Understanding the experience of developing and being diagnosed with lung cancer : exploring the potential of narrative

The purpose of this study was to make a contribution to the earlier diagnosis of lung cancer through seeking to understand the experience of developing and being diagnosed with the disease. Of particular interest was how individuals interpret the symptomatic experiences associated with lung cancer and why individuals may not interpret them as related to it. Situated within the interpretive paradigm and adopting a case study approach, this study sought to develop an understanding of the pre-diagnosis experience of lung cancer. The principal data were illness narratives generated in interviews with 33 individuals who had been diagnosed with the disease, though other data were also drawn upon to facilitate the understanding. Techniques of ‘narrative analysis’ and ‘analysis of narrative’ (Polkinghorne, 1995) were applied to the illness narratives. Of the 33 participants, only two had interpreted their symptomatic experiences as related to lung cancer prior to presenting for medical advice. Many of the remaining participants interpreted their symptomatic experiences as related to normal life or normal illness. It is proposed that individuals interpret their symptomatic experiences through drawing upon storied meaning and emplotting their experience into a narrative plot in a process of experiential emplotment. This positions interpretation as an active and creative process and acknowledges that any interpretation occurs within a particular social context. Many individuals who develop lung cancer cannot see themselves in the disease’s narrative and therefore cannot interpret their experience as related to it. Health education interventions based on this understanding would strive to construct and communicate narratives of lung cancer which are faithful to how the disease is experienced and in whom so as to influence the availability, visibility and acceptability of the narrative plot.