Inaugural lecture. Nursing and the counter culture for cancer

The discourse surrounding cancer is that of warfare and of a militaristic endeavour aimed at helping those with the disease survive. The consequences of such a discourse have not previously been explored in detail; in particular the culture of the 'cancer clinic' has not been examined for how a battle mentality might effect the nature of care and treatment. This paper explores how the biomedical response to cancer and its treatment has established approaches which neglect the more day to day experiences of people living with the disease, and the suffering, disability and distress that it causes. A radical reconstruction of the culture surrounding cancer is called for, so that a new environment of care might be offered. This should be more participatory, collaborative and empowering of people with cancer and their families. It should also shift the dominant theme in cancer management from 'survival' to the here and now, and to the needs and problems people have. An argument is made for the contribution that nursing might make to such a reconstruction through developing new approaches to symptom and problem management, reorganising cancer services so that they are more supportive and patient focused, and through nursing research studies aimed at radically changing the process of research itself.