International Perceptions Of Survivorship

The face of international health has changed over the last century from where acute illness and death occurred at a much earlier age to an illness burden that reflects chronic illnesses and diseases like cancer. Chronic illnesses require longer-term treatment in an environment that can support continuity of care. Additionally, the amount, type, and focus of that care not only varies by economic conditions, but care is also guided by the sociocultural characteristics and history.

Social attitudes play a strong role in all cultures. For example, Europeans unlike some Americans wouldn't wear a ribbon or button indicating their status as a cancer survivor, nor would public figures readily share their struggle openly.14 In many situations the diagnosis may be difficult to hide, so a ribbon does not need to be worn to symbolize survivorship because a much more explicit symbol presents itself, for example, in the form of lack of availability of skin color-matched prosthetics for use by non-white cancer survivors28 or the presence of sudden functional losses. However, the stigma of cancer has been shifting with increased media attention and educational effort.28 In their efforts to ease the negative perceptions of cancer, cultures may respond with an opposite response and expect that once treatment is over, the individual is "cured" and should just return to their usual life activities. This response stems from the belief of some cultures, that if you have cancer, you are expected to die, so if you do not die, then you must be able to get back into your "usual" life; similarly, many in Portugal, for example, consider a cancer diagnosis a death sentence.14

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