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Food experiences of people living with cancer: continuities and discontinuities in their local and global dimensions.

Introduction
Patrice Cohen, Hélène Hoarau and Armelle Lorcy

Full text

  • 1 See tributes to her in Anthropology of Food (Crenn, 2010) et Anthropologie & Santé (Perrey & Querre (...)

1This issue of Anthropology of Food is dedicated to Annie Hubert (1941-2010),1 a nutritional anthropologist who pioneered an anthropological and multidisciplinary approach in the study of nasopharyngeal cancer in France and helped to create a sociocultural epidemiology of the links between diet and cancer. Her work, her personality and her life have inspired the three of us in our commitment to this theme and in our efforts to publish this issue. Our thoughts are with her as we write this introduction and publish the articles that follow.

  • 2 Symposium organised by the Laboratoire d’analyses socio-anthropologiques du contemporain of the Sop (...)

2The genesis of this issue was our chance meeting during the 2014 conference “Fieldwork on cancer: transformations and/or permanent features in the French health model?” at Paris Ouest-Nanterre La Défense University.2 Each of us had started participating in the activities of the NACRe Network that had opened within the Humanities and Social Sciences (for further information, please refer to the interview with Paule Latino-Martel), and we realised that there was little anthropological research on the link between diet and cancer. Curious to learn more, excited to review and consolidate research in this area, and with shared motivation, we had the idea to publish this issue.

  • 3 We wish to thank those who helped with the revision and translation of the call for papers in Engli (...)
  • 4 Especially the Centre International de Recherche sur le Cancer (CIRC) and the World Cancer Research (...)
  • 5 In France, the Institut National du Cancer (INCa) and the Agence nationale de sécurité sanitaire de (...)

3The international call for contributions to this issue, released in 2015,3 solicited reflections on how current links between diet and cancer might point to the social and political construction of a new health issue. Indeed, over the last thirty years, numerous epidemiological, nutritional, and medical studies have focused on of the links between diet, nutrition, and cancer, and they have mobilized scientific national and international networks that are very active (see, in particular, in France, National Food Cancer Research Network- NACRe, or in the United States, the World Cancer Research Fund – WCRF). Such studies cover both the impacts of cancer and cancer treatments on eating behaviours and also the role of food in the development of the disease. They have also led to the development of international groups and consensus conferences that have contributed to public health policy recommendations, both globally4 and in individual countries.5 The links between diet and cancer are not only a medical and public health issue under construction, but also a real social issue with many ramifications in social practices.

  • 6 This phenomenon has been analysed as a veritable “moral economy”, most notably by Fassin (2009) and (...)

4Cancer has become one of the leading causes of morbidity and mortality at a time when medicine, sanitation, and nutrition have pervaded the West,6 where modern societies have shifted towards the search for health and the legitimisation of social issues through health. This led us to question to what extent fighting cancer through diet could have initiated real "nutritional reform" in our societies. Health recommendations and prevention campaigns in fact encourage the use of foods to protect against cancer and to promote "healthy" and "balanced" diets in the general population. Therefore, people suffering from cancer find it all the more important to make dietary changes. We have thus focused on their food experiences, which are now being documented in the social sciences (Locher et al., 2009, 2010; Bell et al., 2009, 2010; Cohen & Legrand, 2011; Hoarau et al., 2012; Fontas et al., 2014; Fontas, 2016; Lorcy, 2014) - as a productive comparative overview. 

  • 7 However, we would like to thank all the authors for their submissions.

5In spite of the diversity of themes proposed in the call for contributions, most of the submissions centred on the relationship that people with cancer have with food (including case studies in France, Spain, Great Britain, Canada, Cambodia, Cameroon, Morocco, Mexico and India), so that became the focus of this issue. We subsequently retained the texts that contributed significantly to reflections on how cancer patients experience food.7

6The underlying goal of this issue is to examine case studies from a variety of countries that focus on the relationships cancer patients have with food in order to discover both what those relationships have in common, and also their particularities and individual logics. The common thread that runs through the articles published here is dietary change, though it has been approached in a rich variety of ways and contexts. Overall, five aspects of the changes experienced by people with cancer emerged. Though this collection of articles is not exhaustive, it offers a better understanding of what is at stake in the social and cultural interactions between diet and cancer, which in the future should be further explored and more thoroughly investigated.

