The Lived Experience of Breast Cancer in the Surveillance Phase of Recovery: A Liminal Process

Friday, 24 July 2015: 3:50 PM

Patricia K. Amado, PhD, MS (Ed), RN, CNS
School of Health and Nursing, University of Miami, Coral Gables, FL



Background: Breast cancer is one of the most prevalent types of cancer today among women of all ages. Many women are being diagnosed each year and learning to cope with a chronic illness. Accompanying the victory of survivorship, however, are challenges in the surveillance phase of recovery. Surveillance is the time after surgery, chemotherapy and /or radiation is complete and the patient is continues to be receiving regular scheduled check-ups by the oncologist. Each individual’s care plan for surveillance may be different depending upon the stage and the treatment received. Breast cancer survivors face many fears during this period of time, including fear of recurrence, loss of health, or fear of dying from the disease to name a few.

Purpose: The purpose of this study was to illuminate the lived experience of women after they have undergone their treatment regime for breast cancer and have entered the surveillance phase of recovery. This study gave a voice to the women’s experience through their life story and the resiliency they demonstrated while transitioning to a new life within the context of illness.

Philosophical Underpinnings: This study was guided by Max van Manen’s hermeneutic phenomenological perspective.

Methods: A purposive sample of 10 women ages 25-75 years old from survivorship clinics in south Florida was selected to explore the question: “What is the lived experience of women with breast cancer in the surveillance phase of recovery? Data collection was gathered with one-hour semi-structured interviews and was audio- taped, transcribed for verification, and member checked by the researcher. Data analysis

included interpretation and description of textual writing guided by van Manen’s six

The purpose of this presentation is premised upon my study based upon hermeneutical phenomenology. The method enables all disciplines to understand the narrative inquiry approach to research; what it is from a therapeutic lens; what uniqueness it provides in dealing with coping and making- meaning out of a chronic illness such as breast cancer and the art of story-telling as a venue for communication and a method to facilitate healing body, mind, and spirit while battling a chronic illness. Through the use of narrative inquiry to study liminality or the in- between time of illness and wellness will provide a path to an innovative method to understand a phenomena ( illness) in order to understand the lived experiences of woman diagnosed with breast cancer. Liminality is the place between wellness and illness and the fear of facing a possible recurrence. It is important as healthcare professionals and laypersons realize the experience of what happens for women in the transition from health to facing a life- threatening disease.

Narrative inquiry represents a better perspective on the story of illness that at times may be difficult to voice. A cognitive engagement of discourse in an open semi- structured format may give voice to the person within the context of their own journey through illness. With semi-structured interviews, the investigator will have a set of questions on an interview schedule, but the interview will be guided by the participants rather than be dictated hence the advantages of this method is as follows:

 There is an attempt to establish rapport with the patient which allows a richer relationship to gather personal experiences of illness

Results: • The ordering of questions is less important as in gathering information in an history and physical ( less empirical approach)

• The interviewer is freer to probe interesting areas that arise.

• The interview can follow the respondent’s interests or concerns. It is a creative method of healing as someone is faced with a chronic and sometimes terminal journey.


Quality of life is a multi- dimensional facet of one’s social, spiritual, and physical, emotional well being. Breast cancer survivors face many fears, whether it is fear of recurrence, loss of health, and fear of dying. In order to treat each person holistically the healthcare provider needs to acknowledge alternative ways of healing for the breast cancer patient. Through introducing narrative therapy as a therapeutic way to express feelings one can make sense of this malady through the art of dialogue and may introduce new ways of learning how one builds resiliency in the journey of illness through their lived story. It is an innovative method to facilitate transition to a new reality such as living with cancer and improve the quality of life living in the in- between times of constant surveillance of this insidious disease.