Surviving adolescent cancer: Narratives of disruption and identity reconstruction
Published:
Dec 22, 2025
Keywords:
cancer, survivors, adolescence, narratives, narrative interview, meaning making, identity
Abstract
The present qualitative study adopted a narrative approach to explore the experiences of young adult survivors who had been diagnosed with cancer during adolescence. We conducted 24 narrative interviews with eight survivors aged between 18 and 25 years old - three interviews with each one of them. The participants' stories were analyzed through a thematic narrative analysis and the main thematic units that emerged are: (a) dealing with a fragile body, (b) renegotiating lost time, and (c) making meaning of illness. The participants' narratives indicate that experiencing cancer during adolescence triggers a rupture in terms of the continuity of temporality. Thus, the identity of survivors is woven around the experience of the illness and is mediated by a long course of challenges–both during the disease, as well as returning to a state of "normality". A common theme of the narratives is the approach of illness as an experience that activates inner forces and leads to the construction of a new meaning in life, along with the creation of a new identity. The findings can inform clinical practitioners highlighting the need to approach cancer not as a life event that is time-limited and ends with the completion of treatment, but as a condition leading survivors to the need for negotiation of pain, body image, relationships and the identity as a whole.
Article Details
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Ntali, E., & Stavropoulos, K. (2025). Surviving adolescent cancer: Narratives of disruption and identity reconstruction. Psychology: The Journal of the Hellenic Psychological Society, 30(2), 116–135. https://doi.org/10.12681/psy_hps.41467
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References
An, H., & Lee, S. (2019). Difficulty in returning to school among adolescent leukemia survivors: A qualitative descriptive study. European Journal of Oncology Nursing, 38, 70-75. https://doi.org/10.1016/j.ejon.2018.12.008
Andersen, E. M. (2022). Surviving cancer while young A meta-ethnography through temporal, social, interactional and personal experiences of survival. SSM-Qualitative Research in Health, 2, 100066. https://doi.org/10.1016/j.ssmqr.2022.100066
Baird, H., Patterson, P., Medlow, S., & Allison, K. R. (2019). Understanding and improving survivorship care for adolescents and young adults with cancer. Journal of adolescent and young adult oncology, 8(5), 581-586. https://doi.org/10.1089/jayao.2019.0031
Baudry, V., Girodet, M., Lochmann, M., Bottichio, M., Charton, E., Flahault, C., ... & Christophe, V. (2024). Supportive care needs of adolescents and young adults 5 years after cancer: a qualitative study. Frontiers in Psychology, 15, 1268113. https://doi.org/10.3389/fpsyg.2024.1268113
Belpame, N., Kars, M. C., Deslypere, E., Rober, P., Van Hecke, A., & Verhaeghe, S. (2019). Living as a cancer survivor: A qualitative study on the experiences of Belgian adolescents and young adults (AYAs) after childhood cancer. Journal of pediatric nursing, 49, e29-e35. https://doi.org/10.1016/j.pedn.2019.07.015
Bender, J. L., Puri, N., Salih, S., D’Agostino, N. M., Tsimicalis, A., Howard, A. F., ... & Gupta, A. A. (2022). Peer support needs and preferences for digital peer navigation among adolescent and young adults with cancer: a Canadian cross-sectional survey. Current oncology, 29(2), 1163-1175. https://doi.org/10.3390/curroncol29020099
Bonanno, A., & Esmaeli, B. (2012). Cancer and facial disfigurement: reducing survivors' stigma in social interaction. Clinical Journal of Oncology Nursing, 16(2), 153–159. https://doi.org/10.1188/12.CJON.153-159
Bradford, N. K., McDonald, F. E., Bibby, H., Kok, C., & Patterson, P. (2022). Psychological, functional and social outcomes in adolescent and young adult cancer survivors over time: a systematic review of longitudinal studies. Psycho‐Oncology, 31(9), 1448-1458. https://doi.org/10.1002/pon.5987
Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. SAGE Publications.
