‘Biographical continuity’: A qualitative study of the role of complementary and alternative medicine in restoring the self after breast cancer diagnosis

• Women with breast cancer used varied Complementary and Alternative Medicines (CAM) • CAM helped them cope with cancer’s ‘biographical disruption’ • CAM supported them in restoring a sense of normality and carrying on with life • They faced tensions in combining CAM with biomedical treatment • These tensions should be acknowledged in the cancer clinical encounter Breast cancer patients frequently use complementary and alternative medicine (CAM) alongside biomedical treatment for symptom relief and to address the disruption caused by diagnosis and treatment. These experiences, however, are often overlooked within the cancer clinical encounter. This study explored CAM use in women with breast cancer, focusing on three main research questions: Why do women with breast cancer use CAM? In what ways does CAM help them maintain or regain a sense of normality? What barriers or tensions do they face when considering or using CAM? This study used a qualitative interpretative-constructivist research design to analyse the subjective meanings women with breast cancer ascribed to their CAM use during their breast cancer journey. Unstructured interviews were conducted with nine female breast cancer patients undertaking treatment at a major NHS cancer Centre in Southeast England. The interviews were analysed using a reflexive thematic analysis. These women engaged with a wide range of CAM therapies during their cancer journey. CAM was used not only to alleviate symptoms, but also to restore a sense of ‘ordinariness’ and biographical continuity. Central to this process were practices of self-care, self-help, and self-management, and the collaboration of CAM practitioners and open-minded medical doctors. Barriers included dominant biomedical approaches, limited information sharing and communication about CAM, financial and geographical constraints, and little clinical validation by medical staff. These women experienced tensions and conflicts when trying to use CAM alongside cancer treatment. They sought overall well-being but often encountered barriers to accessing CAM and sharing their experiences within a biomedical context. This study highlights the role and value of CAM in restoring a sense of normality in the lives of breast cancer survivors, and recommends raising professional awareness of CAM use by women with breast cancer, normalising CAM dialogue in the clinical encounter, and considering relational care in training.