Abstract: “We Named My Brainstem Lesion Harold”: A Normative Approach to Humor Use in Young Adult Cancer Patients and Their Supporters

◆ Nick Iannarino, University of Michigan-Dearborn

Young adult cancer patients (i.e., 18-39; YAs) have been shown to use illness-related humor to help them discuss their cancer experience more openly (Chapple & Ziebland, 2004). However, we do not know the range of ways YA patients and their social network members use humor to make sense of and cope with their illness. Thus, I use normative rhetorical theory (NRT; Goldsmith, 2019) to describe the dilemmas and meanings of humorous messages and the features that make these messages better or worse in this context.


I conducted individual narrative interviews with 21 YA patient-close supporter dyads, 1 triad, 9 individual YA patients, and 8 individual supporters (N=62). I used surprise-liberation theory (SLT; duPre, 1998) to define humor as a surprising deviation from an expectation that causes a pleasurable liberation. I also used constant comparison (Strauss & Corbin, 1998) to explore connections between NRT, SLT, and participants’ descriptions of their uses and evaluations of humorous messages.


Participants used cancer-related humor with social network members to temporarily liberate themselves from their rumination and fear. By demonstrating that it was okay to joke about their cancer, most participants felt that violating others’ expectations of the staid victimhood that typically surrounds cancer made interactions with loved ones easier, which set the tone for the type of support they wanted to receive in return. Humor was used to remind others that despite their diagnosis, participants’ valued identities and relationship with the recipient were not altered. However, they felt the need to also acknowledge that things were NOT normal, and they attempted to address the absurdity of their situation (and feelings of embarrassment and vulnerability) by poking fun at extreme side effects, fertility preservation, loss of body parts, and altered appearance.

However, participants struggled to use humor effectively with audiences who did not appreciate their sense of humor in general or who were not comfortable with joking about cancer. Participants who took for granted that they were more used to their cancer experience than others tended to shock rather than liberate with their humor use. Others’ attempts to use humor fell flat when jokes about participants’ experiences felt malicious and repetitive. Some participants felt that humorous slogans like “Save the Tatas” helped them rally support and gain control, while others found them dehumanizing.


This study extends NRT to a new communicative task within an understudied context. SLT helps explain why humor can be normatively effective in helping YA cancer patients and their close supporters balance task, relational, and identity meanings. However, while participants used cancer-related humor to open up conversations about their illness experience without threatening their need for normality, they were also faced with the knowledge that they HAD been irrevocably changed by their cancer experience. Therefore, participants faced a paradoxical need to balance their humor to stress normalcy while also acknowledging the difficult changes they had experienced. Practically, this study can provide tangible suggestions for how to help patients and supporters use humor more successfully in YA cancer contexts.