Abstract
Previous research has shown that social media platforms afford cancer patients an opportunity to manage their treatment issues. However, limited research has examined personal experiences that cancer patients authentically share through short videos. This study analyses 114 online short videos to examine a colon cancer patient’s (A’Jian) personal experience. Drawing on the concept of the ‘disease course’, which is extended from the life course theory, the analysis reveals that a patient’s physical space and social space have been impaired brutally by the incurable disease cancer. This study unpacks the fundamental dilemmas of a cancer patient by focusing on changes in the disease course afforded by short videos, moving beyond a temporal analytical angle. In addition, this study contributes fresh insights to the intersection of social media and health communication by investigating how short videos afford cancer narratives in the TikTok (short video) era, which provides a new research path on the affordances of visible short videos for future health-related research.
Introduction
As a life-changing event for cancer patients who might face a series of uncertainties and even identity challenges, cancer incidence is increasingly rising across the world. Cancer patients require both clinical and social support throughout their varying stages and disease progression (Yaskowich et al., 2003). Doctors typically guide patients to get professional medical treatment. Meanwhile, cancer patients are also willing to express personal feelings about cancer treatment, such as cancer pain (Zajacova et al., 2021), with other lay patients to seek comfort, offer mutual support and lessen the uncertainty of disease information.
The use of communication technologies is changing the way cancer patients share their experiences with the disease. For instance, breast cancer patients employ Instagram and TikTok to create cancer-related content to support others and mitigate personal feelings of uncertainty (Wellman et al., 2023). Cancer patients typically would like to discuss how they cope with cancer through blogs (McCosker & Darcy, 2013). Bloggers’ personal health universe, which includes personal thoughts, feelings and experiences, has become a useful health information source, showing valuable health information in an unprofessional way (Stavrositu & Kim, 2015). Along with this path, short video apps can similarly be used as a public health source and leveraged by public health services to develop the great potential of social media platforms (Song et al., 2021). In the digital era, people’s everyday lives are increasingly integrated into digital versions due to their intensive use of various social media platforms, such as Facebook and Instagram. Personal expressions online, such as blogs, diaries and short videos, serve as documents that exhibit individuals’ feelings and values, showcasing another digitalised aspect of human existence in society (Lindlof & Taylor, 2017). Therefore, these born-digital archives are worthwhile to explore what people want to convey to the public (Nix et al., 2023) or what extended personal lives people narrate online. For cancer patients, these materials also provide meaningful narratives to understand their feelings beyond clinical contexts.
Some research examines how some adolescents and young adults with chronic disease use video testimonials to reach out to peers (Pereira et al., 2020) or how researchers use solicited video diaries to examine incurable cancer survivors’ overlooked lives (Broom et al., 2018). However, limited research has investigated the personal experiences that cancer patients share through short videos, particularly from a lens that focuses on changes in the disease course. Consequently, this article employs a thematic analysis to unpack the meaning of the short-video narration of a patient’s (A’Jian has to live desperately 1 ) cancer treatment process. This article makes contributions to exploring the affordances of short videos on illness narratives for future research and providing a valuable and practical case analysis for both lay patients and professional doctors.
Literature Review
Cancer Narratives on Social Media
The clinical setting is usually the central sphere when understanding patients’ illness narratives. Also, patients and doctors typically co-define illness narratives through clinical communication (Gonzalez-Polledo & Tarr, 2016). According to Hurwitz et al. (2004), illness narratives are dynamic devices to express and communicate pain and illness in clinical settings and beyond. In other words, illness narratives are constructed subjectively by representing past events and personal feelings on disease, which, to some extent, provides practical experiences for future medical treatment. These views effectively critique the relationship between illness, culture and society. Illness narratives encompass various diseases, such as diabetes, breast cancer and prostate cancer (Fergie et al., 2016; Gupta, 2022; van der Kamp et al., 2022; Wellman et al., 2023). Compared to other chronic diseases that can be under control, cancer, as a seemingly incurable disease for the current level of medical technology, can cause trauma much more easily. Therefore, it is essential to understand what cancer means from the perspective of sociocultural narrative, particularly through cancer narratives in the social media era.
