Navigating fatherhood and identity reconstruction among fathers with nasopharyngeal carcinoma: A qualitative study

Objective: Nasopharyngeal carcinoma (NPC) is highly prevalent in East Asia among working-age men, and chemoradiotherapy causes severe side effects and late effects threatening cancer survivors' quality of life and parenting practices. This study aims to examine the reconstruction of fatherhood and paternal identity among male NPC survivors. Methods: This qualitative narrative inquiry design, with in-depth narrative interviews conducted with 20 middle-aged Chinese fathers with NPC. These participants are recruited through snowball strategies and are located in a regional cancer center in southern China. Thematic analysis was applied for data interpretation. Results: The findings demonstrate that embodied disruption from treatment undermines the traditional breadwinner role. This crisis is amplified by three major themes: (1) embodied disruption and identity continuity, (2) silent institutions: an amplifier of the cancer-related life disruption, and (3) reconstructing fatherhood: from breadwinner to emotional companion. Conclusions: Fathers' experiences reflected an institutionally magnified disruption, in which treatment-related impairment was intensified by gaps in social and institutional support, producing a broader crisis of livelihood and identity. In response, fatherhood was reconstructed not as a free choice, but as a constrained adaptation under structural and gendered pressures. These findings extend biographical disruption theory in the Chinese context and highlight the need for improved sick-leave protection and family-oriented psychosocial care for male cancer survivors.