Specific food experiences from case studies: the role of social and pathological configurations

7The case studies presented in these articles bring to light food idiosyncrasies in social, institutional, family-specific, and individual configurations and relate experiences of the disease that vary by type of cancer, stage of the disease, treatment, and prognosis.

8Thus, these texts show national characteristics that are reinforced or even accentuated by the research methods. Meriem M'Zoughi’s description of the situation in Cambodia highlights the social and cultural patterns of diet and disease that strongly affect patients’ eating practices. The study describes and analyses the less institutionalized medical care given to breast cancer patients in a climate of distrust of Cambodian physicians. The cultural representations of diet and cancer give meaning to the experiences of women treated for breast cancer in a Phnom-Penh hospital, one of the few medical institutions in the country that treat cancer patients.

9The studies carried out in France (Sandrine Bretonnière et al., and Marine Fontas), Spain (Lorenzo Mariano Juárez et al.), and Canada (May-Lei Woo Kinshella) reveal, in turn, that a problem arises when nutritional recommendations go against patients’ expectations and needs. What these countries have in common is highly institutionalized medical care, and nutritional recommendations for cancer patients are often passed on in medical institutions. These articles build on the complex dialectic between nutrition messages and patient experience. Cultural and social eating habits are not left out, but they are presented through the filter of the illness experience, which in turn is strongly influenced by the medical setting and support groups.

10The type of cancer, the body part affected, and the stages of the disease as the patient undergoes medical care—what Marie Ménoret (2007) called the "cancer time frames"—play a very important role in particular food experiences related here.

11The effects of medical treatment and/or disease progression on the sense of taste (e.g., chemotherapy for lung cancer based on platinum salts, resulting in relatively short survival rates) or on the masticatory and digestive organs (e.g., changes in the throat or mouth in patients with laryngeal cancer) require that patients find solutions by adapting their dietary practices (Fontas) or by finding new ways to feed themselves (Mariano Juárez).

12The situation of patients in remission (especially patients with breast cancer, which has one of the highest survival rates, or other cancers with relatively long remissions) raises the question of cancer as a chronic illness; such patients need to modify the time framework of their diets. Along these lines, Kinshella is carrying out studies in Vancouver on dietary changes among patients who have been labelled "cancer survivors" (Twombly, 2004); she followed empowerment groups of such former patients whose objective is to remain healthy and prevent recurrence. In their study of people living with cancer in precarious economic conditions, conducted in the Paris suburbs, Bretonnière and her colleagues analysed persistent worrying about weight loss caused by the disease or excessive weight gain caused by treatments (chemotherapy, hormone therapy, radiotherapy), and an initiative by a government health network to support cancer patients with nutrition concerns through "nutrition workshops."

Food experiences in different medical contexts

  • 8 See in particular Alonso Castellanos et al., 2014; Belqaid et al., 2014; Bernhardson et al., 2008; (...)
  • 9 See in particular Bidlack, 1996; INCa, 2009; Meuric & Besnard, 2012; Senesse et al., 2012; Senesse (...)

13In different "cancer times frames" (Ménoret, 2007), biological and physiological characteristics of cancer, as well as treatments patients undergo, may bring about sensory, taste, and metabolic disturbances that are already well documented in medical and nutritional literature.8 However, in addition to strictly biological and nutritional dimensions, the food experiences and living conditions of people with cancer are at the centre of new questions (Ganzer et al., 2015; Morley & Neufeldt, 2001; Ottosson et al., 2013). Though scientific nutrition literature exists that provides nutritional guidelines and recommendations and personalised dietary advice,9 the few studies in the social sciences on the diet of people with cancer demonstrate that such recommendations are not adequate to meet the patients’ needs and experiences, and that cancer centres are not entirely adapted to patients’ individual needs (Fontas, 2016).