Much previous research has been conducted on cancer narratives in the digital era. Digital media has become a common way to help us picture and comprehend people’s experiences of cancer (Lenemark, 2019). With the widespread use of communication technologies, online platforms such as Instagram, Tumblr and Flickr are changing how people share and negotiate about their body conditions (Gonzalez-Polledo & Tarr, 2016; Sendra & Farré, 2020). Personal illness narratives on social media platforms not merely reflect on subjective experiences but also contribute to providing physical symptoms for other patients (Hardey, 2002). For instance, McCosker and Darcy (2013) suggest that cancer blogs can serve as hubs to constitute the experience of living with cancer by identity and affect management, which also offers support by sharing health and medical information. For some patients who disclose cancer on TikTok, their positive/negative disclosure plays the important role of informing and warning others compared to seeking support (Pluta & Siuda, 2024). After receiving the diagnosis of cancer, social media use gradually becomes vital media. Some cancer patients’ lived experiences of choices and dilemmas are presented through engaging with social media strategically, ecologically and culturally (Stage et al., 2020). The related research shows that cancer patients are moderately moving to social media to gain specific support. Namely, using social media, to some extent, relieves cancer patients’ misery through sharing cancer information and seeking out helpful support.
As stated above, cancer patients usually utilise social media platforms to help them narrate their personal feelings after being diagnosed with cancer in the digital era. They would like to gain support, discuss their experiences with peers who have cancer as well and share personal experiences to help other strangers. In the meantime, these narratives become valuable materials for understanding cancer patients’ inner thoughts outside clinical contexts.
Vlogging Cancer Experiences on Social Media
It is suggested that cancer narratives on social media are increasingly widespread in the digital era. Social media platforms offer a new channel for patients and health professionals to communicate health-related issues (Li et al., 2024). Generally, this health-related information is in texts, such as personal online diaries or unprofessional journalism (Buis & Carpenter, 2009; Neubaum & Krämer, 2015). To some extent, writing is becoming a patient’s cultural medium, working as a powerful tool to benefit and self-cure themselves (Tan, 2008). Blogs, as a typical communication virtual space, are a more common means for cancer patients to gain social support, which increase access to and facilitate the exchange of medical information (Rains & Keating, 2011). Publishing and sharing information online are gradually becoming an important phenomenon. Cyberframing cancer is a way of handling this chronic disease and is also a discourse to show how people are coping with it (Donovan et al., 2017; Kim & Lee, 2014).
Blogging might be the most visible and accessible mode of storytelling in Web 2.0. It is a community-like, text-based persona (Alexander, 2011; Chung & Kim, 2008). With the easy fabrication of short videos in the age of TikTok/YouTube, some cancer survivors are utilising this new vehicle to produce information and resources to offer emotional support (Chou et al., 2011). Making a cancer narrative video online enables a sense of feeling in a community within adolescent and young adult cancer populations (Pereira et al., 2017). Other adolescent and young adult cancer patients adopt video testimonials to reach out to their peers and explore their thoughts and illness experiences (Pereira et al., 2020). The function of making short videos about cancer experiences is analogous to narrating personal experiences in texts. The difference lies in authenticity and contextualisation. In other words, in short videos, audiences can clearly see the filmmakers’ emotions. It is much easier for audiences to perceive video makers’ personal feelings. Video analysis provides an opportunity for researchers to investigate the ‘broadcasting self’ (Pace, 2008) of cancer patients.
Video diaries offer a direct understanding of participants’ experiences and provide data that are less controlled by the researcher (Gibson, 2005). Karisalmi and Nieminen (2017) suggest that video diaries are a potential method to gather and understand patient experiences from children. Concerning the case in this research, it can be treated as an unsolicited video diary. In other words, these videos are cancer patients’ personal documents that are of their own accord, which is one of the main reasons for choosing it as a single research case.
