Paper short abstract:

In this presentation, we explore the experiences of cancer patients living in economic and social precarity in France. We focus on the inequities in access to health care and conceptualizations of cancer among these vulnerable populations residing in a high-resource country.

Paper long abstract:

In this presentation, we explore the experiences of cancer patients living in economic and social precarity in France. We focus on the inequities in access to health care among these vulnerable populations residing in a high-resource country with a national health system. In addition, we present the results of ethnographic research which illustrate the lived experience of cancer from the perspective of patients in conditions of marginality, such as undocumented immigrants. We draw on a four-year study of West African breast cancer patients under treatment in Paris public hospitals, and an ongoing study of health insurance coverage for undocumented immigrants in the cities of Paris and Bordeaux, to identify the constraints confronted by low-income cancer patients and the creative strategies mobilized to obtain support from clinicians, social workers, interpreters, kin, and grassroots organizations. We examine how structurally vulnerable patients navigate bureaucracies, institutional conventions, and diverse discourses of risk as they confront a cancer diagnosis and assess the merits of treatment options presented to them. Decisions regarding whether or not to begin biomedical treatment, such as surgery or chemotherapy, to continue with treatment, or to seek alternative remedies such as ritual therapies involve working through complex conceptualizations of cancer as a stigmatized disease category, the subjective experience of cancer for the patient, and the collective disruption to transnational family networks.