Category: Analysis

Source: The Conversation – Canada – By Giancarlo Di Giuseppe, PhD Candidate, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto

Imagine being 25, fresh out of post-secondary education and full of optimism about starting your career, and then you hear the words: “You have cancer.”

You are suddenly faced with an unexpected health shock that not only threatens your physical health, but also your financial future. Most of your time is now spent feeling unwell and travelling to and from the hospital for treatment, while your friends and colleagues continue to build their careers.

This is the reality for nearly 1.2 million adolescents and young adults diagnosed with cancer each year worldwide, a number that is projected to rise. Just over 9,000 Canadian adolescents and young adults are diagnosed with cancer annually, and 85 per cent of them will survive their illness.

And while survival is the primary goal, many don’t realize that it comes with a hidden price that extends far beyond immediate medical costs.

It is estimated that the average Canadian affected by cancer faces $33,000 in lifetime costs related to their illness, totalling $7.5 billion each year for patients and their families.

But we have recently discovered the true economic impact on adolescents and young adults with cancer is often far greater than the previous numbers show and lasts much longer than previously recognized.

The financial penalty of survival

We compared 93,325 Canadian adolescents and young adults diagnosed with cancer and 765,240 similar individuals who did not experience cancer, and found that surviving cancer leads to long-term reduced income, which may last a lifetime.

On average, a cancer diagnosis results in a greater than five per cent reduction in earnings over a 10-year period after diagnosis.

As expected, income loss is more pronounced right after diagnosis, with survivors earning 10 to 15 per cent less in the first five years.

However, these hidden survival costs are not the same for everyone, and the financial toll varies greatly depending on the type of cancer. For instance, survivors of brain cancer see their average annual income drop by more than 25 per cent. This is a devastating financial burden — and one that endures.

The true lifetime effects are unknown, but it is not difficult to imagine how a financial setback like this can completely derail a young person’s financial future.

Why cancer costs young survivors more

Adolescents and young adults who are survivors of cancer experience “financial toxicity,” which refers to the direct costs of cancer, such as treatment or medication costs, and indirect costs like reduced work ability, extended sick leave and job loss.

Over one-third of young cancer patients report financial toxicity.

Many cancer survivors experience lasting adverse physical and cognitive effects that limit everyday functioning.

Even in the Canadian universal health-care system, which does not require payment for cancer treatment, many younger Canadians are unable to work and need to rely on family members for financial support.

The impact on work capacity is significant for adolescents and young adults who are just beginning their careers, causing them to miss critical years of career development during treatment and recovery that can have cascading economic effects.

These challenges can ultimately lead to financial instability and hardship.

Paying the price

Beyond the individual hardships, the issue of financial instability among young cancer survivors is becoming a broader societal challenge.

In 2025, young Canadian cancer survivors are entering an economy with an unfavourable job market and rising youth unemployment, as well as a widening gap between wages and housing affordability.
Rising inflation and general unaffordability are also compounding financial difficulties young Canadian cancer survivors face, ultimately making financial recovery more challenging.

Income is a fundamental social determinant of health, and financial inequities can perpetuate health disparities in cancer survivors after treatment.

Patients are forced into making devastating financial choices like depleting their savings and incurring debt.

Policy

A Canadian Cancer Society 2024 report highlights the urgency for support systems to address financial well-being after cancer.

Based on our research, which assesses the financial life of adolescent and young adult survivors of cancer, we have some recommendations for Canadian policymakers, businesses and primary care providers.

Policymakers should:

• Make employment insurance benefits that better support survivors post-treatment.
• Provide tax credits for groups of cancer survivors disproportionately affected by financial toxicity, such as those with brain cancer.

Primary care providers should:

• Incorporate financial navigation counselling into their cancer care.
• Provide resources for navigating insurance and financial assistance programs.
• Routinely screen for financial toxicity as part of survivorship care.

Employers should:

• Create a supportive work environment that accommodates the unique needs of cancer survivors.
• Recognize the physical and mental challenges faced by young survivors and provide flexible work arrangements.

Young cancer survivors have already faced one of life’s most difficult challenges. They shouldn’t have to struggle with financial insecurity.