Changes in Disease Course
In this research, I intend to use the disease course as a theoretical framework to describe cancer patients’ video narratives about personal cancer experiences, which purposively focuses on the most prominent changes influenced by cancer from being diagnosed as a cancer patient until death in a less-ordered but more flexible path (Heinz & Krüger, 2001).The disease course is an exploratory concept derived from the life course theory. The life course theory examines how people go through a sequence of age-based stages and social roles within institutional social structures (Cockerham et al., 2017). In this sense, the life course theory emphasises time, sequence and linear structure within a life span. In the life course, changes in major life events, such as starting a new relationship and a job loss (Haehner et al., 2024), are typically the objectives to be monitored. Life events, particularly those that happened in a longitudinal order, are publicly investigated, focusing on changes in human lives over a long stretch of a lifetime (Mayer, 2009). Accordingly, life outcomes triggered by all sorts of life events, such as mental and physical health, become the prominent research question (Haehner et al., 2024). These changes, influenced by significant life events, can also be understood as transitions in different life stages. In other words, culturally and institutionally framed status inconsistencies are perceived as social trajectories to understand individual lives (Heinz & Krüger, 2001). For example, McFarland et al. (2013) suggest that cancer diagnosis significantly influences personal religiosity; particularly people who are diagnosed with cancer at an early age have a strong association with increased religiosity.
Clearly, the life course theory keeps a close eye on life history from the longitudinal approach, such as age-based trajectories and transitions (Elder et al., 2007). Accordingly, this framework is suitable for explaining the primary conditions at the turning point for people who are diagnosed with cancer. However, this research does not examine the question in a timely order, such as respective changes in three stages (diagnosis, treatment and death). Because the changes for cancer patients can not exist only in one phase, patients’ physical and mental pain caused by cancer can last till the end since they are diagnosed as a cancer patient for the first time.
In addition, a cancer diagnosis should specify a time span from diagnosis to death (Wen et al., 2011) for patients, rather than only using a general description, such as the timeline of the disease trajectory. Also, the life course theory is too broad a concept to interpret this, because cancer patients might not pay any attention to this disease before the diagnosis. Therefore, this research prefers to emphasise ‘what is important’ or ‘what effects cancer diagnosis brings to patients’. I suggest using the exploratory concept of disease course as a theoretical framework to organise cancer patients’ personal expressions after receiving a cancer diagnosis from a complete perspective, which is a more micro-level framework compared to the life course theory. The disease course focuses on people’s changes, transitions and turning points within the life course. During the final stage of life with cancer, what stories or personal feelings cancer patients want to say through short videos will be analysed in the following sections.
In this research, I intend to articulate a cancer patient’s illness narrative through unsolicited short videos. In addition, I will structure the analysis by focusing on changes between cancer and patients’ personal lives in the disease course.
Rationale: Delimiting the Research Object
This article draws on the case study to understand a patient’s cancer experience. Notably, short videos are a relatively new media format compared to the previous personal home pages/blogs (Hardey, 2002; Kim & Lee, 2014). This case works as a representative to show how short videos afford people to manage their cancer issues. Case studies are typically intensive descriptions of a single unit, which can be an individual, a family, a household, a community, an organisation, an event or even a decision (Hancock & Algozzine, 2006; Priya, 2021). The case in this study is one internet vlogger who uploaded his personal cancer treatment through short videos. There are two layers of reasons for choosing it as an example. First, the case is a typical representative for some ordinary people with cancer who live in rural areas in China. According to Chan and Wei (2021), China’s society is a typical urban–rural dual system. At the same time, rural areas are usually the neglected side. From my observation of A’Jian’s video content, he is from a rural place in Hebei Province. Therefore, it is necessary to examine what it means for ordinary people with cancer in China to use this new format of digital media, which can also provide valuable experiences for people who are from other underdeveloped countries. Second, the case of A’Jian is a complete unit from diagnosis to death. It intends to explain ‘what is happening’ in the ‘disease course’. Through investigating the whole system, we can, therefore, know the fundamental dilemmas faced by cancer patients, particularly across the cancer trajectory from diagnosis to death (Wen et al., 2011). Given the above considerations, this study intends to use A’Jian’s case for exploratory research. The insights from this study can positively influence future research, such as why cancer patients embrace the new form of communication technology in the digital era and how short videos afford people to cope with their cancer problems through extensive interviews.
