Buying Time: Incurable Prognosis, Temporal Uncertainty and the Costs of Metastatic Breast Cancer

Understandings of living well with incurable, life-limiting disease are limited. This article examines how living with a 'contracted future', albeit of uncertain duration, affects how one spends time (wisely) in the present and plans future time. Mobilising the concept of timescapes and interviews with women with metastatic breast cancer, we examined how an incurable prognosis shaped how women experienced time, what meanings they ascribed to time and at what cost. Thematic analysis derived five themes: 'quality time'-the imperative to spend time well; 'out-of-sync timing'-experiencing temporal disconnect with others; 'making time'-motivation to extend their time through treatments; 'time mis/calculations'-planning amid uncertain certainty; and 'the tempo of living beyond prognosis'-responding to initial contraction and subsequent expansion of temporal horizons. Our analyses reveal how pressures to live well, die well and be remembered well complicated women's experiences of how to be in the present and future, incurring substantial social and economic costs. We illuminate how the quest for improved quality of life and extended longevity can result in emotional and financial precarity, experienced most profoundly by those with limited economic resources, revealing the economic and social factors that shape how time is spent well by those with metastatic disease.