By recognizing that survivorship starts at cancer diagnosis, we must broaden the conversation about cancer care beyond the clinical to the economic.

Jason D. Pole does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointments.

Giancarlo Di Giuseppe does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The hidden costs of cancer for young survivors is derailing their financial futures – https://theconversation.com/the-hidden-costs-of-cancer-for-young-survivors-is-derailing-their-financial-futures-256420

Source: The Conversation – Canada – By Marie Trotter, PhD Candidate, Department of English, McGill University

Are you addicted to endless scrolling? Trapped by the algorithms on your smartphone? Theatre might just be the antidote.

“Denmark’s a prison,” says Hamlet, Prince of Denmark, in one of Shakespeare’s most famous dramas. In this scene, he is speaking to his friends Rosencrantz and Guildenstern, who have been recruited to spy on him by his mother and uncle.

Hamlet isn’t literally imprisoned, but he does feel trapped by his circumstances. He comes to realize that his uncle murdered his father, married his mother and then seized the kingship. He is being watched. He wants to escape the surveillance of the Danish court.

More than 400 years after Hamlet’s first performance, experts have warned that we are trapped and manipulated by the surveillance of our smartphones. Our online behaviour has transformed us into marketable data, and addictive algorithms have bound us to an endless recycling of what we have “liked.”

Digital tribalism threatens democracy

This digital herding also affects who we interact with online. We often find ourselves gathering with others who like the same people and share the same politics, seeking both protection and alleviation from loneliness.

This new form of digital entrapment has given birth to a kind of tribalism — a strong sense of loyalty to a group or community — that political and social researchers warn may threaten a foundational practice of democracy: the possibility of authentic conversation among people.

The technologies of surveillance have drastically changed since Shakespeare’s time. Today, our habits are transformed into data by a virtual panopticon of devices.

The loneliness that many of us, especially young people, are suffering echoes Hamlet’s sense of isolation and inability to voice his true feelings.

While our culture is very different from Shakespeare’s London, his plays — and those by others — still have the potential to bring people together and help us think deeply about our shared experience.

Shakespeare’s playhouse conversations

In Hamlet, the prince knows something is rotten in Denmark, but he finds that he cannot speak publicly about it. All alone on stage, he says: “But break, my heart, for I must hold my tongue.”

Today, it seems, he could just as easily be speaking about how we curate ourselves online in our unquenchable desire to be seen and heard by others. But it doesn’t have to be this way.

Consider Shakespeare’s playhouse, an extraordinary gathering place for thousands of people. It was a space where all kinds of people could have conversations with the actors and each other about all kinds of themes, like the justice of “taming” an unruly woman (The Taming of the Shrew), how to push back against the power of a tyrant (Richard III) or how Christians might think differently about Jews (The Merchant of Venice).

Shakespeare opened established ways of thinking to questioning, inviting audiences to see the world and each other in new ways.

And audiences in Shakespeare’s time didn’t just sit quietly and listen. They interacted actively and loudly with the actors and the stories they saw on stage.

Historical research suggests theatre helped change early modern society by making it possible for commoners to have a public voice. In this way, Shakespeare contributed to the emergence of modern democratic culture.

Conversation pieces

Hamlet is one of Shakespeare’s most frequently performed tragedies, and his anguish under a surveillance state speaks to our own struggles for freedom and belonging.

In his soliloquies, he questions his own indecisiveness, but he prompts the audience, too, searching for their support: “Am I a coward?” he asks. His questions break the fourth wall, looking for answers in the audience.

Sometimes they talk back: from an intoxicated spectator at the Royal Shakespeare Company in the 1960s who shouted “yes!” to a teenager at the Stratford Festival in 2022 who whispered “no,” audiences want to speak with Hamlet, responding to his self-doubt with their own perspectives.

Hamlet knew about the theatre’s liberating power, too. In his search for a public voice, he chose to stage a play to expose corruption in Denmark. “The play’s the thing,” he said, “wherein I’ll catch the conscience of the king.”

Psychology researchers agree. Attending a play is proven to provoke the awakening of conscience, helping audiences empathize with political views that differ from their own. This understanding leads to pro-social behaviour outside the theatre.

