Liminality as a framework for understanding the experience of cancer survivorship: a literature review

Abstract

To report a narrative review of literature that drew on the concept of liminality as a framework for understanding the cancer experience. In doing so, we explored the utility of liminality for guiding research on experiences of cancer survivorship. The 'rites of passage' model uses the concept of liminality to explore transition. Taking cancer survivorship as a process, liminality may facilitate our understanding of this phenomenon. Searches of Medline, PsycInfo, British Nursing Index, Cinahl, ASSIA, Web of Science, Cochrane Library and British Library databases were conducted, covering 1985-2011. Search terms were cancer and liminal* or rite* of passage. A narrative review, using a textual narrative approach, was undertaken to provide a comprehensive overview of the topic. Studies were arranged into groups according to the stage of the cancer trajectory on which they focused. Findings from each study were presented to highlight facets of the liminal experience at each stage. Ten studies were included for review. Liminality depicts the ambiguity and uncertainty often experienced by people affected by cancer. Although liminality appears useful for understanding experiences of cancer risk, diagnosis, treatment and the period following active treatment, little research has explored the concept with respect to long-term survivorship. Gaps in current evidence highlight the need for additional research to ascertain the utility of liminality for understanding experiences of long-term survivorship. Research exploring the personal and social implications of living a liminal life, at all stages of the cancer trajectory, is also warranted.