Table 2.

Twelve themes with exemplar participant responses

Entering cancer: Facing diagnosis and treatment
1. The diagnosis	“I think about it every day. Every single day.” (P1) “I had 4 days by myself in Boston…and I would go sit down and the tears would just roll. I called my counselor back home the second day, and he said get a counselor down there, which helped. It was really bad.” (P12)
2. Confronting mortality	“I want to die a good man. When I wake up in the morning, I ask God to keep me awake…if I had to stand in front of the gates now, I did a lot of nasty, nasty things when I was younger, but I believe I’ve been forgiven. And that’s what I look forward to, a nice peaceful death, and the ride, and the white light, or whatever. I believe there is a re-uniting with my family and my loved ones.” (P9) I don’t make very big plans too far down the road because of what goes on with the type of cancer I have. I mean they can say I’m cured and all that, but I know what’s going on. I know what I feel. I feel like I’ve been run over and stomped on.” (P6)
3. Treatment schedules	“I open up my pillbox in the morning, I don’t have to have breakfast! It’s like Kix, ya know.” (P4) “All of a sudden you are diagnosed, then you are expected to be your own advocate. To get going and know what’s going on and what the doctor says and all of that…my suggestion would be to actually have classes for people who are new to everything. How could you be your own advocate? Because that could be a real big help….” (P12)
4. Treatment effects	“It’s never ending…the fear is [cancer] is lurking here somewhere, and it’s going to pop up.” (P5) “All of us have had a lot of different experiences that brought us to the point where we cope with this insanity that we’ve got. And that’s what I call it. Insanity. I hate it. I hate it.” (P1)
5. Treatment relationships	“Then we started talking about cancer… and I said, Am I gonna die from this? Do you think I’ll die from this?… so she [the doctor] looked at me and she says, I’ll put it this way, and it sticks, everyday I think about it, she says, you may not die from it but you’ll die with it. And I said thanks…she told me the facts right there.” (P6) “My PC on the outside [of the VA] who I have been seeing for over 20 years, and he’s in recovery also which really brought us tighter, he’s a super nice guy…if there’s one person on this earth that I’m going to put my life in their hands, it’s him. I had that much faith in the man.” (P9)
Negotiating cancer: Finding a passage through
6. Coping	“Good times are like taking an aspirin. You can have a good time if it picks you up for that particular hour, or day, or whatever. But bad times, I think you learn to avoid them as much as possible.” (P4) “They suggested that I take a prostate test, and the colon, that kind of thing, and I kind of put up a wall. After everything I had been through with the treatments, I didn’t want to hear. I’m not ready for it, I guess…I’ve had enough needles. I’ve had enough treatments. Maybe down the road somewhere, but I don’t, like, want to go from one thing to the next.” (P14)
7. Social support	“[T]his old Portuguese woman, I never even knew her, put her hand on my shoulder and pulled me aside…and she said don’t you dare walk out of here,… she says, I have a daughter in here getting treated for breast cancer–full breast, and I lost a son 4 years ago to cancer. I have a husband at home with cancer. And I thought, oh gee, what can I say to her. She said sit down and wait for your damn ass to be called in the room. That’s just what she said to me…. After that, my outlook changed.” (P6) “My father, all the time, he’s saying, just 1 day at a time…It didn’t hit home, but now it’s reality…it’s this day, it’s this time, and that’s it. I just try to concentrate on that, focus on where I’m at and what I’m doing, try to be the best person I can be and enjoy.” (P14)
8. Religion and spirituality	“I’m probably more spiritual…. I would be lying if I said that I wasn’t. I have a friend who is very connected with angels. And when I was in surgery, she was in Florida, and she actually sent me a little stuffed angel.” (P10) “It reinforced my faith is what it did. I didn’t have any fear when I got it [cancer], and I understand why I didn’t have any fear. I believe there’s a higher power out there for me, and it reinforced it.” (P11)
9. Acceptance	“Well, this is just another chapter in your life story. It’s an inescapable one–you got it, you’re not going to change it.” (P8) “I had some regrets…. Maybe that’s why I got it…. I know I shouldn’t have picked up them cigarettes. But then, you know, it’s too late. It is what it is, and now I just deal.” (P14)
10. Hardiness from life experience	“[Y]ou came here for 16 years for anxiety and PTSD,… but now you are facing cancer like its nothing. I said, well, cancer I can deal with because I know what it is–it’s cancer. How worse can it get?…I’ve dealt with so much, what’s another thing? It’s just cancer.” (P6) “[I]n the military, we were in, Nam…I was in a special operating group, and I put myself in a crappy situation 1 time. I’m on the horn [with the officer], and I said, situation is hopeless. He had to get us out. And he said to me, if the situation is hopeless, there is nothing to worry about, click. And that did more to prepare me for when they said you have cancer, its growing fast, we’ll do what we can. I just heard that man’s voice, and I said okay, you gotta dig right in here because if it’s hopeless, he was right, there is nothing to worry about.” (P5)
Meaning making: Changing perspectives of life and oneself
11. Life perspectives	“It’s changed my life to the point where I called my boss and said I can’t build boats for a year. Why not, why? And I told him. He said take 2 years if you need it. It’s affected my life. I want to get rid of it.” (P2) “I look at it [life after cancer] as you continue on with your normal things. That you’re not handicapped as other people are, ya know? That I continue on with my everyday way of life.” (P13)
12. Self-perspectives	“I’ve become a great father and a great grandfather, while maybe before I was just an average father.” (P5) “It’s a word—Cancer. You never associate it with you. I think that sometimes when I say to myself, What was it like before cancer, what did I feel like, what was I thinking all the time, did I even think about anything? I don’t remember, it’s like you dwell more on it every day with cancer. You make the most of it and you do what you have to do.” (P6)