Brierley, M. E. E., Sansom‐Daly, U. M., Baenziger, J., McGill, B., & Wakefield, C. E. (2019). Impact of physical appearance changes reported by adolescent and young adult cancer survivors: A qualitative analysis. European Journal of Cancer Care, 28(4), e13052. https://doi.org/10.1111/ecc.13052
Brinkmann, S. (2011). Interviewing and the production of the conversational self. In N. K. Denzin & M. D. Giardina (Eds.), Qualitative inquiry and global crisis (pp. 56-75). Walnut Creek, CA: Left Coast Press.
Brinkman, T. M., Li, C., Vannatta, K., Marchak, J. G., Lai, J. S., Prasad, P. K., ... & Robison, L. L. (2016). Behavioral, social, and emotional symptom comorbidities and profiles in adolescent survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology, 34(28), 3417. https://doi.org/10.1200/JCO.2016.66.4789
Cantrell, M. A., & Conte, T. M. (2009). Between being cured and being healed: the paradox of childhood cancer survivorship. Qualitative Health Research, 19(3), 312-322. https://doi.org/10.1177/1049732308330467
Cho, D., & Park, C. L. (2015). Cancer‐related identities in people diagnosed during late adolescence and young adulthood. British journal of health psychology, 20(3), 594-612. https://doi.org/10.1111/bjhp.12110
Cho, S., Wurz, A., Henry, B., Tran, A., Duong, J., Noel, M., ... & Schulte, F. (2024). Making sense of the cancer journey: Pediatric cancer survivors’ and their parents’ autobiographical memories. Journal of Cancer Survivorship, 18(1), 68-78. https://doi.org/10.1007/s11764-023-01384-3
Cook, J. L., Russell, K., Long, A., & Phipps, S. (2021). Centrality of the childhood cancer experience and its relation to post‐traumatic stress and growth. Psycho‐Oncology, 30(4), 564-570. https://doi.org/10.1002/pon.5603
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Darabos, K., & Ford, J. S. (2020). “Basically, You Had Cancer and Now You Don't”: Exploring the Meaning of Being a “Cancer Survivor” Among Adolescents and Young Adult Cancer Survivors. Journal of adolescent and young adult oncology, 9(4), 534-539. https://doi.org/10.1089/jayao.2019.0176
De, R., Zabih, V., Kurdyak, P., Sutradhar, R., Nathan, P. C., McBride, M. L., & Gupta, S. (2020). Psychiatric disorders in adolescent and young adult-onset cancer survivors: a systematic review and meta-analysis. Journal of adolescent and young adult oncology, 9(1), 12-22. https://doi.org/10.1089/jayao.2019.0097
Dewar, E. O., Ahn, C., Eraj, S., Mahal, B. A., & Sanford, N. N. (2021). Psychological distress and cognition among long-term survivors of adolescent and young adult cancer in the USA. Journal of Cancer Survivorship, 1-9. https://doi.org/10.1007/s11764-020-00969-6
Docherty, S.L., Kayle, M., Maslow, G.R., & Santacroce, J. (2015). The adolescent and young adult with cancer: A developmental life course perspective. Seminars in Oncology Nursing, 31(3), 186-196. https://doi.org/10.1016/j.soncn.2015.05.006
Echo, L.W., Kent, E.E., Trevino, K.M., Parsons, H.M., Zebrack, B.J., & Kirchhoff A.C. (2016). Social well-being among adolescents and young adults with cancer: A systematic review. Cancer, 122(7), 1029-1037. https://doi.org/10.1002/cncr.29866
Elsbernd, A., Pedersen, K. J., Boisen, K. A., Midtgaard, J., & Larsen, H. B. (2018). “on Your Own”: Adolescent and young adult cancer survivors' experience of managing return to secondary or higher education in Denmark. Journal of Adolescent and Young Adult Oncology, 7(5), 618-625. https://doi.org/10.1089/jayao.2018.0058
Fern, L., & Whelan, J. (2013). National Cancer Research Institute teenage and young adult clinical studies group: The United Kingdom approach to research. International perspectives on AYAO, part 4. Journal of adolescent and young adult oncology, 2(4), 161-166. https://doi.org/10.1089/jayao.2012.0030
Frank, A. W. (2013). The wounded storyteller: Body, illness, and ethics (2nd ed.) University of Chicago Press.
