Abstract
Objective: Breast cancer has been rapidly increasing in Asian American women in the United States. Breast cancer may have different physical and psychosocial impact on young and older women's quality of life (QOL), but little is known about QOL among Asian American breast cancer survivors of different age groups. The purpose of this study was to identify the differences in the needs and challenges among young and older Asian American breast cancer survivors.
Methods: In-depth interviews with four young (under age 55) and five older (≥ 55 years old) breast cancer survivors were conducted in Chinese or Korean. Brief interviews were conducted with three caregivers of older survivors. Interviews were recorded and transcripts were translated into English. Using qualitative data analysis software Max QDA, transcripts were analyzed by two independent coders to identify common and unique themes across interviews. Any discrepancies between coders were discussed among the investigators and resolved.
Results: Both young and older women experienced serious emotional or psychosocial distress due to breast cancer and most of them had limited coping methods. Young women reported greater stress and in many cases cancer stress was mixed with stress from work or other life stress such as being a single mother. Family was the major source of support for both young and older women, and adult children were the main caregivers for some older women. Young women who did not have a spouse had a weaker supporting system and mostly relied on themselves to deal with cancer. Concerns such as burdening family members were common among all participants and most of them hid feelings to their family. This was confirmed by the interviews with caregivers who admitted that they did not talk much about emotions with the patients and did not have good coping strategies. Language was a common barrier for young and older breast cancer survivors, but it was more difficult for older women who had limited English proficiency. Some older women solely relied on their family members or interpreters to communicate with the doctors. On the other hand, young women were more active in communicating with physicians and reported effective strategies such as preparing written notes and bringing a native speaker with them to the visits. Doctors played a leading role in treatment decision making for most participants, but family influence was more evident among older women. While young women experienced “sad,” “angry” or “disappointed” about their body changes, older women didn't seem to have been affected by the body change as it had on younger women. Both young and older women expressed the need for more culturally relevant resources. Almost none of the participants had attended support groups and most of them agreed that they would join one if there was one for Asian. Conclusion: Young and older Asian American breast cancer survivors shared some common challenges in coping with cancer, but they also had distinct needs in many aspects of QOL. A linguistically and culturally appropriate intervention should provide information, teach skills to cope with problems and manage stress, increase self-efficacy in the context of cultural background and build a support group for women of same ethnicity. It is desirable to have separate interventions for young and older women to cater to their unique needs.
Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B28.
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