Empathy, insight and social engagement

After watching a play by American playwright Dominique Morisseau about the impacts of the 2008 auto plant closures in Detroit, audiences were more likely to donate to and volunteer with charities supporting the homeless.

Seeing the vulnerability of fellow human beings onstage helps audience members become more empathetic towards each others’ experiences.

Theatre also helps the artists who make it rediscover their humanity. In the 2013 book Shakespeare Saved My Life, English professor Laura Bates writes about her experience teaching “the bard” to men in solitary confinement who could only speak to each other through slots in their cell doors.

One incarcerated person found a kindred spirit in Richard II, who is imprisoned at the end of his play. Reading Macbeth helped him understand the mistakes he made in his search for power.

A woman in a similar program in Michigan saw herself in Lady Anne’s grief in Richard III. Beyond empathizing with the characters, prisoners also felt empowered to confront the roles they had played in their past and to imagine new roles for the future.

Building community

The path towards empowerment or freedom through theatre is not limited to incarcerated spaces or grand professional stages.

Liberating theatre can take place wherever people gather: in living rooms and community centres; in parks and church basements; in a drama classroom or even on Zoom, where people can read plays aloud, improvise scenes from their own lives and create new stories together.

These modest theatrical gatherings offer something our devices cannot: the experience of being present with others in shared creative work.

When we step into the roles of characters, we step outside the algorithmic predictions that have come to direct or define us online.

When we collaborate to tell a story, we build the kind of community that allows us to bear witness for each other. Hamlet ends with the Danish prince asking his friend, Horatio, to tell the truth about what has happened: “In this harsh world draw thy breath in pain to tell my story.”

The theatre’s liberating power belongs to anyone willing to gather with others, turn off their phones and tell stories.

Each small theatrical gathering becomes an act of resistance — a reclaiming of our capacity for connection and conversation.

Marie Trotter receives funding from the Social Sciences and Humanities Research Council of Canada.

Paul Yachnin receives funding from the Social Sciences and Humanities Research Council of Canada.

– ref. How Shakespeare can help us overcome loneliness in the digital age – https://theconversation.com/how-shakespeare-can-help-us-overcome-loneliness-in-the-digital-age-259628

Source: The Conversation – Canada – By Jean Ketterling, Assistant Professor, Political Studies – Women’s and Gender Studies Program, University of Saskatchewan

Following a campaign by Australian anti-porn organization Collective Shout, the video game distribution platforms Steam and itch.io recently made changes to their policies about hosting games with adult themes.

While Steam removed many games, the campaign has had a particularly strong effect on itch.io because it is a smaller company with low barriers for creators who want to publish their games. The changes meant all content deemed adult NSFW (not suitable for work) on itch.io was unsearchable.

The campaign has also involved pressuring payment processing companies to “cease processing payments” to platforms hosting games that Collective Shout views as objectionable.

Itch.io has since announced it will be re-indexing free adult NSFW content, making it searchable again, and is “actively reaching out to other payment processors that are more willing to work with this kind of content.”

The battle over NSFW content is provoking concern about censorship and threatening game makers’ livelihoods. As game studies scholars who focus on sex, sexuality, gender and sexual violence, we are concerned about censorship campaigns that target pornography, and the knock-on effects on queer creators and sexual education content.

Read more:
Thousands of games have been censored from major platforms, with LGBTQIA+ creators caught in the crossfire

What happened to NSFW content on itch.io and Steam?

According to a timeline published by Collective Shout, the campaign began in March 2025 as an effort to have the controversial game No Mercy removed from Steam. While the developer removed the game in April, Collective Shout then called on payment processors to stop processing payments for similar content.

The campaign is less interested in the content or context of these games than achieving the organization’s broader anti-pornography goals.

As journalist Emanuel Maiberg writes, while No Mercy may aim to shock, it retreads many commonplace pornographic tropes, and Steam offers users tools to filter out adult content.

Nonetheless, bringing such games to payment processors’ attention set off a chain reaction and provoked heightened scrutiny on a wide range of sexual content.

On July 16, the third-party data website Steam DB posted that Steam had updated its content policy and removed many games that appeared to have incest themes.

