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Modern medical advances have made it possible for most women who are diagnosed with early stage breast cancer to have a low risk for cancer recurrence. But despite an optimistic future, many of these women report that they worry that their cancer will come back.
While some worry about cancer recurrence is perfectly understandable, for some women these worries can be so strong that they have an impact on what treatments women choose, how often they seek care, and their quality of life as cancer survivors.
A University of Michigan study found women with the least anxiety about recurrence are those who have a greater ease in understanding the clinical information presented to them, those who experienced fewer symptoms and who received more coordinated care. However, for Latina women who primarily speak Spanish, a reason to worry less is being lost in translation.
Less acculturated Latina breast cancer patients were particularly vulnerable to high levels of worry, while African Americans patients reported significantly less worry than other races. Other factors associated with high levels of anxiety included undergoing radiation treatment, being employed, experiencing more pain and fatigue and being younger, according to the study, published early online in the medical journal Cancer.
Nancy Janz, PhD, University of Michigan School of Public Health in Ann Arbor, led the study that investigated whether worry about recurrence was related to race and ethnicity, acculturation—the process by which members of one cultural group adopt the beliefs and behaviors of another group—clinical and treatment factors, and how women viewed their experience in the health care system while being treated for breast cancer.
For this study, 2,290 women with non-metastatic breast cancer who were diagnosed from June 2005 to February 2007 and reported to Detroit or Los Angeles cancer registries were studied. A patient's level of worry was determined by assessing her concern about cancer returning to the same breast, the other breast, and spreading to other parts of the body.
Previous studies suggested women are frequently dissatisfied with the information they receive about their recurrence risk. The current study's authors highlight the need for clinicians to provide better counseling about recurrence.
“How much women worry about recurrence is often not aligned with their actual risk for cancer recurrence,” said Janz. “Clinicians need to better understand the factors that increase the likelihood that women will worry and develop strategies and appropriate referrals to help women with excessive worry,” she added.
Janz believes programs to assist women must be culturally sensitive and tailored to patients' differences in communication style, social support, and coping strategies. She also stresses the importance of women with breast cancer being appropriately presented risk information so that they can understand their risk and effectively participate in treatment decisions.
If you or someone you care about is facing breast cancer, establishing open communication with the care team is essential. Ask questions and make sure you understand the treatment options and outcomes to ensure your symptoms are under control and aid in your recovery.
Source: Cancer, Vol. 117, No. 7, April 1, 2011.
Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues for EmpowHER, she pens Nonsmoking Nation, a blog following global tobacco news and events.
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