Ghazal, L. V., Merriman, J., Santacroce, S. J., & Dickson, V. V. (2021). Survivors’ dilemma: Young adult cancer survivors’ perspectives of work-related goals. Workplace health & safety, 69(11), 506-516. https://doi.org/10.1177/21650799211012675
Grinyer, A. (2009). Life after cancer in adolescence and young adulthood: The experience of survivorship. New York: Routledge.
Güner, P., Şar, V., & Pehlivan, T. (2018). Three phases of cancer in the process of mental trauma: Diagnosis, treatment, survival. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi, 9(1). https://doi: 10.14744/phd.2017.79663
Hubbard, G., & Forbat, L. (2012). Cancer as biographical disruption: constructions of living with cancer. Supportive Care in Cancer, 20(9), 2033-2040. https://doi.org/10.1007/s00520-011-1311-9
Hughes, L., Taylor, R. M., Beckett, A. E., Lindner, O. C., Martin, A., McCulloch, J., ... & Stark, D. P. (2024). The Emotional Impact of a Cancer Diagnosis: A Qualitative Study of Adolescent and Young Adult Experience. Cancers, 16(7), 1332. https://doi.org/10.3390/cancers16071332
Husson, O., Zebrack, B. J., Aguilar, C., Hayes‐Lattin, B., & Cole, S. (2017). Cancer in adolescents and young adults: Who remains at risk of poor social functioning over time?. Cancer, 123(14), 2743-2751. https://doi.org/10.1002/cncr.30656
Johnson, A. K. (2022). Cancer as interruption: exploring the experiences of adolescents who have completed treatment for cancer (Doctoral dissertation, University of British Columbia). https://dx.doi.org/10.14288/1.0416556
Jones, J. M., Fitch, M., Bongard, J., Maganti, M., Gupta, A., D’Agostino, N., & Korenblum, C. (2020). The needs and experiences of post-treatment adolescent and young adult cancer survivors. Journal of clinical medicine, 9(5), 1444. https://doi.org/10.3390/jcm9051444
Keegan, T. H., Abrahão, R., & Alvarez, E. M. (2024). Survival trends among adolescents and young adults diagnosed with cancer in the United States: comparisons with children and older adults. Journal of Clinical Oncology, 42(6), 630-641. https://doi.org/10.1200/JCO.23.01367
Kent, E. E., Parry, C., Montoya, M. J., Sender, L. S., Morris, R. A., & Anton-Culver, H. (2012). “You’re too young for this”: Adolescent and young adults’ perspectives on cancer survivorship. Journal of Psychosocial Oncology, 30, 260–279. https://doi.org/10.1080/07347332.2011.644396
Kim, Y., Lee, K. S., & Koh, K. N. (2018). Difficulties faced by long-term childhood cancer survivors: A qualitative study. European Journal of Oncology Nursing, 36, 129-134. https://doi.org/10.1016/j.ejon.2018.08.003
Kwak, M., Zebrack, B. J., Meeske, K. A., Embry, L., Aguilar, C., Block, R., ... & Cole, S. (2013). Trajectories of psychological distress in adolescent and young adult patients with cancer: a 1-year longitudinal study. Journal of clinical oncology, 31(17), 2160-2166. https://doi.org/10.1200/JCO.2012.45.9222
Le Boutillier, C., Archer, S., Barry, C., King, A., Mansfield, L., & Urch, C. (2019). Conceptual framework for living with and beyond cancer: A systematic review and narrative synthesis. Psycho‐Oncology, 28(5), 948-959. https://doi.org/10.1002/pon.5046
Levitt, H. M., Motulsky, S. L., Wertz, F. J., Morrow, S. L., & Ponterotto, J. G. (2017). Recommendations for designing and reviewing qualitative research in psychology: Promoting methodological integrity. Qualitative Psychology, 4(1), 2–22. https://doi.org/10.1037/qup0000082
