THE EXPERIENCE OF CANCER

The illness career of the person with cancer has been characterized as a 'living-dying' experience in which, faced with the intolerable inco mpatibility of life and death, the individual and his or her family at tempt to maintain control and 'normalize' everyday activity. Unfortuna tely, in their everyday struggles, families in North America appear to face social isolation from existing community services and networks t hat might assist them. Perhaps because the illness is so heavily medic alized and stigmatized, most persons with cancer and their families do not participate in them. A minority benefit from self-help organizati ons such as Cancer Society groups and survivor coalitions. The palliat ive care and hospice/home care movements provide an alternative to dyi ng in the acute-care hospital, again, for a minority. Half of those wi th cancer survive more than 5 years; for these persons, the ordeal has just begun. Survivors must cope with physical disabilities due to sur gery and the side effects of other treatments, the psychological traum as of fear of recurrence and social stigma, and the disappointment of a considerably reduced range of future possibilities for career and de velopment. The fact that their relationships with others are negativel y affected is well documented, particularly with intimate relationship s. In a sense, a person never really 'gets over' cancer: it is a sword of Damocles that continues to hang over the individual and his or her family for the rest of the person's life. The challenge facing North American communities, now that fear and loathing of the disease is bei ng scrutinized, is to empower persons with cancer and their families t o address their own unmet needs and to lobby within their own communit ies to ensure that these needs are met.