Trajectories of cancer patients in therapeutic and political contexts

  • Research type

    Research Study

  • Full title

    Trajectories of cancer patients in therapeutic and political contexts: A multi-sited study

  • IRAS ID

    255714

  • Contact name

    Cinzia Greco

  • Contact email

    cinzia.greco@manchester.ac.uk

  • Sponsor organisation

    University of Manchester

  • Duration of Study in the UK

    2 years, 6 months, 30 days

  • Research summary

    Research Summary

    This project asks how therapeutic innovations and changes in healthcare policy have transformed the trajectories of patients with lung and breast cancer since 1988. It explores this question by combining an anthropological perspective with a historical one within a single theoretical framework. The key goals of this project are to explore 1) the history of therapeutic innovations in breast and lung cancer and 2) of healthcare policies in the UK and in France since 1988, and 3) through the concept of patients’ trajectories, the experiences of the patients with breast and lung cancer and their interactions with medical institutions while undergoing treatments. This research aims to study illness both as an individual and biographical experience and in its economic and political dimensions. I will conduct a multi-sited ethnography in Greater Manchester (UK) and Île-de-France (France) with in-depth interviews with patients with breast and lung cancer, their relatives, and medical and administrative staff of healthcare institutions. The ethnography will be combined with documentary research on the history of medical innovations in the treatment of the two cancers and of healthcare policies in the two countries.

    Summary of Results

    The research project studied the trajectories of patients with breast and lung cancer, that is, their experiences of the illness, of the treatments, and of the relations with different medical institutions. It studied how such trajectories are influenced by medical innovation and by changes in healthcare policy. The research is based on qualitative interviews with patients with breast and lung cancer, medical professionals working on the two conditions, and administrative personnel of NHS Trusts.
    The research has shown how, for both cancers, expectations of improvement are linked to what are commonly called targeted therapies, that is, drugs that act on specific molecular targets in the tumours of subgroups of patients, allowing better results for such subgroups. In the case of breast cancer targeted therapies are available for most, but not all, patients. In the case of lung cancer most targeted therapies are suitable only for small groups of patients, to the point that some of the medical professionals consider other kind of innovations – a larger use of surgery, a faster access to therapies, and screening, to have more potential in improving overall survival times.
    The research has further shown that for breast cancer, which has better survival times and rates, patients experience several kinds of therapies (hormonal, chemotherapy and radiotherapy, in addition to surgery) to diminish the possibility of relapse. In the case of lung cancer, which has worse survival times and rates, the determining aspect of the patient experience is to be suitable for surgery, which requires more preparation and better general health conditions, with other kinds of therapies having a more limited role in the experiences of patients.

  • REC name

    North West - Greater Manchester South Research Ethics Committee

  • REC reference

    19/NW/0059

  • Date of REC Opinion

    19 Mar 2019

  • REC opinion

    Further Information Favourable Opinion