Methods
The qualitative data in this article are from A’Jian’s official account (Ixigua, n.d.) on the Xigua Video platform. The name of the account is called ‘A’Jian has to live desperately’. 2 The author, A’Jian, did not intend to share personal stories of cancer diagnosis and treatment online in the beginning. Instead, he mentioned his motivation for doing short videos (We Media) is to earn money to help him cover his medical treatment fees and relieve his family’s financial condition. With the exacerbation of cancer, he only posts his personal feelings and thoughts about cancer while lying on the bed, as his body condition cannot afford him to film complicated videos such as the original videos of vlogging how he took his daughter to purchase birthday presents. In the videos, he shared that he only benefits from the views of the platform and the audiences’ donations, which is a limited profit. However, he persisted in posting videos online to bring in some money for his painkiller fee or future potential operation. These videos have less traces of software editing. We can also see it clearly from the contents that typically show as a ‘news broadcast’ (speaking upon the camera for around 2–5 minutes). On 29 May 2020, he posted his first video. On 10 September 2021, his brother notified audiences that A’Jian had passed away. His unsolicited video diary sustained the entire disease phase. A’Jian uploaded 114 short videos in total.
The 114 short videos in A’Jian’s official account were downloaded by the author apart from the last one of his ‘passing away’. In the following stage, I applied a thematic analysis to this empirical material. Thematic analysis is a theoretically flexible method to search for themes or patterns within data (Braun & Clarke, 2019; Byrne, 2022). It tends to provide a detailed yet complicated account of data (Nowell et al., 2017). There is no standardised thematic analysis (Braun & Clarke, 2023), but this method maintains flexibility, consistency and coherence (Holloway & Todres, 2003), trying to refine a web-like illustration that summarises the primary meaning of data (Attride-Stirling, 2001).
Regarding my research case, I followed Braun and Clarke’s (2006, 2019) step-by-step guide, particularly bearing in mind the key feature of the reflexivity of this method. First, I conducted open coding assisted by NVivo, primarily focusing on familiarising myself with the contents and generating initial codes. For example, I coded some video excerpts that are related to A’Jian’s daughter as ‘two children are the motivation for moving forward’ (10 June 2021). Then, I began to search for prominent themes within the data, grouping similar codes into one theme through constant comparison. For the related video excerpts, which show how A’Jian worried about his daughters’ future life, I grouped them and named them ‘concerning daughters’. Also, I paid close attention to the coherence between various themes, making the analytical structure a thematic ‘map’. As such, I employed physical and social spaces to organise all the themes, highlighting the most significant changes for the patient. In the end, the themes were exhibited as the following four aspects.
All the excerpts from A’Jian’s videos in the findings were translated by the author. During the translation, the author considered the cultural context and language use to maintain the accuracy and readability. For the whole article, I also used Grammarly to help me check up the accuracy of grammar.
Findings
The short-video narrative presents a picture of the dynamics of how cancer entangles with patients in the disease course. In other words, changes in the disease course evidence how cancer impacts A’Jian in detail. The first aspect consists of the cancer pain and their declining physical body. The second aspect is sharing informal cancer knowledge via the personal fragile body, which is congruent with the first aspect’s core argument: declining physical body. The third aspect focuses on an adrift life, showing a strong desire to return to normal. The final aspect describes how cancer influences A’Jian’s kinship. Overall, the former two aspects centre on the physical space, analysing how cancer affects a patient’s physical body. The latter two aspects focus on the social space, examining how cancer impairs a patient’s social networks.