14Patients seeking information may be tempted by alternative medicine, or turn to people within their own social circles, or find advice on the internet and other media (Cohen & Legrand, 2011; Fontas, 2016). They can encounter nutritional standards that are difficult to apply (Bell et al., 2009; Lorcy, 2016) or that require substantial rearrangement of their lifestyle and relationships (Lorcy, 2014; Morley & Neufeldt, 2001; Mróz et al., 2011; Mróz & Robertson, 2015).

15However, through food, it is the very experience of cancer that is examined. Recent studies focus on the patient’s intimacy, subjectivity, and desire for autonomy (Marche, 2006; Vega (dir.), 2016. Derbez et al. (eds.), 2016.), or on patients’ own nutritional decisions made according to their thought processes, their life history, their medical follow-up, and the various social, cultural, and family resources available to them (Ménoret, 2007; Broom & Tovey, 2008; Cohen et al., 2016.).

16The articles in this issue support the results of previous works by noting that diet, for people with cancer—and/or their relatives—is a day-to-day concern. They highlight the various dimensions of the changing food experiences of people living with cancer. The experiences are diverse, shaped by biological, nutritional, social, cultural, sensory and psychological dimensions. 

  • 10 The nutritional recommendations stated refer to norms. For further information on the experience of (...)

17Nevertheless, interactions with the medical community remain paramount, because they structure the overall cancer experience. Depending on the country and the type of care centre, conventional medical support can be provided to reduce the risk of malnutrition and infection and to better assist patients in their daily lives. When dietary recommendations10 are available during hospital care, they can meet the expectations of some patients. However, sometimes nutritional management in cancer care is misguided and does not meet the expectations and needs of patients (Bell et al., 2009). Dietary requirements can then lead patients to rebel; as the imposed dietary changes get more and more brutal, they can cause frustration, anxiety and feelings of helplessness. Such was the experience of men with laryngeal cancer in Spain in the case described by Mariano Juárez and his colleagues. Indeed, the men were unable to continue eating through their mouths and had to relearn how to eat. To do so, they had to follow the recommendations of doctors who encouraged them to find technical and nutritional solutions. These solutions were less than acceptable for the men because they did nothing or little to improve body image, which remained a major concern as, according to the patients, it affected their relationships with others. M'Zoughi, in turn, addresses the dual nature of oncologists’ recommendations to women with breast cancer in the studies in Phnom-Penh, Cambodia. While some recommendations were justified by, and even legitimised, Khmer culture requirements, others were in contradiction with a number of dietary taboos, creating a "food cacophony" (Fischler, 2001, 2011). This has also been documented in other countries, including France (Cohen & Legrand, 2011; Fontas, 2016).

  • 11 The guilt felt by cancer or ex-cancer patients relating to different social expectations has been a (...)

18The articles by Kinshella and by Bretonnière and her colleagues highlight adverse effects of nutritional recommendations, such as guilt, moralising about one’s behaviour, and anxiety. In Canada, following Bell's work (2010), Kinshella analyses the moralistic connotations of the nutritional recommendations given by support groups for cancer patients in remission. By promoting "good" foods and cautioning against "bad" foods, this education on "healthy eating" practices induces adverse effects in how the knowledge is assimilated by participants. The study shows that some patients feel guilty11 and stigmatized when they realise they could have developed the disease because of their “bad eating habits”. In order to comply with the recommendations, these patients then need help and support from family and friends to restore self-confidence. The articles by Bretonnière and her colleagues and by Kinshella describe cases of cancer for which no specific dietary management is needed, and the only recommendations from health professionals are often terse orders “to eat normally", "to eat healthy foods", "not to lose weight, "not to gain weight", "to practice sports", or "to do regular physical activity". Here the authors show that "nutritional anxiety" is inherent not only to the treatment and the evolution of the disease, but also to the recommendations themselves. Incentives to balance food intake and nutritional value to stay healthy and to prevent a recurrence are all the more destabilizing as no advice or recommendation specifically adapted to each patient is offered. In this period of anxiety and uncertainty, most of these men and women, suffering or having suffered from cancer, seek new and reassuring personal eating habits in a social space that they will need to redefine.

