Ghosts in the machinery: Living with and beyond radiotherapy treatment for gynaecological cancer.

This paper explores post-treatment experiences of women who have had radiotherapy for gynaecological cancer. Drawing on data from a project which explored post-treatment wellbeing, conceptual metaphors of ghosts/haunting are used to engage with enduring legacies of cancer and 'neglected matters' in post-treatment trajectories. Current arrangements of care contribute to the idea that participants are 'out of the other side of cancer' once active treatment completes. Despite broader ambitions for holistic cancer rehabilitation, fragilities of body and mind persist, even when the outward representation is one of health, of looking well, of moving on. We show how neglected matters of cancer (visceral late effects, psychological suffering and lives not lived) are part of living with and beyond cancer. These 'ghosts' manifest in chronic states of unsettledness that are temporarily relieved by individualised 'fixes', such as mobilisation of 'mind over matter' discourse and mindfulness. This discourse and its associated tools are a powerful yet impoverished framing of approaches to living with and beyond cancer. We argue for the need to attend to 'neglected matters' of post-treatment trajectories differently.

The ambivalence of radiotherapy: Re-framing effects and their temporalities in treatment for gynaecological cancer.

Within the biomedical paradigm, treatment effects are typically split into primary and secondary effects with temporality playing a key role in this separation. Yet, this kind of ordering of effects with some effects understood as happening on the 'side', secondary and temporary, does not fit with how they are experienced by many patients who undergo treatment for cancer. Drawing on empirical data from a research project that gathered narratives of women's experiences of radiotherapy for gynaecological cancer, we observe radiotherapeutic effects that are experienced as ambivalent and temporally diverse and as overlapping demands that the women endure and manage. We propose Derrida's concept of pharmakon as a relevant and useful analytic for understanding radiotherapy treatment, thus bringing into focus the ambivalent effects of radiotherapy - it is both therapeutic and toxic. Pharmakon, we argue, offers a way of disrupting the logics that govern current practices of therapeutic radiotherapy, and provides a way to re-negotiate the ordering and temporal understandings and practices of therapeutic efficacy, outcome and accountability of radiotherapy treatment - away from a temporal fragmentation of treatment effects and patients' bodily experiences to a focus on how best to support the whole patient in living with the ambivalent, temporally diverse and overlapping effects and demands of treatment.