European Journal of Oncology NursDOI:10.1054/ejon.2001.0143, avail

The arts in cancer care:learning fromexperience

E D I T O R I A L

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It is increasingly being recognized that the use of

the arts can have a wide range of benefits for

people who are ill, and their carers. There are

several ways in which the arts can help. Perhaps

the most obvious relates to the quality of life of

individual people who are unwell. Music, dance

and the visual arts can contribute enormously to

well-being and give new dimension to people’s

lives.

Public exhibitions of work, for example those

organized by the charity A Picture of Health, can

encourage viewers to talk about cancer, which

we know is a taboo subject for many (Farrer-

Brown 1999). A Picture of Health has hosted a

number of exhibitions in relation to both breast

cancer and childhood leukaemia. These comprise

a series of oil paintings and images such as the

children’s ward, taking of a blood sample, out

patient consultations and initial investigations

and have been accompanied by short descriptive

text. Such images are both deeply moving and

informative.

Yet another dimension is that of the arts in

professional development and education. The

need for nurses and other members of the cancer

care team to be able to understand and

empathize with patients and put the patient’s

point of view first is obvious. A short play

entitled Time Bomb, directed by Marina Sossi

and written by two women who have undergone

mastectomies for the treatment of breast cancer

(together the trio form the Little Gift Company),

has been described as a ground-breaking initia-

tive in that it is the first time a play on breast

cancer has been performed from the patients’

perspective (Wood 2000). Performances are

followed by workshops where members of the

audience are encouraged to ask questions and to

explore issues raised.

Personal accounts of illness by the patient or a

relative provide potent narratives (for example the

book by Ruth Picardie). Such sources of informa-

tion are both arresting and perceptive, but they do

not represent the wide variation of individual

patient experiences nor can they be expected to

include rigorous and detailed information about

the disease, its treatments and the range of

support available (Herxheimer et al. 2000). A

new web-based initiative named DIPEx combines

a systematic collection and analysis of interviews

with people about their experience of illness with

5 (2), 75^76# 2001Harcourt Publishers Ltdle online at http://www.idealibrary.com.on

evidence of the effects of treatment, and informa-

tion about support groups and other resource

materials which the authors hope will be of use to

patients, carers and healthcare professionals.

Finding effective ways through which health-

care professionals can listen, whether to verbal

reports or by the various means of non-verbal or

artistic expression, can help create a dialogue

between patients with cancer and their healthcare

professionals. This will lead to a better under-

standing of the experience of cancer. Such

understanding is crucial to the delivery of

effective care. This involves employing as many

communication techniques as creativity can

appreciate and allowing people choice in how

they wish to convey this information. As the late

Meryl Winningham (2000) wrote in her text

Fatigue in Cancer creativity can help us to

‘sometimes leap across the chasm that science

alone cannot breach’ (p17). Working with a

range of processes including photography, paint-

ing, poetry, drama and prose patients seek to fill

out the gaps in our clinical appreciation of

patient experiences.

Ensuring that the services we provide are

patient-centred is challenging. However, we must

strive to ensure that the patient perspective is

integral to service development, delivery and

evaluation. The arts provide us with an impor-

tant vehicle through which to help achieve this,

offering us access to the inchoate experiences

that comprise patients’ lived experiences of the

world of cancer care and its treatment. I hope the

content of this editorial and the material which

follows it will have demonstrated to readers the

wide variety of approaches that can be utilized to

publish something of these experiences, experi-

ences that can be invisible to the specialist and

the general public and for which there are few

outlets in standard cancer care practice.

On the following pages you will find a sele-

ction of poetry by a lady called Betty Munnoch.

She has provided the following autobiographical

account. Betty was born in Canada, married a

Scot in 1951 and came to live in Scotland.

Unfamiliar with the educational system in Scot-

land she obtained her Scottish Highers in order

to help her family and then went on to graduate

in English at Edinburgh University. Until

her retirement she taught adults in Further

Education.

76 European Journalof Oncology Nursing

She has always had a special love of poetry but

believed it to be the ‘preserve of youthful genius’.

However, after joining a writing group in 1991

she found great pleasure in writing poetry,

mainly free verse.

Since February 1999 she has been undergoing

treatment in Glasgow for inoperable oesopha-

geal cancer. She is grateful for the chemotherapy

and the combined radiotherapy and chemother-

apy that have allowed her to beat the dire

statistics to date and now the laser and PDT

have indeed brought what she refers to as

‘halcyon days’.

Many have written of cancer in prose but few

have chosen poetry to deal with such specific

experiences. When feeling ill she wanted to keep

on writing, but only poetry seemed adequate to

express her feelings. Releasing her from minutiae

it helped her to an overview of her life and

situation. She hopes others may find it of some

value.

Our thanks should go to the many who

continue to teach us out of their experiences,

European Journal of Oncology Nursing 5 (2), 75^76

what cancer means to them in their lives and how

they have found meaning in the midst of it. They

challenge us to do what we can to alleviate

suffering and discomfort.

Alison Richardson

Editor

REFERENCES

Farrer-Brown G. (1999) A picture of health. In: Haldane

D, Loppert S (Eds) The Arts In Health Care:

Learning From Experience. King’s Fund Publishing,

London

Herxheimer A, McPherson A, Miller R, Shepperd S,

Yaphe J, Ziebland S (2000) Database of patients’

experiences (DIPEx): a multi media approach to

sharing experiences and information. The Lancet,

Vol. 355, April 29, 1540–1534

Picardie R (1998) Before I Say Goodbye. Penguin Books,

London

Winningham M, Barton-Burke M (2000) Fatigue in

Cancer. A Multidimensional Approach. Jones &

Bartlett Publishers. Sudbury, Massachusetts

Wood C (2000) Play explores cancer. Somerset Standard