Between the local and the global: looking for personal food practices and food spaces

  • 12 This modification involves the choices, the supply, the preparation, and the eating of food.

19In fact, variations of a complete "transformation of the social food space"12 (to quote M'Zoughi, inspired by Poulain [2012, 2013]) for people living with cancer appear throughout this collection of articles. One’s social space is disrupted especially by new food choices that depend as much on the individual experience of cancer as on recommendations and nutritional restrictions issued by state governments and international agencies through current health policies or new measures. In other words, cancer entails a redefinition of the patient’s social food space, which is defined by a combination of factors from local to global. Several authors in this issue expose not only difficulties, concerns, and errors, but also describe how people with cancer (or who have had cancer) go about finding their own new eating habits. New food choices are required depending on the type of cancer; its physical impact; the therapy adopted and the disruption it can cause (Mariano Juárez et al.; Fontas); the cultural interpretation of the disease (M'Zoughi); and the diverse range of questions patients (and former patients) ask and the information they receive. This information can be obtained from family and friends, alternative medicine experts, the Internet, magazines and mainstream publications, medical teams (Fontas), or support groups during the illness (Bretonnière et al.) or after having had cancer (Kinshella).

20The social food space thus becomes a space for initiatives, for being "proactive" (Bretonnière et al.; Kinshella), and for seeking autonomy and regaining control over one's body and life, specifically in a context in which individuals are held accountable and are morally judged (Bell, 2010; Kinshella). Inspired by their own experience, by the knowledge they have acquired, and by the recommendations that are lavished upon them, patients patch together their own social food space, interpreted in different ways in the various articles. Bretonnière and her colleagues use the concept "performative autonomy" (originally proposed by Bretonnière in 2016) to refer to decision-making abilities of people with cancer to accept or refuse treatment or a given recommendation. They are thus driven to seek accessible resources outside the hospital. The search for food guidelines outside the institution can use a lot of a patient’s energy, and patients sometimes get lost among the diverse and often contradictory food recommendations. A local health network’s initiative to provide nutrition workshops offers a new kind of continuity in food trajectories. The continuity comes not so much from the way knowledge is transferred, but from participatory activities that respond to the needs of the patients, whose autonomy is restored in a collective framework they find reassuring. This performative autonomy corresponds to the concept of "empowerment" (Twombly, 2004), used by Kinshella in the case of people in remission from cancer in Canada who are seeking a diet that will limit the risk of recurrence and allow them to live comfortably. Health diets that are widespread in Canadian society have found their way into these support groups and thus influence patients’ new diets. Some foods are thus highly valued (e.g., quinoa [Chenopodium quinoa], a pseudo-cereal with high nutritional potential, is designated as emblematic by the author), while others are "demonised" (e.g., sugar, which is said to feed the cancer).

21Finally, among these initiatives, Fontas describes the "food coping strategies" developed by patients and their families following the diagnosis of cancer. She provides a complementary approach to the "individual strategies" described by Bretonnière and her colleagues. In this case, strategies are cobbled together using information gathered at the local and global levels, as patients seek to meet new food standards while going through the physical experience of cancer. Changes in social food spaces then allow us to see how social dynamics play out.