On July 24, itch.io released a statement explaining that it had de-indexed all adult NSFW content while it conducted a “comprehensive audit of content” to ensure that the platform “can meet the requirements of our payment processors.”

De-indexing content makes it impossible to find via a browser search (although it remains available through a direct link), provoking concern about censorship and loss of livelihood.

A counter-campaign to protest censorship also emerged and various industry groups responded.

Platform policies and pornography

Feminist movements have a long history of debating pornography, and nuanced research is readily available that carefully analyzes pornography, including in a dedicated academic journal. Similarly, there is a growing body of research on sex and sexuality in video games.

Anti-pornography movements, however, do not seem to be informed by these discussions and debates. Rather, campaigns like Collective Shout’s rely on feelings of discomfort, disgust and shock to bring about broad censorship.

This can undermine the diversity of sexual expression, punishes non-normative and kinky content and disproportionately affects LGBTQ+ creators.

Steam’s updated policy states that developers should not use their platform to publish content that violates payment processor or card network policy, “in particular, certain kinds of adult only content.”

Itch.io clarified its existing policy by providing a list of content prohibited by payment processors, including real or implied non-consensual content, underage or “barely legal” themes, incest or pseudo-incest content, bestiality or animal-related content and fetish content involving bodily waste or extreme harm, among others.

Such prohibitions may feel like common sense. However, there is a danger these provisions could be used to de-platform broad swaths of content. This could include games made by survivors of sexual violence or child abuse reflecting on their experiences, or consent education games such as Hurt Me Plenty.

Research has shown similar policies on porn platforms are interpreted so broadly that they de-platform otherwise legal content. When implemented, these policies impact creators’ abilities to earn a living.

De-platforming sex in games

Video game censorship is not new. American game developer Brenda Romero describes the creation of the Entertainment Software Rating Board (ESRB) in 1994 as the industry’s attempt to self-regulate after several controversies regarding violent and sexual content.

The ESRB was created by the Entertainment Software Association to assign age ratings to games in North America. While creating the ESRB helped stave off governmental regulation, it did so by curtailing the space for sexual expression in games.

Video games with explicit sexual content are likely to receive an adults only rating and large box chain retailers may refuse to stock them.

To be economically viable, game developers are forced to remove references to sexual activity from their games, as was the case with the infamous “hot coffee” modification in Grand Theft Auto: San Andreas.

This type of self-censorship is a problem that extends beyond games. According to feminist media scholar Susanna Paasonen, platforms often conceptualize sex as risky, objectionable and lacking expressive value, imposing their subjective understanding of obscenity and risk on culturally diverse audiences.

Many arguments for censorship rely on an assumption that games predominately have an audience of children. However, the average American gamer is 36 years old, and removing access to diverse sexual content for adults is to deny an entire realm of human experience.

Thus, the “de-sexing” of platforms is a problem in and of itself.

Payment processors dictating content

Collective Shout’s appeal to payment processors is a strategy that exploits the power these companies have, because payment processors and credit card networks have significant influence on the sex industry. By refusing to process payments for certain products or services, they have the power to effectively censor anything they deem unnacceptable.

The process leaves little room for transparency around what qualifies as unacceptable, and can leave those impacted by such bans with limited ability to challenge them.

Given that payment processors focus more on protecting their brand reputation than promoting a diversity of sexual expression, they are vulnerable to the agendas of outspoken organizations that use them as a backdoor to police sexual expression.

As researchers, we are equally concerned with the ways these policies threaten the preservation of video games. Despite their long history, sex and pornography games are a neglected archive.

It is imperative to build and sustain public game archives that can withstand such targeted attacks and preserve the record of human desire from multiple perspectives.

Jean Ketterling is the principal investigator of The Pornography, Platforms & Play Project, which is supported in part by funding from the Social Sciences and Humanities Research Council of Canada. She is the vice-president of the Canadian Game Studies Association.

Ashley ML Guajardo is president of the Digital Games Research Association.

Carl Therrien and Kenzie Gordon do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Censoring video games with sexual content suppresses the diversity of human desire – https://theconversation.com/censoring-video-games-with-sexual-content-suppresses-the-diversity-of-human-desire-262436