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. 2025 Feb 24.
doi: 10.1007/s11764-025-01765-w. Online ahead of print.

Narrative meaning-making at the crossroads between life and death: a qualitative study into contemplating literary texts with advanced cancer patients

Niels van Poecke  1   2 , Michael Scherer-Rath  3 , Yvonne Weeseman  4   5 , Zoë Bood  6 , Nirav Christophe  7 , Henny Dörr  7 , Judith de Vos-Geelen  8 , Aart Beeker  9 , Gerty de Klerk  9 , Eric Bras  10 , Hugo Vlug  11 , Frans Bossink  12 , Frans Savelkoul  13 , Liesbeth M Timmermans  14 , Esther Helmich  15 , Mirjam A G Sprangers  5   16 , Hanneke W M van Laarhoven  4   5
Affiliations

Narrative meaning-making at the crossroads between life and death: a qualitative study into contemplating literary texts with advanced cancer patients

Niels van Poecke et al. J Cancer Surviv. .

Abstract

Purpose: Advanced cancer patients may perceive their disease as an experience of contingency: a (sudden) disruption of the life-narrative evoking existential concerns such as loss of meaning and identity. The research project In Search of Stories aimed to investigate whether and how reading and discussing literary texts assisted participants in integrating their diagnosis as the experience of contingency into their life-narrative.

Methods: This qualitative study reports on interviews with 25 advanced cancer patients, who read a story from a curated collection of 10 literary texts. They discussed the story with a spiritual caregiver, using a reading guide to structure the conversation. The interviews were thematically analyzed using template analysis.

Results: Participants identified with contingency experiences and related existential concerns presented in the texts, including loss of meaning and identity, bodily alienation, and social estrangement. Reading and discussing literary texts also enabled participants to engage in self-regulation; in exploring how to relate to devalued emotions and attitudes, and in further developing their identity post-diagnosis.

Conclusions: A structured reading of literary texts revolving around contingency experiences enables advanced cancer patients to identify with and articulate emotions, attitudes, and existential concerns such as loss of meaning and identity. This allows them to break down barriers in talking about their illness experiences and to transition towards acceptance of their diagnosis as the experience of contingency.

Implications for cancer survivors: Reading and discussing literary texts about contingency may support people with advanced cancer to integrate their own experience of contingency into the life-narrative.

Keywords: Advanced cancer; Contingency experiences; Literature; Narrative meaning-making; Self-distancing.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

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