From a sense of loss to social isolation: between food ruptures and continuities

22The articles published in this issue provide original reflection on dietary changes in terms of ruptures and continuities. Fontas explains how "food trajectories" (a concept borrowed from Corbeau [2007]) in the disease timeline of people with cancer consists of "breaks, fits and starts", starting at diagnosis and depending on the therapeutic treatments undergone. These ruptures are even more apparent, pronounced, and painful in the case of cancers of the upper aerodigestive tract (sinuses, pharynx, larynx and mouth, among other organs). Mariano Juárez and his colleagues describe the daily life of men who experienced such ruptures in terms of "loss": the loss of a mouth that is no longer functional, a voice, a sense of taste, and pleasure in eating, which results in an insatiable "cultural hunger". Beyond the physiological and sensory effects, it is a strong, deeply emotional loss that takes the form of a loss of identity. Having to forgo standard table manners at shared meals leaves them feeling a sense of "shame", so they must now face social loss as they carefully avoid shared meals where guests may feel uncomfortable.

23Whatever the form of ruptures caused by cancer, several of the articles note that they have a significant social impact. Whether it be "food desocialisation" (Fontas) or "social isolation" (Bretonnière et al.; Mariano Juárez et al.; Kinshella), people with cancer (or those having had cancer) are likely to experience these situations, either temporarily or longer term. Fontas shows to what extent food desocialisation depends on the context, on the "food disturbances" experienced ("in a situation of discomfort"), on unfavourable socio-economic conditions, or, for example, on whether one lives alone. She echoes the observations of Bretonnière and her colleagues on the "social isolation" of women and single mothers in France, and those of Mariano Juárez and his colleagues in Spain. Kinshella also notes that even "in a situation of comfort" (to quote Fontas), as during cancer remission, there is still a risk of significant social isolation. Food changes initiated and maintained by people with cancer, who seek to limit the risk of recurrence by eating "in a healthier way", can contribute to social isolation when these practices are not shared by relatives. 

24Several authors stress the importance of conviviality among people living with cancer as a path to "food resocialisation" (Fontas), since conviviality promotes a return to normalcy and restores continuity in daily life. Firstly, Fontas says food resocialisation is facilitated by a "comfortable situation" that arises when treatment-induced side effects diminish or disappear. People undergoing treatment feel better prepared to resume a social life when family and friends show their support during meals through conviviality and by enjoying the food. When family organisation breaks down because of cancer, meeting regularly with fellow patients (or former patients) or participating in support groups activities or nutrition workshops can help alleviate the burden of isolation. Bretonnière and her colleagues explain how, thanks to a participatory model (therapeutic patient education), workshops in France not only help facilitate training in nutritional knowledge, but also create a space for sociability and conviviality among those who share the disease experience. This participation allows them to reconnect within family. Secondly, according to Kinshella, shared representations and a common understanding of food within support groups in Canada help build a community whose members give each other mutual support while facing the fear of recurrence and keeping alive the hope for healing. In both cases, it is not only the strength of the group (Aebischer & Oberle, 2016), but also the dedicated social space that helps these patients build their own ground rules in the food sphere.

Change one’s diet to reconfigure one’s world

25It has been shown scientifically that food (including drinks, food supplements, herbal compounds, and the like) is as much a risk factor for cancer as a protective agent (Hubert, 1991) and perhaps a healing agent as well. In other words, the relationship between diet and cancer involves an ambivalent view of food, which is sometimes perceived as harmful, sometimes as beneficial. It reiterates the classic anthropological opposition between food as poison and food as cure, between food as good for you and food as bad for you (Vigarello, 1999); this opposition is as present in common, everyday representations and practices as it is in less conventional views (Cohen & Legrand, 2011). Cancer is considered one of the major diseases of modern society; the concepts involved with cancer prevention through diet (both primary and secondary prevention) serve to resolve not only the disorder of uncontrolled body cells but also social disorder at large, including food practices deemed non-conforming.

26Such are the ideas developed in most of these articles. The texts demonstrate that, beyond personal choices and individual projects, dietary changes imply new nutritional categories that offer new ways to think about food and also about the patient’s world. Thus, the ways in which cancer survivors "restore order" to their health and to their world through food—as Kinshella highlights—create a new anthropological perspective on dietary changes. This perspective fits with the ideas developed in the 2016 issue of Anthropologie & Santé under the direction of Anne Vega. The authors show how people living with cancer use their experience of illness "as an opportunity to reconfigure their relationship with themselves, with others, and with the society as a whole, that is to say, to develop new forms of social autonomy" (Vega & Pombet, 2016, our translation).

