Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Andres S. Martin

Subject Area(s)

Film studies, Oncology

Abstract

Film is a powerful medium for sharing illness narratives, and can exert a significant influence on public medical discourse. The childhood cancer narrative has more recently emerged on the screen, and these images have yet to be analyzed. This study aims to evaluate the childhood cancer experience in commercially produced, readily available films with a character with childhood cancer, with a particular focus on psychosocial care. Twenty-nine films were reviewed, using quantitative and qualitative content analysis to identify the medical and psychosocial characteristics of the cinematic childhood cancer experience. Psychosocial support was rated on a five-point scale (0-4) based on the availability and efficacy of support characters in the categories of non-professional internal (e.g. parent), non-professional external (e.g. friend), professional medical (e.g. oncologist), and professional psychosocial (e.g. social worker) supports. Main themes were identified and described, and relevant scenes were extracted into an educational DVD. Film depicts an unrealistic, bleak picture of childhood cancer, with a 66% mortality rate among the 35 characters evaluated. A range of psychosocial stressors are reflected that are consistent with those experienced in reality. Psychosocial support is limited to resources already available to families prior to the cancer diagnosis: the average support rating across all 29 films is 2.4 for non-professional internal and external supports, 1.6 for professional medical supports, and 0.3 for professional psychosocial supports. Seven themes emerged on the screen: disruption, social impact, psychological impact, physical toll, struggle/war/fight, coping, and barren landscape. Images of an isolated family courageously battling cancer alone with limited support from a treatment team solely dedicated to medical care is emphasized. In conclusion, cinema highlights the struggle between life and death in pediatric cancer, but minimizes the importance of the psychosocial dimension of care, which can perpetuate the stigma that exists around psychosocial interventions. These films, and the included DVD, can be used to encourage discussion among medical providers about how to optimize psychosocial care in pediatric oncology so that such care is not abandoned in actual practice as it is, for entertainment purposes, on the screen.

Comments

This is an Open Access Thesis.

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