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The salience of existential concerns across the cancer control continuum

Published online by Cambridge University Press:  30 March 2012

Virginia Lee  and
Carmen G. Loiselle
Virginia Lee*
Affiliation:
McGill University Health Centre, Montreal, Quebec, Canada
Carmen G. Loiselle
Affiliation:
School of Nursing and Department of Oncology, Faculty of Medicine, McGill University, Quebec, Canada Department of Psychosocial Oncology, Jewish General Hospital, Montreal, Quebec, Canada
*
Address correspondence and reprint requests to: Virginia Lee, Nurse Scientist, McGill University Health Centre, 1650 Cedar Avenue Room S2-214, Montreal, QC H3G 1A4, Canada. E-mail: virginia.lee@muhc.mgill.ca
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Abstract

Despite significant improvement in cancer survival, the fear of death still remains rooted in individuals' beliefs about cancer. Existential fears pertaining to cancer cut across the cancer control continuum and taint decisions related to prevention, screening, surveillance, and follow-up recommendations, as well as the overall management of cancer-related issues. However, individuals are innately predisposed to cope with their cancer-related fears through mechanisms such as reliance on the process of meaning making. To better appreciate the potential impact of existential concerns across the cancer control continuum, the Temporal Existential Awareness and Meaning Making (TEAMM) model is proposed. This tripartite model depicts three types of perceived threats to life related to cancer including a “social awareness” (i.e., cancer signals death), “personalized awareness” (i.e., I could die from cancer), and the “lived experience” (i.e., It feels like I am dying from cancer). This construal aims to enhance our understanding of the personal and contextual resources that can be mobilized to manage existential concerns and optimize cancer control efforts. As such, existential discussions should be considered in any cancer-related supportive approach whether preventive, curative, or palliative, and not be deferred only until the advanced stages of cancer or at end of life. Further delineation and validation of the model is needed to explicitly recognize and depict how different levels of existential awareness might unfold as individuals grapple with a potential, actual, or recurrent cancer.

Keywords

CancerExistential concernsMeaningPsychosocial adjustmentCancer control continuum
Type
Review Article
Information
Palliative & Supportive Care , Volume 10 , Issue 2 , June 2012 , pp. 123 - 133
Copyright
Copyright © Cambridge University Press 2012

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