27According to Fontas, for people with lung cancer in France, the goal is to reorganise the spatial and temporal worlds of patients and their families; restructure their sensory world (taste and food sensations); and rethink their eating patterns (e.g., with new categories of the right foods). According to M'Zoughi, women with breast cancer in Cambodia restructure their diet by taking into account cultural ideas about how sick people should eat while also adapting to cultural representations of cancer. The women must avoid harmful foods, seek nutritional balance and moderation in eating, and strengthen their body weakened by disease and medical treatments. These dietary principles place patients in cultural referents that are different from but not in complete contradiction with the interpretive framework of local biomedicine.

28For Kinshella, in Canada, in an environment full of ambiguous and sometimes contradictory health information, individual plans for dietary changes sparked by the empowerment of cancer survivor support groups point to two ways to put things in order. Firstly, a biological and symbolic order is established in response to the experience of cancer as dispossession and disconnection between people and their bodies. The desire for autonomy leads them to act at the very site of their dispossession (inside their body) by changing their diet. Sources of pollution (e.g. demonised sugar and chemical products) are thus discouraged or even banned; the new ideal diet focuses on the purity of whole and organic foods. Secondly, a moral and social order is configured based on symbolic values (e.g., purity and pollution) tied to social history. Kinshella thus identifies discourse by cancer survivors criticising the industrialisation of the global food system. Some survivors also express their connection to a wider community of producers and consumers by building an alternative global food system (Beagan et al., 2010). They therefore defend organic foods and agriculture, sustainable and ethical food production (of which quinoa is the symbol), local farming, and growing their own vegetables, as has already been documented in studies of people with cancer in other cultural and national contexts (e.g. Broom & Tovey, 2008; Bégot, 2010; Cohen & Legrand, 2011; Cohen et al., 2016).

29In the French case observed by Bretonnière and her colleagues, the emotional dimension is ever present and fuels cancer patients’ drive to reconfigure their diet and their world. The nutritional recommendations are worrisome because of the lack of resources to adopt them; this leads people with cancer to find ways to address the issue themselves. But, beyond that, reconfiguring the world is also rediscovering the conviviality, the pleasure of sharing meals in one's own home with those who share a similar experience of the disease and also with loved ones who are just as jolted by cancer and its effects on the intimacy of everyday life.

  • 13 Cf. the following studies dealing with the emotions of patients with cancer and of their relatives: (...)

30Finally, beyond the dynamics of empowerment that allow patients to act on their body, their disease, and their world, disease patterns and material constraints limit manoeuvring ability. For patients with cancer of the aerodigestive tract (Mariano Juárez et al.), the world is reduced to the experience of their physical and social handicap. Recreating order in one's health, in one's diet, is all the more difficult when eating retains only a nutritional purpose and is devoid of its affective and identity dimensions. In this context, reconfiguring the world comes with a heavy emotional burden that is emphasized by the present authors; these authors feel that the emotion burden is too often ignored in scientific literature and in medical care, though some researchers have already laid the groundwork for its description and analysis.13 For the cancer survivors studied by Kinshella, the defence of natural and ethical values depends on the financial means of the survivors. Since industrial food is always cheaper than organic food, food supplements, and vitamins, poverty is not only a constraint but also a source of frustration, as not being able to access the right diet causes additional stress.

Conclusion

31Ultimately, the articles in this issue show that the food experience of cancer patients is sensitive and intimate, at the crossroads of the experience of the disease itself and multiple medical, institutional, cultural and social configurations. Though the concept has been explored here in all its diversity, its complexity, and its many social and cultural aspects, investigations have just begun. The topic is all the more inexhaustible as food experiences of cancer patients vary according to societal changes, growing social inequalities in health (Leclerc et al., 2000, Derbez & Rollin, 2016), scientific advances, and changing political stakes. It will likely be a new field for future research, one in which local and global dimensions are intertwined. Beyond the experience of the disease, it is also important to scrutinize the links between nutrition and cancer in a scientific and political framework—including behind the scenes in public health—and to consider to what extent the consideration of such links for maintaining health capital can be translated into the production of new "food reforms".

