Årg. 14 Nr. 26 (2017): Social smitte
Originalartikler

Staying alive? Navigating Uncertainty in Cancer in Childhood

Pia Løvschal-Nielsen
Afdeling for Antropologi, Institut for Kultur og Samfund, Aarhus Universitet
Rikke Sand Andersen
Aarhus Universitet
Lotte Meinert
Aarhus Universitet

Publiceret 2018-03-22

Nøgleord

  • uncertainty

Citation/Eksport

Løvschal-Nielsen, P., Andersen, R. S., & Meinert, L. (2018). Staying alive? Navigating Uncertainty in Cancer in Childhood. Tidsskrift for Forskning I Sygdom Og Samfund, 14(26). https://doi.org/10.7146/tfss.v14i26.24327

Resumé

Abstract In this article we explore how institutions and individuals in Denmark deal with uncertainty of cancer in childhood. Based on a seven months ethnographic fieldwork conducted on a paediatric oncology ward from 2011-2013, we examine how uncertainty and insecurities manifest in the interface between cancer treatment and childhood in the Danish welfare state. We develop our argument theoretically with the American pragmatist philosophy and its ideas that people are responding to a hazardous world in constant transformation. Through a focus on micro practices we explore how uncertainty manifests especially for children and their families, and how they navigate insecurities. Important collective attempts to create some measure of certainty and security are done in treatment practices, but we argue that biomedical practices dealing with uncertainty of cancer paradoxically give rise to existential and social uncertainty among children and their families, which they struggle with, also after the end of cancer treatment, as long-term social effects of cancer in childhood. We suggest that more attention could be paid to assist children in dealing with uncertainty and insecurities imminent to being in cancer treatment in the Danish welfare state and the social effects of this.

Referencer

  1. American Cancer Society (2014). Cancer Facts & Figures 2014. Special Section: Cancer in Children & Adolescents (pp. 25-43). Atlanta: American Cancer Society. (Accessed June 25th 2015)

    Boisvert, R.D. (1998). Chapter 2: Thinking. In: R.D. Boisvert, John Dewey: Rethinking Our Time (pp. 29-48). Albany: State University of New York Press

    Bryant, R. (2003). Managing side effects of childhood cancer treatment. J Pediatr Nurs. Vol.18, 113-125, DOI:10.1053/jpdn.2003.11, doi.org/10.1053/jpdn.2003.11

    Dansk Børnecancer Register (2016). National Årsrapport 1985-2015 [Danish Register of Cancer in Children (2016): National Annual Report 1985-2015]. Aarhus: KEA, Aarhus University

    http://www.kea.au.dk/da/kliniskkvalitet/kliniske-databaser/B%C3%B8rnecancerRegister.html (accessed February 2nd, 2016)

    Dewey, J. (1929). The Quest for Certainty. A Study of the Relation of Knowledge and Action. New York: Minton, Balch & Company

    Douglas, M. (2001). Dealing with Uncertainty. Ethical Perspectives. Vol. 8(3), 145-156, doi: 10.2143/EP.8.3.583185

    Einhorn, E.S. & Logue, J. (2003). Modern Welfare States: Scandinavian Politics and Policy in the Global Age. Westport and London: Praeger

    Flaherty, M.G. (2011). The Textures of Time. Agency and Temporal Experience. Philadelphia, Pennsylvania: Temple University Press

    Gilliam, L. & Gulløv, E. (2014). Making children ‘social’: Civilising institutions in the Danish welfare state. Human Figurations: Long-term perspective on the human condition. Vol. 3(1)

    Guerny, J. C., Krull, K. R., Kadan-Lottick, N., Nicholson, H. S., Nathan, P. C., Zebrack, B. & Ness, K. K. (2009): Social outcomes in the childhood cancer survivor study cohort. Journal of Clinical Oncology, 27, 2390–2395, doi: 10.1200/JCO.2008.21.1458

    Gulløv, E. (2011): Welfare and Self Care: Institutionalized Visions for a Good Life in Danish Day-care Centres. Anthropology in Action. Vol. 18(3), 21-32, doi:10.3167/aia.2011.180303

    Hacking, I. (1992):‘Style’ for historians and philosophers. Studies in History and Philosophy of Science. Vol 23(1): 1-20

    Hacking, I. (1990): The Taming of Chance. Cambridge: Cambridge University Press

    Kaatsch, P. (2010): Epidemiology of childhood cancer. Cancer Treatment Reviews. Vol. 36, 277-285, doi.org/10.1016/j.ctrv.2010.02.003

    Keating, P. & Cambrosio, A. (2011). Cancer on Trial: Oncology as a New Style of Practice. Chicago: University of Chicago Press

