Wellcome Trust Research Fellow, Centre for the History of Science, Technology and Medicine (CHSTM), University of Manchester, Manchester, UK.
Anthropol Med. 2022 Mar;29(1):107-121. doi: 10.1080/13648470.2022.2041547. Epub 2022 Mar 11.
In this article, I explore how the concept of chronicity is mobilised by different actors in reference to metastatic breast cancer (MBC) and the transformation of the condition as a consequence of medical innovations. I do so by using data collected in the UK between 2017 and 2019 through in-depth interviews with medical professionals involved in the treatment of MBC and with patients living with MBC. I show how chronicity appears as a multidimensional and uncertain concept, which I analyse through the image of the nebula. While the medical literature tends to consider MBC chronic or on route to chronicisation, the medical professionals interviewed were uncertain as to whether MBC can be considered a chronic disease, and attempted to discuss chronicity through survival times, the kind of management possible for the disease, and how it compares to other conditions more commonly considered chronic. In some cases, the patients considered the idea of chronicity a source of hope or a way to link their condition to those of people with other diseases; however, they generally rejected the definition as inappropriate for their experience of the illness. Analysing the fluid uses of the concept of chronicity in the case of MBC contributes to the debate within medical anthropology on how medical categories acquire different values and uses and on the circulation of meanings between the biomedical context and the patient experience.
在本文中,我探讨了慢性概念是如何被不同的参与者在转移性乳腺癌(MBC)中调动起来的,以及随着医学创新的出现,这种情况是如何转变的。我通过在英国进行的深入访谈,收集了 2017 年至 2019 年的数据,这些访谈对象包括参与 MBC 治疗的医疗专业人员和患有 MBC 的患者。我展示了慢性是如何作为一个多维和不确定的概念出现的,我通过星云的形象来分析它。虽然医学文献倾向于认为 MBC 是慢性的或正在向慢性化转变,但接受采访的医疗专业人员对 MBC 是否可以被认为是一种慢性疾病存在不确定性,并试图通过生存时间、对这种疾病的管理方式以及与其他更常被认为是慢性疾病的比较来讨论慢性。在某些情况下,患者认为慢性的概念是一种希望的来源,或者是将他们的病情与其他患有慢性疾病的人的病情联系起来的一种方式;然而,他们普遍认为这种定义不适合他们对疾病的体验。分析 MBC 案例中慢性概念的灵活使用,有助于医学人类学中关于医学类别如何获得不同的价值和用途的争论,以及生物医学背景和患者体验之间的意义循环。