The concerns that loom largest in the minds of breast cancer patients during the first year after surgery are not loss of attractiveness or sexuality, as is often thought. Instead, it’s fear of death, pain, and overwhelming bills. That’s according to a multi-ethnic survey shows.
Adverse reactions from friends, family, partners, and others were among the least intense of the concerns reported in the survey of 223 women as they weather the crisis following breast cancer surgery. Issues of attractiveness, femininity, sexuality, and self-sufficiency ranked as mid-level concerns.
To the extent that personal relationships appeared at all among the high-level concerns, they did so as cares about not being able to live out important relationships — for example not seeing children grow up and having life with a partner cut short.
“What we have here is a snapshot of the experiences of women who are in treatment for early-stage breast cancer — the concerns that occupy their minds and the association between those concerns and facets of their well-being,” said Stacie M. Spencer, PhD, the University of Pittsburgh psychologist who led a team of nine scientists from the University of Miami and Jackson Memorial Hospital in Miami. Their findings were reported in Health Psychology.
“Clinically, the pattern of concerns serves as a reminder that what may be easiest to discuss with a patient may not be what the patient is most worried about,” the researchers say.
They suggest that counselors place greater emphasis on giving patients “an avenue for confronting issues of mortality…and directing energies to concerns that are strong yet controllable, such as increasing health-enhancing behavior, planning for children’s future, and developing a plan for dealing with medical bills.”
The research team surveyed 151 non-Hispanic White women, 48 Hispanics, and 24 African Americans using a 28-point “Profile of Concerns for Breast Cancer” created for the study. The participants’ emotional adjustment was also assessed by three measures and their psycho-sexual well-being assessed by two measures.
Hispanic women reported higher levels of concern on most points than did the other groups. The high scores they gave to survey items were paralleled by high measures of emotional distress and sexual and social disruption in their assessments of emotional adjustment and psychosexual well-being.
African American women expressed “notably lower” concern about life and pain issues and sexuality issues than did the other two groups. The researchers suggest these ethnic differences may relate to the notion that it is culturally appropriate for Hispanic women to acknowledge their feelings, and also appropriate for African American women to present a strong image to others.
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