Portraying Cancer Pain and the Declining Physical Body
Typically, A’Jian would narrate his physical pain by describing his body condition impacted by the disease. Individuals without cancer cannot maintain empathy in the position of cancer patients to understand how painful it is because cancer pain is usually associated with subjective components of physical damage and is often expressed as an unpleasant sensory and emotional experience (Raja et al., 2020; Zajacova et al., 2021). A’Jian used languages such as ‘rolling up on the bed’, ‘curling up together’, ‘the pain in stomach is lasting for a day and a night’ and ‘cannot speak’ to show the torments of cancer pain on him. For instance, on 11 October 2020, A’Jian posted a video called ‘a patient with advanced cancer tells you what cancer pain is and why he is afraid and scared’ to describe his condition when the pain came:
Cancer pain would bring me very negative emotions. While in pain, my family and children did not dare to be together with me. If they spoke with me or consoled me while I was in pain, I would shout at them, whoever they were. At the time, I was out of control. No matter how strong your will is, the cancer pain will beat you up.
Cancer pain is not an injury caused by a small fall. Instead, it has haunted cancer patients since the first day. With the exacerbation of this disease, any techniques such as drugs, physical methods and even neurosurgical means cannot alleviate the physical symptoms (Baszanger, 1992). As A’Jian said on 28 May 2021: ‘Last night, I felt painful till around 4 am, and I feel exhausted today’. This feeling is not the only time or two. On the contrary, A’Jian mentioned that he would be woken up by the pain every night: ‘I have almost forgotten the feeling of sleeping like a log since the day I got cancer … It is luxurious for me to sleep for two hours now continuously’. The ceaseless pain made him accept it in a joking tone:
In fact, this pain sometimes is an enjoyable thing for me. It makes me forget other disorders in my body.
Aside from cancer pain, A’Jian also posted several videos to update his declining body condition. After diagnosis, cancer becomes an impairment of the normal state of the living body, even a threat to social life (Karos et al., 2018; Raffaeli & Arnaudo, 2017). On 25 and 27 January 2021, he said his urethra was blocked, so he had to ask for help from the doctor. Aside from this, he also recorded other conditions such as ‘the plan to have chemotherapy drugs’, ‘the plan to do operations in the future’, ‘losing much weight’ and ‘hope to have an intravenous drip in order to have a good Chinese New Year’. In addition, the most representative story here is that he tried to stop eating meals to fight against the pain. On 19 May 2021, he first expressed that his body would be relatively cozy if he did not have any food. He could bear the pain, though the body was still uncomfortable in such a condition. On 20 May 2021, he sustained having nothing for 3 days in order to be more bearable:
It has been three days since I have had anything. Instead of feeling hungry, I am sweating all the time, just like having a shower. And I do not have the power to speak, I feel very tired just speaking only a few words. However, my body is not as painful as that before
On 22 May 2021, the fifth day of fasting for A’Jian, he seemed much weaker than before.
I feel like I really cannot make it if I continue to stop eating food. In the morning, I did not have any strength while in pain. After taking painkillers twice, I felt better then. If I kept doing this, I would be gone first before being smashed by devilish cancer.
From A’Jian’s video expressions, his vlogs absolutely became his ‘pain worlds’ (Gonzalez-Polledo, 2016, p. 2), displaying desperate cancer pain he had experienced. In his physical space, cancer pain consists of the first difficulty he had to face alone and the most significant change in his disease course.