Mack, J. W., Fasciano, K. M., & Block, S. D. (2019). Adolescent and young adult cancer patients’ experiences with treatment decision-making. Pediatrics, 143(5). https://doi:10.1542/peds.2018-2800
Mayer, D. K., Nasso, S. F., & Earp, J. A. (2017). Defining cancer survivors, their needs, and perspectives on survivorship health care in the USA. The Lancet Oncology, 18(1), e11-e18. https://doi.org/10.1016/S1470-2045(16)30573-3
McDonnell, G. A., Shuk, E., & Ford, J. S. (2020). A qualitative study of adolescent and young adult cancer survivors’ perceptions of family and peer support. Journal of health psychology, 25(5), 713-726. https://doi.org/10.1177/1359105318769366
Monforte, J., & Smith, B. (2023). Narrative analysis. In H. Cooper, M. N. Coutanche, L. M. McMullen, A. T. Panter, D. Rindskopf, & K. J. Sher (Eds.), APA handbook of research methods in psychology: Research designs: Quantitative, qualitative, neuropsychological, and biological (2nd ed., pp. 109–129). American Psychological Association. https://doi.org/10.1037/0000319-006
Morris, B. A., Lepore, S. J., Wilson, B., Lieberman, M. A., Dunn, J., & Chambers, S. K. (2014). Adopting a survivor identity after cancer in a peer support context. Journal of Cancer Survivorship, 8(3), 427-436. https://doi.org/10.1007/s11764-014-0355-5
Murray, M. (2015). Narrative psychology. In J.A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (3rd ed., pp.85-107). SAGE Publications.
Osmani, V., Hörner, L., Klug, S. J., & Tanaka, L. F. (2023). Prevalence and risk of psychological distress, anxiety and depression in adolescent and young adult (AYA) cancer survivors: a systematic review and meta‐analysis. Cancer Medicine, 12(17), 18354-18367. https://doi.org/10.1002/cam4.6435
Pahl, D. A., Wieder, M. S., & Steinberg, D. M. (2021). Social isolation and connection in adolescents with cancer and survivors of childhood cancer: A systematic review. Journal of Adolescence, 87, 15-27. https://doi.org/10.1016/j.adolescence.2020.12.010
Pennant, S., C Lee, S., Holm, S., Triplett, K. N., Howe-Martin, L., Campbell, R., & Germann, J. (2020). The role of social support in adolescent/young adults coping with cancer treatment. Children, 7(1), 2. https://doi:10.3390/children7010002
Prikken, S., Luyckx, K., Raymaekers, K., Raemen, L., Verschueren, M., Lemiere, J., ... & Uyttebroeck, A. (2023). Identity formation in adolescent and emerging adult cancer survivors: a differentiated perspective and associations with psychosocial functioning. Psychology & health, 38(1), 76-93. https://doi.org/10.1080/08870446.2021.1955116
Quinn, G. P., Gonçalves, V., Sehovic, I., Bowman, M. L., & Reed, D. R. (2015). Quality of life in adolescent and young adult cancer patients: a systematic review of the literature. Patient related outcome measures, 19-51. https://doi.org/10.2147/PROM.S51658
Radley, A., & Chamberlain, K. (2001). Health psychology and the study of the case: From method to analytic concern. Social science & medicine, 53(3), 321-332. https://doi.org/10.1016/S0277-9536(00)00320-8
Riemann, G. (2003, September). A Joint Project Against the Backdrop of a Research Tradition: An Introduction into" Doing Biographical Research". In Forum Qualitative Sozialforschung/Forum: Qualitative Social Research (Vol. 4, No. 3). https://doi.org/10.17169/fqs-4.3.666
Riessman, C. K. (1993). Narrative analysis. SAGE Publications.
Riessman, C. K. (2008). Narrative Methods for the Human Sciences. Sage Publications, Thousand Oaks.
