Narrative medicine applications for neuro-oncology patient identity and quality of life

Brain cancer and its treatments bring a unique threat to the patient’s identity and quality of life by challenging their essential identity in significant ways, possibly including impaired cognitive skills, loss of memory, reduced coordination, altered feeling states, and limited capacity for self-expression. These impairments may have a devastating and worsening impact on the patient as the cancer progresses and may be exacerbated by the side effects of treatment. This presentation will consider possible applications for Narrative Medicine (NM) to help these patients retain and rediscover self-identity. NM encourages patients to engage their stories of illness and treatment through guided conversations and emotional writing, with attentive listening at the heart of NM sessions. Patient experiences may be shared in conversation with a NM provider, or written in a patient journal and discussed at a later time. NM sessions were incorporated into the care of patients with brain tumors at the University of Kentucky Neuro-Oncology Program. NM made visible contributions for patients discussed in the case histories of this study. Understanding the patient’s story is critical for evaluating the significance of impairments due to brain cancer and treatment relative to the patient’s unique sense of self and quality of life. NM is at the nexus of clinical management and quality of life concerns for brain cancer patients. Insights from NM sessions may also help the treatment team as they assess patient needs, attitude, and abilities. This presentation will help the audience to understand the personal and unique impact of brain cancer on each neuro-oncology patient and the need for Narrative Medicine (NM) interventions and appropriate responses by all treatment team members to ameliorate the impact of these symptoms for improved patient quality of life.