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Patients with cancer believed that chemotherapy had to “hurt” or “cause side effects” to be effective

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QUESTION

What are cancer patients’ perceptions of adjuvant chemotherapy?

DESIGN

Ethnography.

SETTING

Cancer treatment centre in western Canada.

PATIENTS

30 patients with colon or rectal cancer who were regular, irregular, or 1-time participants in a support group.

METHODS

Field notes were recorded after participant observation at monthly support group meetings lasting 1.5 hours and events, including a full-day retreat and a colorectal cancer forum. The support group was open to patients, caregivers, supporters, and occasional observers. In-depth semistructured interviews were also conducted with 8 participants, with questions probing topics related to cancer diagnosis, treatments, and the support group. Interviews were recorded and transcribed verbatim; both data sets were analysed for themes.

MAIN FINDINGS

Side effects of chemotherapy. Many patients had ongoing side effects after active chemotherapy, including chemotherapy-induced peripheral neuropathy, whereas some patients had only a few side effects. A dominant idea expressed in the support groups was the belief that for chemotherapy to be effective, it had to “hurt” or “cause side effects.” When …

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