INVENTING NEOLOGISMS ���REGARDING BREAST CANCER ���IN THE REPUBLIC OF KOREA

Miwon Seo, Ph. D candidate Ecole des Hautes Etudes en Sciences Sociales, Cadis-CRC MIWON.SEO [AT]GMAIL.COM

At the conference “Qualitative Cancer Research: Taking Stock, Stepping Further”

April 29th, 2014. at 2 p.m. Berlin School of Public Health, Charité Universitätsmedizin Berlin, Germany

ABSTRACT

!   Objectives:

o  Understanding the usage of newly created expressions to call cancer

o  Neologism: a newly made expression with existing words, to give a new meaning

o  Link to patients’ subjectivity

!   In Seoul, Republic of Korea, Ethnography and semi-structured interviews

! Grounded Theory (Glaser & Strauss, 1967; Strauss & Corbin, 1990, Charmaz, 2006)

OUTLINE

! Fact sheets on cancer in ROK

! Neologisms

! Neologisms : who and why use them?

!   Discussion

!   Conclusion

FACT SHEET : ROK, CANCER���Cancer Incidence

!   Cancer incidence: from 111,234 (2001) to 218,017 (2011)

!   Cancer incidence among women: from 43,756 to 107,866

!   Breast cancer incidence in women: from 7,116 to 15,942

0

50000

100000

150000

200000

250000

2001 2011

Whole population

Women

Breast cancer in women

Source : Korea Statistical Information Service, 2013

FACT SHEETS : ROK, CANCER���WORLD COMPARISON

21,6 22,9

27,2 28,3

36,2 38,9 40,1 41,0 42,3 42,7 43,2 44,9

48,9 50,2

53,4 57,9

60,0 61,0

65,5 67,7

69,9 71,6

76,0 76,2

81,8 82,3 82,7 83,2 84,8 86,2 86,3 86,6 87,9 89,1 89,4 89,4

93,9 96,8 96,8

99,7 109,4

0 25 50 75 100 125 150

China India

Mexico Turkey

Indonesia Korea Chile

South Africa Brazil Japan

Russian Fed. Greece Poland Estonia

Slovak Republic Hungary Portugal

Spain Slovenia

Czech Republic Austria OECD

United States Norway

Germany Luxembourg

Sweden Canada

Australia Iceland

Italy Finland

United Kingdom Denmark

New Zealand Switzerland

Ireland Israel

Netherlands France

Belgium

Age-standardised rates per 100 000 females

•  Belgium : 109.4 •  France: 99.7 •  South Korea: 38.9

•  Age-standardised rates per 100 000 females •  Female breast cancer incidence rates (OECD, 2008)

FACT SHEET : ROK, CANCER��� Five-year Relative Survival Rate

Source : Korea Statistical Information Service, 2013

 0,0

 10,0

 20,0

 30,0

 40,0

 50,0

 60,0

 70,0

 80,0

 90,0

 100,0

1993-1995 1996-2000 2001-2005 2006-2010 2007-2011

All Cancer

Women

Women with Breast Cancer

FACT SHEET : ROK, CANCER��� Five-year Relative Survival Rate

5-year Relative Survival Rate of Breast cancer patients (2007-2011) 91.3%

The total number of female breast cancer survivors

202,751

NEOLOGISM��� WHY IMPORTANT?

!   To observe the underlying values in coping with a cancer.

!   Relation with inner struggles of patients and all the interactions that she has with the other people

!   With a physician's discourse

!   With a physician’s social roles

!   Any rules control over what he says?

NEOLOGISM��� WHY IMPORTANT?

!   Legislative framework

“By type, a medical person has the mission to seek the improvement of public health and contribute to help citizens enjoy

healthy lives by performing his/her mission specified in the following subparagraphs, respectively:

A medical doctor's mission is to administer medical treatment and to provide guidance for health.”

(Official translation of Medical Service Act, Chapter 1. Article 2. wholly amended on Apr. 11, 2007)

NEOLOGISM��� WHY IMPORTANT?

§  Legislative framework

“Except otherwise as provided by this Act or other Acts and subordinate statutes, a medical person shall not divulge or disclose

any person's confidential information he/she becomes aware of in the course of performing medical treatment, assistance in childbirth, or

nursing.”

(Official translation of Medical Service Act, Chapter 2. Article 19 (Prohibition of Disclosure of Confidential Information))

NEOLOGISMS IN USE

Chakhan Am

(착한암)

Pancrea

cancer

Breast cancer

Sunhan Am (순한암)

Yamjŏnhan Am

(얌전한암)

Myŏngpum Am

(명품암)

Thyroid cancer

Kŏbugi Am (거북이 암)

KEYWORDS

Am (암 /am/): a cancer

KEYWORDS

Chakhan (착한 /chakhan/): (kind) not causing harm or damage; generous; helpful

KEYWORDS

Sunhan (순한 /sunhan/): (tame) not wild or dangerous

KEYWORDS

! Yamjŏnhan (얌전한 /yamŏnhan/): (well-behaved) silent, self-possessed

KEYWORDS

Nappŭn (나쁜 /nappŭn/): (bad, evil) the opposite word of ‘chakhan’

KEYWORDS

Kŏbugi (거북이 /geobugi/): a turtle

(meaning being slow like almost everywhere in the world)