Riessman, C. K. (2015). Ruptures and sutures: Time, audience and identity in an illness narrative. Sociology of health & illness, 37(7), 1055-1071. https://doi.org/10.1111/1467-9566.12281
Sansom-Daly, U. M., & Wakefield, C. E. (2013). Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review. PubMed, 2(4), 167–197. https://doi.org/10.3978/j.issn.2224-4336.2013.10.06
Sawyer, J. L., Mishna, F., Bouffet, E., Saini, M., & Zlotnik-Shaul, R. (2023). Bridging the gap: Exploring the impact of hospital isolation on peer relationships among children and adolescents with a malignant brain tumor. Child and Adolescent Social Work Journal, 40(1), 91-105. https://doi.org/10.1007/s10560-021-00764-x
Smith, B., & Monforte, J. (2020). Stories, new materialism and pluralism: Understanding, practising and pushing the boundaries of narrative analysis. Methods in Psychology, 2, 100016. https://doi.org/10.1016/j.metip.2020.100016
Smits-Seemann, R. R., Yi, J., Tian, T., Warner, E. L., & Kirchhoff, A. C. (2017). A qualitative inquiry of childhood and adolescent cancer survivors' perspectives of independence. Journal of adolescent and young adult oncology, 6(1), 91-95. https://doi.org/10.1089/jayao.2016.0022
Steinberg, D. M., Santiago, R. A., Tanenbaum, M. L., Cline, G. D., & Schneider, N. M. (2020). “It made me the person I am today…”: survivors of childhood, adolescent, and young adult cancer reflect on their experiences. Journal of Adolescent and Young Adult Oncology, 9(2), 239-246. https://doi.org/10.1089/jayao.2019.0122
Svašek, M., & Domecka, M. (2020). The autobiographical narrative interview: A potential arena of emotional remembering, performance and reflection. In The interview (pp. 107-126). Routledge.
Tanner, S., Engstrom, T., Lee, W. R., Forbes, C., Walker, R., Bradford, N., & Pole, J. D. (2023). Mental health patient‐reported outcomes among adolescents and young adult cancer survivors: A systematic review. Cancer Medicine, 12(17), 18381-18393. https://doi.org/10.1002/cam4.6444
Thompson, A. R., Sewards, I., & Baker, S. R. (2020). Cancer and changes in facial appearance: A meta‐ethnography of qualitative studies. British journal of health psychology, 25(1), 129-151. https://doi.org/10.1111/bjhp.12398
Tindle, D., Windsor, C., & Yates, P. (2019). Centralizing temporality in adolescent and young adult cancer survivorship. Qualitative health research, 29(2), 173-183. https://doi:10.1177/1049732318797087
Walker, A.J., & Lewis, F.M. (2016). Adolescent and young adult cancer survivorship: A systematic review of end-of-treatment and early post-treatment. Nursing and Palliative Care, 1(1), 1-6. https://doi:10.15761/.1000101
Walker, A. J., Lewis, F. M., Lin, Y., Zahlis, E., & Rosenberg, A. R. (2019). Trying to feel normal again: early survivorship for adolescent cancer survivors. Cancer nursing, 42(4), E11-E21. https://10.1097/NCC.0000000000000629
Willig, C. (2013). Introducing Qualitative Research in Psychology. McGraw-Hill Education.
Warner, E. L., Kent, E. E., Trevino, K. M., Parsons, H. M., Zebrack, B. J., & Kirchhoff, A. C. (2016). Social well‐being among adolescents and young adults with cancer: a systematic review. Cancer, 122(7), 1029-1037. https://doi.org/10.1002/cncr.29866
Winnicott, D. W. (1971). Playing and reality. London: Tavistock
Wong, A. W., Chang, T. T., Christopher, K., Lau, S. C., Beaupin, L. K., Love, B., Feuerstein, M. (2017). Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words. Journal of Cancer Survivorship, 11(6), 751-764 https://doi.org/ 10.1007/s11764-017-0613-4
Zucchetti, G., Bellini, S., Bertolotti, M., Bona, F., Biasin, E., Bertorello, N., Fagioli, F. (2017). Body image discomfort of adolescent and young adult hematologic cancer survivors. Journal of adolescent and young adult oncology, 6(2), 377-380. https://doi.org/10.1089/jayao.2016.0067