Sharing Informal Cancer Knowledge via a Fragile Body
As outlined in the above literature review, cancer pain indeed threatens patients’ basic needs, including the emotional and social dimensions (Karos et al., 2018). Blogs are usually valuable tools for patients to seek related cancer information (Kim & Lee, 2014). As a cancer patient, A’Jian also narrated unprofessional cancer knowledge for the lay public and other cancer patients in short videos by reflecting on his personal fragile body. First, A’Jian posted several videos about cancer itself, such as ‘what is cancer pain’ and the introduction of medicines to relieve his pain. On top of explaining cancer pain, the symptoms before cancer and symptoms after chemotherapy are also the main contents A’Jian liked to share with audiences. For instance, on 27 December 2020, he told the audience about his body condition before he was diagnosed as a cancer patient:
It was not apparent in the first place for me before I was recognized as a cancer patient. The very first condition for me is the increased urge to go to the toilet, not feces. It was not that I wanted to defecate every day, just either good or bad sometimes. I thought that I was constipated. So, I did not pay much attention to that. After a while, this condition became more frequent, sometimes resulting in stomach aches or bellyaches. The doctor said that it was Helicobacter pylori or other reasons, which I could not remember.
Second, A’Jian also recorded his past negative lifestyles and body symptoms as a warning for the public. These contents echo with the TikTok educating function for cancer patients (Pluta & Siuda, 2024). Sometimes, patients hope to inform and warn others to avoid the possibility of getting cancer by changing their personal unhealthy lifestyles. In this situation, he somewhat undertook a different role in supporting other people by information sharing (Iannarino, 2018). The extracts below show a detailed description of A’Jian’s past body condition:
I had the habit of drinking and smoking before. I kind of smoked a pack of cigarettes a day. As for alcohol, I normally drink 3 to 4 times a month. My everyday diet was not very regular. I also stayed up late … (9 May 2021). In the early times, it was apparent to defecate frequently, sometimes with bellyaches. My appetite was not very good, either. Initially, these symptoms were not easy to identify. While I was getting the treatment, most patients did not pay close attention to that or just treated it as a stomach-ache … (2 June 2020).
After a cancer diagnosis, patients typically would like to seek relevant information through online support networks, groups and blogs in the digital era (Kim & Lee, 2014). This is a practical and straightforward way for people with cancer to get a sense of assurance and reduce the uncertainty. Through his personal embodied cancer experience, A’Jian used unsolicited videos to chronicle individual suggestions for the lay public, echoing the point of how cancer gradually impacted his physical body.
Desiring to Live a Normal Life Like an Ordinary Person
Uncertainty can be a common experience in the context of illness (Miller, 2015), particularly for people with chronic disease and cancer. The previous everyday life is suddenly interrupted by cancer. A’Jian also had a similar feeling that he could not have a promising future with a normal trajectory like every ordinary person. First, financial hardship was the most challenging thing for him, because he could not do anything but wait to end his life. He mentioned his rough family situation several times in the vlogs, which was the main reason he could not go to the hospital to get treatment. He even wanted to do a part-time job to earn some money. As he noted below about being a streamer:
I have got an idea of doing livestreaming to sell some products. Because of my body condition, there was no suitable job for me. I think livestreaming can be a bit time flexible. I can do it for some time when my body condition improves (16 May 2021).
Second, A’Jian felt extremely miserable facing the incurable cancer. He used phrases such as ‘hopeless life’, ‘pessimistic attitude’ and ‘too many life obstacles’ to describe his plight. For example, on 4 May 2021, he expressed how hard it was to bear cancer pain every day like usual. Suddenly, he cried desperately with a sentence: ‘why is life so hard …?’ It showed that A’Jian’s insides had collapsed because of the daily torture of cancer.
However, A’Jian did not lose the hope to get back to the normal world. On 11 January 2021, he quoted a piece of good news saying that a cancer patient had been cured in 4 months. He was looking forward to efficacious anti-cancer medicines in the future. In addition, he also told the audience about his pleasant dream one night:
I had the same dream several times. In the dream, one of my uploaded videos became very popular. Many people helped me, and I eventually became rich. Then, I can afford the cost of the operation. I woke up from the dream with a big smile (6 June 2021).