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Notes

1 See tributes to her in Anthropology of Food (Crenn, 2010) et Anthropologie & Santé (Perrey & Querre, 2011).

2 Symposium organised by the Laboratoire d’analyses socio-anthropologiques du contemporain of the Sophiapol - EA3932 and sponsored by the Société française d’ethnologie (Paris). A selection of the symposium proceedings was published in the 2016 issue of Anthropologie & Santé 13, under the direction of Anne Vega.

3 We wish to thank those who helped with the revision and translation of the call for papers in English and Spanish, especially Maryjo Otero. We wish to thank as well Steffi Garnotel, Charlotte Dietrie, Frédérique Menant, and Margaret Buckner for the translation and the revision of the Introduction in English.

4 Especially the Centre International de Recherche sur le Cancer (CIRC) and the World Cancer Research Fund (WCRF) associated with the American Institute for Cancer Research (AICR).

5 In France, the Institut National du Cancer (INCa) and the Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses). See especially “Conclusions des expertises scientifiques collectives s’appliquant à la population française”, accessed on September 15, 2017: https://www6.inra.fr/nacre/Prevention-primaire/Vous-informer-sur/Conclusions-pour-la-population-francaise-des-expertises-scientifiques-collectives

6 This phenomenon has been analysed as a veritable “moral economy”, most notably by Fassin (2009) and Fassin & Eideliman (2012).

7 However, we would like to thank all the authors for their submissions.

8 See in particular Alonso Castellanos et al., 2014; Belqaid et al., 2014; Bernhardson et al., 2008; Boltong & Keast, 2012; INCa, 2006; Jakubowicz, 2006; Larsson et al., 2005, 2007; Ravasco, 2005.

9 See in particular Bidlack, 1996; INCa, 2009; Meuric & Besnard, 2012; Senesse et al., 2012; Senesse & Vasson, 2012; Rock et al., 2012.

10 The nutritional recommendations stated refer to norms. For further information on the experience of people suffering from cancer in their relationship to biomedical and social norms, read Vega (dir.), 2016.

11 The guilt felt by cancer or ex-cancer patients relating to different social expectations has been analysed in several studies: Saillant, 1988; Ménoret, 2007; Sarradon-Eck, 2004; Sinding and Gray, 2005; Bell, 2010; Vega, 2012; Maley et al., 2013; Lorcy, 2016.

12 This modification involves the choices, the supply, the preparation, and the eating of food.

13 Cf. the following studies dealing with the emotions of patients with cancer and of their relatives: Cowley et al., 2000; Glajchen, 2004; Marche, 2006; Rizk, (dir.) 2007; Locher et al., 2010; McQuestion, 2011; Vega, 2012; Lorcy, 2014.

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References

Electronic reference

Patrice Cohen, Hélène Hoarau and Armelle Lorcy, « Food experiences of people living with cancer: continuities and discontinuities in their local and global dimensions.  », Anthropology of food [Online], 12 | 2017, Online since 11 March 2018, connection on 27 May 2018. URL : http://journals.openedition.org/aof/8284

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About the authors

Patrice Cohen

anthropologist, Social Dynamics Laboratory (DysoLab, EA 7476), University of Rouen-Normandie (France), patrice.cohen@univ-rouen.fr

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Hélène Hoarau

anthropologist, Lab. CeDS EA 7440, University of Bordeaux-University Hospital Centre of Bordeaux (France), h.hoarau@free.fr

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Armelle Lorcy

anthropologist, University Hospital Centre of Quebec University Laval (Quebec, Canada), armelle.lorcy@hotmail.fr

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Copyright

Licence Creative Commons
Anthropologie of food est mis à disposition selon les termes de la licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International.

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