    Kræftens Bekæmpelse (2015). At overleve kræft som barn har konsekvenser for resten af livet – også selv om man ikke kan se det. [Surviving Cancer as a Child has consequences for the remainder of life – even if one cannot see it]. The study is available in Danish at: https://www.cancer.dk/dyn/resources/File/file/8/5138/1448010192/

    at_overleve_kraeft_som_barn_rapport_hjemmeside.pdf (Accessed August 29th 2016)

    Langer, S. & Højlund, S. (2011). An Anthropology of Welfare: Journeying towards the Good Life. Anthropology in Action. Vol. 18(3), 1-9, doi:10.3167/aia.2011.180301

    Livingston, J. (2012). Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic. Durham, N.C.: Duke University Press

    Lock, M. & Nguyen, V. (2010): An Anthropology of Biomedicine. Malden & Oxford: Blackwell Publishing

    Maurice-Stam, H., Grootenhuis, M.A., Caron, H.N. & Last. B.F. (2007): Course of life of survivors of childhood cancer is related to Quality of Life in young adulthood. Journal of Psychosocial Oncology, 25(3), 43-58, doi.org/10.1300/J077v25n03_03

    Pedersen, K.M., Andersen, J.S., & Søndergaard, J. (2012). General Practice and Primary Health Care in Denmark. Journal of the American Board of Family Medicine. Vol. 25, Supplement, 34-38, doi:10.3122/jabfm.2012.02.110216

    Rosenberg, C.E. (2007). Our Present Complaint: American Medicine, Past and Present. Baltimore, MD: The Johns Hopkins University Press

    Simoni, S.B., Lund, L.W., Erdmann, F., Andersen, K.K., Winther, J.F., Schüz, J., Johansen, C., Schmiegelow, K. & Dalton, S.O. (2016). Effect of socioeconomic position on survival after childhood cancer in Denmark. ACTA ONCOLOGICA. Vol. 55 (6), 742-750, doi.org/10.3109/0284186X.2016.1144933

    Steffen, V., Jenkins, R. & Jessen, H. (2005): Matters of life and death. In: Steffen, V., Jenkins, R. & Jessen, H. (eds.): Managing Uncertainty: Ethnographic Studies of Illness, Risk and the Struggle for Control. Copenhagen: Museum Tusculanum Press, pp. 9-31

    Stein, K.D., Syrjal, K.L., & Andrykowski, M.A. (2008). Physical and Psychological Long-Term and Late Effects of Cancer. Cancer, Vol. 112(11), 2577-2592, doi: 10.1002/cncr.23448

    Steliarova-Foucher, E., Colombet, M., Ries, L.A.G., Moreno, F., Dolya, A., Bray, F., Hesseling, P., Shin, H.Y., Stiller, C.A., and the IICC-3 contributors (2017): International incidence of childhood cancer, 2001-10: a population-based registry study. Lancet Oncol, Vol. 18:719-31, doi.org/10.1016/S1470-2045(17)30186-9

    Tørring M.L. (2014. Hvorfor akut kræft? Et bud på en epidemisk forståelse af tid og kræft-tendenser i Danmark. Tidsskrift for forskning i sygdom og samfund, nr. 20, 13-45 [Why acute cancer? An estimate of an epidemic understanding of tendencies of time and cancer in Denmark. Journal of research in illness and society, no. 20, 13-45]

    Tørring, M.L., Frydenberg, M., Hansen, R.P., Olesen, F. & Vedsted, P. (2013): Evidence of increasing mortality with longer diagnostic intervals for five common cancers: A cohort study in primary care. European Journal of Cancer, 49(9), 2187-2198, doi.org/10.1016/j.ejca.2013.01.025

    Vindrola-Padros, C. (2012). The Everyday Lives of Children with Cancer in Argentina: Going Beyond the Disease and Treatment. Children & Society. Vol. 26(6), 430-442, doi: 10.1111/j.1099-0860.2011.00369.x

    Vigh, H. (2009). Motion squared. A second look at the concept of social navigation. Anthropological Theory. Vol. 9(4), 419-438, doi: 10.1177/1463499609356044

    Vigh, H. (2007). Navigating Terrains of War. Youth and Soldiering in Guinea Bissau. New York and Oxford: Berghahn Books

    Whyte, S.R. (1997). Questioning misfortune. The pragmatics of uncertainty in eastern Uganda. Cambridge: Cambridge University Press

    Whyte, S.R. (2009). Epilogue. In: L. Haram. & C.B. Yamba (Eds.), Dealing with uncertainty in contemporary African lives (pp. 213-216). Uppsala: Nordiska Afrikainstitutet.