Furthermore, A’Jian also expressed his loneliness since the cancer diagnosis. During the Spring Festival in 2022, he posted a video sharing his loneliness and helplessness. On 16th January 2021, he said similar feelings again:
Do I have to live a devilish life forever? Since the day when I was diagnosed with colon cancer, I did not even have a person to communicate with my inner thoughts. I was regulating my mood by myself, just like a dog hidden in the dark corner, licking the wound.
In August 2021, after 2 months of suspending filming videos, A’Jian started to do it again. In this final period of his life, he said ‘he was still there’ two times to express that he was persisting in fighting against cancer. Overall, A’Jian’s normal life had been undermined by cancer. Typically, he should have lived with his family in a visible, established social trajectory. However, his relationships with society were torn down fiercely. The incurability of cancer had affectively haunted himself (Broom et al., 2018).
Concerning Daughters and Parents
Being diagnosed as a cancer patient means a fundamental reshaping of one’s relationship (Williams Veazey et al., 2025). Cancer patients and their close supporters both must endure an altered life impaired by cancer (Iannarino, 2018). For A’Jian, discontinuing kinship with his daughters was his most significant concern. Every time he mentioned his daughters, he expressed tremendous guilt because he would be unable to accompany them in the future. Initially, he would sometimes film a few joyful moments with his daughters in daily lives. For example, in the fifth video, he took his younger daughter to buy a birthday present for both his daughters. On 7 June 2020, he presented photos of his two daughters and their room, which featured a playhouse corner. In this video, A’Jian shared a story to show why he was upset about his helplessness to leave his daughters alone:
I typically had meals at my mom’s house every day. Sometimes, I had no appetite, so I did not go there for the meal. Then, my mom would have a joke with my daughters. My daughters asked my mom why dad was not coming for the meal. My mom would say I was a bad child. So, my mom was not preparing my meal. Then, they would not agree, continuing to ask why: ‘If you do not care about our dad, then we do not eat, either. (“Then, A’Jian was on the verge of tears.”).
Because of cancer, he did not even have the chance to go on a spring excursion with his daughters (24 April 2021). Thinking of children’s care for A’Jian, he knew he had the mission to try to live well and fight against cancer though his body was getting weaker and weaker. On 11 May 2021, he told a story about his daughters’ innocent care:
Last night, seeing that I was feeling very unwell. They went out to buy this bowl of strawberries [A’Jian showed the fruit to the audience in front of the camera], using their own pocket money, 20 Chinese Yuan. They said that having more fruit can help me return to normal because I don’t eat fruit in my daily life. They wanted to save money to buy some for me
Consequently, A’Jian wanted to persist whenever he wanted to give up. His mom also said: ‘you do not need to care about other people, but do you want to leave your daughters alone?’ Seeing his daughters crying miserably in front of him, A‘Jian could not be heartless anymore and leave his daughters alone. ‘My mom said your children could have a dad if you lived longer. They could have a person to call dad (after school)’ (14 August 2021). On 14 May 2021, he also expressed a similar concern:
Whatever the end, I just hope my daughters can find a person to call dad after school. Typically, my daughters would go home first, seeing me in good condition, and calling dad. Then, they would go out to have fun. A’Jian is afraid that they cannot find me one day after school. There is no one person for them to call dad. That is not what I want.
In addition, A’Jian felt guilt for his parents. On 8 December 2020, he described how much misery he brought to his parents:
In fact, the most miserable people are my parents. They would never give up if they got any measures. When I saw my parents full of self-accusation and helplessness, people could not understand this without experiences like mine. No parent would give up their child; it is just that they do not have the necessary abilities.
A’Jian felt very guilty for his parents’ suffering in life after his diagnosis of cancer. He said his mother was very weak and needed to take care of his daughters. His mother’s life was wrecked brutally by life (13 August 2021). Because of the unfortunate news of receiving a cancer diagnosis, he felt life was continuously smashing his family. Incurable cancer constantly ruins patients’ social bonds with their families. Individuals would find it hard to live without recalibration of their contact with family members (Lewis et al., 2024).