KEYWORDS

Myŏngpum (명품 /myŏngpum/): luxury goods

KEYWORDS

! Ajumma (아줌마 /adjumma/): married, mostly middle-aged, who spent most of her life for the well-being of her family

NEOLOGISMS USED IN NEWSPAPERS

!   To assert that the life is not threatened by cancer

The five-year survival rate of pancreatic neuroendocrine cancer that Steve Jobs have is over 50 %. Medical circles thus say that Jobs got 'chakhan am’. (Joongang Daily, 5th Mar. 2011)

'Chakhan am' is cancer that barely threatens life. (Hwang (M.D.), Daily Kyunghyang, 8th Mar. 2014)

NEOLOGISM USED BY WOMEN ���WITH BREAST CANCER

The president of the national breast patients’ association said, “breast cancer grows slowly and the survivor rate is high, so it is named as ‘chakhan am’”. Detected early, the survival rate of breast cancer is over 95 %. (Joongang Daily, 2nd Sep. 2013)

“The president of our self-help group heard that she had a 'chakhan am' cancer from her doctor, she was operated three years ago. I didn't realize that our doctor uses 'chakhan' or 'nappŭn' for cancer. He told the president that she had a 'chakhan am’ (she didn't hear him saying it before)”. (Interview with a patient named Hanna, Feb. 24, 2014)

NEOLOGISMS USED IN NEWSPAPERS

!   To build a contrast between the newly built belief and the expert’s opinion

Many people consider small-sized thyroid cancer (smaller than 5mm of diametre) as 'chakhan am’, which sometimes leads them not to remove it. So called 'kŏbugi am', thyroid cancer grows slowly, thus there is no urgency to remove it, but it should be removed one day. (Maeil Daily, 26th Jul. 2013)

As thyroid cancer grows more slowly than other cancers, it is called 'kŏbugi am'. However, if we leave it in the body, the character of cancer changes into an evil one. (interview with Park (M.D.), Chosun Daily, 2nd Aug. 2013)

NEOLOGISM USED BY WOMEN ���WITH BREAST CANCER

!   To highlight the positive side of having a cancer and consider it as a turning point

!   “I did not name breast cancer a ‘myŏngpm am' by chance. This is a ‘myŏngpm am’, as there are many women who are well treated after being ill. Their livelihood has been changed. They look back on their own life and they change also what they were wrong.” (Interview, 29th Oct. 2013)

NEOLOGISM USED BY WOMEN ���WITH BREAST CANCER

Hanna: Do you know what a 'chakhan am’?

Me: Well, thyroid cancer is named as 'chakhan am’.

Hanna: No, I met a patient who got thyroid cancer three years ago, her doctor told her that not every cancer is bad, but the one with higher degree of aggressiveness is a 'nappŭn’ (evil or bad) one.

Me: You learned that your cancer is a 'nappŭn am’ after gathering information with your closest people then from your doctor.

Hanna: I would like to hear the same thing from my doctor. In spite of my leading questions, he never said that.

(Interview with Hanna, 24th Feb. 2014)

DISCUSSION

!   A cliché

!   In a continuous negotiation process

!   A fluctuating adjustment process

!   Positioning of physicians far less forceful and designating and putting emphasis on individual's autonomy and responsibility

!   Individual's autonomy and responsibilities to patients’ side to take good care of their body.

DISCUSSION

!   No consensus for their usage, but more restrictive usage in written sources

!   Little space for debate and discussions engaging biomedical knowledge

!   The need for democratization of knowledge on the disease from the experts' side

!   Interpretations on personal illness experience from patients’ side

CONCLUSION

!   A change from an authoritarian, paternalistic attitude to a more responsive and sensitive perception of the patient

!   Patients who feel free and confident to consent to treatments that a physician suggests

!   Power relation between patient and doctor : money

! What is a good communication?

REFERENCES

u  Grounded Theory

•  Barney G. Glaser; Anselm L. Strauss (1967), The discovery of grounded theory: strategies for qualitative research. Chicago.: Aldine.

•  Anselm L. Strauss; Juliet Corbin (1990), Basics of Qualitative Research: Grounded Theory Procedures and Techniques, Sage

•  Charmaz, K. (2006). Constructing grounded theory : a practical guide through qualitative analysis. London; Thousand Oaks, Calif.: Sage Publications 

•  Chapter 10. Qualitative Data Analysis, p. 320-357 in Russell K. Schutt (2012) Investigating the Social World: The Process and Practice of Research: Seventh Edition, SAGE Publications, Inc, 2012.

REFERENCES

u  More on Korean Breast Cancer Patients

•  Myungsun Yi et al. “Informational Needs of Korean Women with Breast Cancer: Cross-Cultural Adaptation of the Toronto Informational Needs Questionnaire of Breast Cancer”, Asian Nursing Research, December 2007;1(3):176-186.

•  Nelson, Laura C. 2012. “Diagnosing Breast Cancer in South Korea: ‘Western’ Behaviors, Stress, and Survivor Activism.” Journal of Korean Studies, 17 (2): 253–68. doi:10.1353/jks.2012.0020.

THANK YOU FOR LISTENING ������

IF YOU HAVE QUESTIONS ���PLEASE EMAIL ME AT MIWON.SEO [AT]GMAIL.COM

Research Funding : French National Institute of Cancer 2013-2015

Ph. D under supervision of Philippe Bataille and Alain Delissen