The "invisible scars" of breast cancer treatments

Inspired by Marcia Inhorn's article "Defining Women´s Health. A Dozen Messages from More than 150 Ethnographies" (2006) a key dimension of my doctoral work was to focus on how Spanish women living with breast cancer define their own health priorities. Drawing on 38 fieldwork interviews with women living with breast cancer conducted in Spain between 2006 and 2008, I draw attention to the significance of what Ludica (2013) refers to as the "invisible scars of cancer" for a holistic understanding of women's experiences. I highlight two under acknowledged thematic concerns that emerged during our conversations: (1) the impact of treatments on women's ability to experience sexual pleasure; (2) the pain caused by axillary lymph node dissection (ALND) or armpit surgery. The aim of this paper is two-fold. First, to spark debate on some of the pressing problems affecting women living with breast cancer in Spain, which may be generalizable to other contexts. A second objective is to challenge the popular idea that a breast cancer survivorship is a wonderful journey through "cancerland". Dominant biomedical and mass-media tendencies in conceptualising survivorship have treated it in terms of a positive "transformative journey" that softens the disease. The most invoked image is that of the courageous, energetic, selfless and optimistic heroin. It is my premise that these invisible scars are often missing or simply obscured in the framings of medical and anthropological research as well as public discussions when they do not fit the "monovocal discourse" of breast cancer (Sandell, 2008). The present article is a timely reminder of the fact that for a shockingly high number of women diagnosed, the experience of breast cancer is emotionally and physically painful and quite often disabling. An understanding of women's experiences is essential to provide resources more sensitive to women's needs.