Discussion and Conclusion
This research aimed to gain an understanding of the personal experiences that cancer patients narrated, as afforded by short videos. My analysis of one case (A’Jian) revealed that a patient’s physical and social spaces are impaired brutally by the incurable disease cancer. To present the findings more theoretically, I exploratorily applied the disease course, which is extended from life course theory, to organise the whole analytical framework, which mainly focuses on the changes, turning points and transitions in the disease course. Based on my findings, I suggest that cancer brings the patient (A’Jian) four significant aspects of fundamental dilemmas in the whole disease course. It means that these changes in the disease course consist of cancer patients’ ‘vital needs’ (Elder et al., 2007, p. 3; Mayer, 2009). This analysis, to some extent, provides practical directions for curing cancer patients in the future.
Previous research has analysed cancer’s significant influence on patients, such as biographical disruption (Iannarino, 2018), survivors’ uncertainty (Miller, 2015) and even survivor couples’ identity challenges (Miller & Caughlin, 2013). My research, to some extent, maintained consistency in comparison to past research, reaffirming the destructive features of cancer. However, I reframed how the patient (A’Jian) narrated the relationships between cancer and his body, as well as the relationships with social networks in real life (physical space and social space). The findings provide a different interpreting lens by focusing on how the patient perceives his relationships with two different spaces. Namely, the changes in the relationships between the patient and the physical/social space constitute the most significant crisis. Also, this explanation moves beyond the temporal narrative structure influenced by cancer. Instead, it intends to clarify how the patient (A’Jian) perceives the most noticeable dilemmas after receiving the diagnosis. In other words, cancer can have significant influences on patients in different stages, such as the beginning, the middle and the end (Elder et al., 2007; Wen et al., 2011); however, it is more important to map out how cancer patients perceive these dilemmas that cut off their normal life trajectories in the whole disease course. Therefore, this study suggests that the destructive effects of cancer on patients’ physical space and social space are the most significant changes for them in the final stage of life.
In addition, the above findings are captured through the affordance of short videos. The positive function of new communication technology in health, such as personal home pages, has been identified by previous research as a potential area for investigation (Hardey, 2002). Relevant research has been conducted to uncover how patients use social media platforms such as Instagram and Tumblr to narrate cancer pain (Gonzalez-Polledo, 2016; Gonzalez-Polledo & Tarr, 2016; Sendra & Farré, 2020). This study adds the different genres of short videos to investigate what and how cancer patients adopt short videos to narrate personal cancer experiences, aligning with the new trend in the TikTok (short video) era because of the easy fabrication of short videos. The affordance of short videos helps cancer patients move into this new communication setting to solve personal problems or at least relieve private dilemmas, which can be a fresh research path for future health-related research.
There are limitations to this current work. As discussed above, this study uncovers the potential of short videos to narrate personal cancer experiences. However, it currently only focuses on what and how people adopt short videos to manage their issues, which only reveals the high possibilities of short videos as a different tool to help cancer patients. Therefore, future research can further examine why and how patients use them. Also, this study only analyses a cancer patient’s online vlogging case. Due to this trait, this research lacks generalisability for all cancer patients. In future research, interviewing a few internet celebrities such as Douyin (TikTok) influencers might be a potential way to explore more cancer patients’ feelings about being a vlogger influencer on social media, which can unpack a more significant explanation of cancer patients’ thoughts in this final stage of their life, afforded by short videos. In addition, this case is from one male adult. For future interview research, it would be beneficial to recruit both males and females in a balanced manner to avoid sample homogeneity.
Footnotes
Declaration of Conflicting Interests
The author declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
Funding
The author disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This research is jointly supported by Loughborough University and China Scholarship Council [202206780005].