkin-disease

http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-what-is-hodgkin-disease

http://www.cliffsnotes.com/study-guides/sociology/sociological-research-methods/ethics-in-sociological-research

http://www.cliffsnotes.com/study-guides/sociology/sociological-research-methods/ethics-in-sociological-research

http://www.cancer.ie/cancer-information/what-is-cancer#sthash.7lazXSSN.dpbs

http://www.cancer.ie/cancer-information/what-is-cancer#sthash.7lazXSSN.dpbs

http://www.cancer.net/cancer-types/lymphoma-non-hodgkin/stages

http://www.cancer.net/cancer-types/lymphoma-non-hodgkin/stages

http://www.theguardian.com/lifeandstyle/2012/oct/07/life-after-cancer

http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/sexualsideeffectsinwomen/sexualityforthewoman/sexuality-for-women-with-cancer-chemo-and-way-you-look



tsinwomen/sexualityforthewoman/sexuality-for-women-with-cancer-chemo-and-way-you-

look, accessed February 19, 2016.

Nettleton, Sarah. 2013. The Sociology of Health and Illness. 3rd ed. Cambridge: Polity Press.

The Downside of Beating Cancer (14 June 2011) Mail Online.

Seltzer, Leon F. 2011. “Why We Hide Emotional Pain – Strong People Won’t Let Themselves

Cry, Right?” Health Professionals. Retrieved February 29, 2016

(https://www.psychologytoday.com/blog/evolution-the-self/201109/why-we-hide-emotional-

pain).

Williamson, Heidi 2010. “Adolescents’ and Parents’ Experiences of Managing the

Psychosocial Impact of Appearance Change During Cancer Treatment.” Journal of Pediatric

Oncology Nursing. 3:168-175.

Park, Crystal L., Zlateva, Ianita and Blank, Thomas O. 2009 “Self-identity after Cancer:

“Survivor”, “Victim”, “Patient”, and “Person with Cancer.” National Institutes of Health Pp.

430-435. Retrieved February 1, 2016

(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763169/).

Elverdam, B and Rasmussen, Dorte M. 2007. “Cancer survivors' experience of time – time

disruption and time appropriation.” Journal of Advanced Nursing. 57:614-622.

Lonnquist, Lynne E and Gregroy L. Weiss. 2006. Sociology of Health, Healing, and Illness;

The Sick Role. California: Pearson Prentice Hall.

Pierret, J. 2003. “The Illness Experience: State of Knowledge and Perspectives for Research.”

Sociology of Health and Illness. Retrieved February 12, 2016

(http://onlinelibrary.wiley.com/doi/10.1111/1467-9566.t01-1-00337/epdf).

Parsons, Talcott. 1951. The Social System England: Routledge & Kegan Paul Ltd.



https://www.psychologytoday.com/blog/evolution-the-self/201109/why-we-hide-emotional-pain

https://www.psychologytoday.com/blog/evolution-the-self/201109/why-we-hide-emotional-pain

http://jpo.sagepub.com.jproxy.nuim.ie/search?author1=Heidi+Williamson&sortspec=date&submit=Submit

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763169/

http://onlinelibrary.wiley.com/doi/10.1111/1467-9566.t01-1-00337/epdf



7.0 Appendices

(SEER 18 2005-2011)

christina gibney full sociology thesis pdf finished

Documents