Prostate cancer: a “limnal” experience

“Liminality” and “biographical disruption” are not terms familiar to the average prostate cancer patient — unless perhaps that patient is a social anthropologist.

These two terms are used to discuss specific aspects of life-affecting events that may either change the relationship of a person to others around him or place him into some form of socially transformed state for a period of time. So, to use an easily understood example, bar mitzvah is a “limnal” event for a Jewish boy because it ritualizes his understanding that it is time for him to take responsibility for his own actions. He has “come of age.”

A paper published recently in Supportive Care in Cancer addresses the diagnosis of prostate cancer as a limnal or biographically disruptive event for men. It profoundly changes many of their lives in unexpected ways. And for some men it may indeed place them, for extended periods of time, into what may feel like a socially “isolated” state of mind — rather like being a stateless person who no longer has a legal “home.”

One may be tempted to think that this is just psychosocial babble at a first glance, but there are some very good reasons why a closer medical understanding of this effect may underlie almost everything about how an initial diagnosis of prostate cancer (or indeed any cancer) needs to be addressed. It is all too common to hear that prostate cancer patients didn’t really understand their situation or the risks involved with different types of treatment until well after the event. The failure to make sure that men and their partners really appreciate the life-changing nature of a diagnosis of prostate cancer may be at the very core of what needs to happen to change perceptions about this disorder.

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