Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Buying time: incurable prognosis, temporal uncertainty and the financial and emotional costs of metastatic cancer   (126376)

Andrea L Smith 1 , Marika Franklin 2 , Giselle Newton 3 , Katherine Kenny 2 , Frances Boyle 4 , Sophie Lewis 2
  1. The Daffodil Centre, University of Sydney, Sydney, NSW, Australia
  2. University of Sydney, Camperdown, NSW, Australia
  3. Centre for Digital Cultures and Societies, University of Queensland, Brisbane
  4. School of Medicine, University of Sydney, Sydney, NSW, Australia

Aim
To explore how women with metastatic breast cancer (MBC) navigate the complexities of time, resources (financial), identity, and relationships when living with a ‘contracted future’ of uncertain duration, and how this shapes their present and future planning.

Methods
We conducted up to three in-depth interviews over a 12-month period with 38 women living with MBC in Australia. Interviews explored cancer experiences, health management, resource allocation, and relationships. Data were collected August 2017-January 2020 and analysed using Braun and Clarke’s reflexive thematic analysis.

Findings

We identified five themes: (1) the imperative of ‘quality time’; (2) temporal disconnection or ‘out-of-sync timing’; (3) ‘making time’ through treatment; (4) planning amid uncertainty (‘time mis/calculations’); and (5) the shifting ‘tempo of living beyond prognosis’. Women navigated complex pressures to live well, die well, and be remembered well, often at significant social, emotional, and financial cost. These pressures generated questions regarding what constitutes responsible allocation of one’s time and money in both the present and the future. Critically, access to economic resources shaped how time was lived and spent well for these women. These women were caught in an ever contracting and protracting, complex temporal entanglement involving renegotiations, reimaginations and reprioritisations of both contracted and protracted time.

Conclusions

Our study illuminates the economic and social factors that shape how time is spent well by those with metastatic disease. Our findings demonstrate that the pursuit of a quality life and longer life can render individuals in a financially and emotionally precarious situation. This precarity is most acutely felt by those with fewer economic resources. Further attention should be focused on understanding what is needed to support people who are ‘outliving’ their prognosis, both in Australia and internationally, particularly those with fewer resources whose quality of life may be at greater risk.