Managing the illness experience of women with advanced breast cancer: hopes and fears of cancer-related insecurity
Corresponding Author
M. Banning EdD, MSc, PGDE, BSc
Brunel University, Uxbridge, UK
Correspondence address: Maggi Banning, School of Health Sciences and Social Care, Brunel University, Uxbridge UB8 3PH, UK (e-mail: [email protected]).Search for more papers by this authorT. Tanzeem MPhil
Shaukat Khanum Cancer Memorial Hospital and Research Centre, Johar Town, Lahore, Pakistan
Search for more papers by this authorCorresponding Author
M. Banning EdD, MSc, PGDE, BSc
Brunel University, Uxbridge, UK
Correspondence address: Maggi Banning, School of Health Sciences and Social Care, Brunel University, Uxbridge UB8 3PH, UK (e-mail: [email protected]).Search for more papers by this authorT. Tanzeem MPhil
Shaukat Khanum Cancer Memorial Hospital and Research Centre, Johar Town, Lahore, Pakistan
Search for more papers by this authorAbstract
The cultural significance of a diagnosis of advanced breast cancer is important in Pakistan particularly due to the high incidence in women, limited breast cancer screening, healthcare resources and cancer educational programmes in Pakistan. The psychological impact of breast cancer is therefore an important concern for women. This qualitative study explored the psychological impact of advanced breast cancer in Pakistani women. Twenty-one women with advanced breast cancer were interviewed. Women acknowledged feelings related to the insecurity of health, resistance to cancer, the impact of their illness on their physical and emotional well-being and marital relationships and emotions related to cultural discrimination. The majority of women had metastatic spread to bone, liver or lungs. More effort is needed to educate women on the aetiology of cancer, breast self-examination and mammographic screening to ensure that all Pakistanis are educated that cancer is not a communicable disease or one that is transmitted by personal contact.
References
- Aziz Z., Sara S., Akram M. & Saeed A. (2004) Socioeconomic status and breast cancer survival in Pakistani women. JPMA. The Journal of the Pakistan Medical Association 54, 448–453.
- Banning M. (2011) Employment and breast cancer: a meta ethnography. European Journal of Cancer Care 20, 708–719.
- Banning M., Hafeez H., Hassan M., Faisal S. & Zafar A. (2009) The impact of culture, sociological and psychological issues on breast cancer patients in Pakistan. Cancer Nursing 32, 317–324.
- Banning M., Hassan M., Faisal S. & Hafeez H. (2010) Cultural interrelationships and the lived experience of Pakistani breast cancer patients. European Journal of Oncology Nursing 14, 304–309.
- Bhurgri Y., Bhurgri A. & Nishter S. (2006) Pakistan –country profile of cancer and cancer control, 1995–2004. Journal of the Pakistan Medical Association 56, 124–130.
- Bottomley A. & Jones L. (1997) Breast cancer care: women's experience. European Journal of Cancer Care 6, 124–132.
- Bottoroff J.L., Johnson J.L., Bhagat R., Grewal S., Balneaves L.G., Clarke H. & Hilton B.A. (1998) Beliefs related to breast health practices: the perceptions of South Asian women living in Canada. Social Science and Medicine 47, 2075–2085.
- Brown M., Koch T. & Webb C. (2000) Information needs of women with non-invasive breast cancer. Journal of Clinical Nursing 9, 713–722.
- Cancer Research UK Statistical Information Team (2011) Statistics on the risk of developing cancer by cancer type and age. What is the lifetime risk of developing cancer? British Journal of Cancer 105, 460–465.
- Cohen M.Z., Kahn D.L. & Steeves D.H. (1998) Beyond body image: the experience of breast cancer. Oncology Nursing Forum 25, 835–841.
- Coleman M.P., Quaresma F. & Berrino J. (2008) Cancer survival in five continents: a worldwide population based study (Concord). The Lancet Oncology 9, 730–756.
- Department of Health (2010) The Research Governance Framework for Health and Social Care. Department of Health. Available at: http://www.d.%20gov.uk/en/Aboutus/Researchgoverance/DH_4002112
- Fallowfield L. & Jenkins V. (1999) Effective communication skills are the key to good cancer care. European Journal of Cancer 35, 1592–1597.
- Fallowfield L.J., Hall A. & Maguire G.P. (1990) Psychosocial outcomes of different treatment policies in women with early breast cancer outside a clinical trial. British Medical Journal 301, 575–580.
- Global Summit Health Care Systems and Public Policy Panel (2008) Breast cancer in limited resource countries: health care systems and publicity. The Breast Journal 12 (Suppl. 1), 154–169.
- Gysels M., Richardson A. & Higginson I. (2004) Communication training for health professionals who care for patients with cancer: a systematic review of effectiveness. Supportive Care in Cancer 12, 692–700.
- Hislop T.S., Waxler N.E. & Coldman A.J. (1987) The prognostic significance of psychological factors in women with breast cancer. Journal of Chronic Diseases 40, 729–735.
- Khokher S., Mahmood S. & Khan S.A. (2010) Response to neoadjuvant chemotherapy in patients with advanced breast cancer: a local hospital experience. Asian Pacific Journal of Cancer Prevention 11, 303–308.
- Khokher S., Qureshi W., Mahmood S., Saleem A. & Mahmud S. (2011) Knowledge, Attitude and Preventive Practices of women for breast cancer in the Educational Institutions of Lahore, Pakistan. Asian Pacific Journal of Cancer Prevention 12, 2419–2424.
- Kralik D., Brown M. & Koch T. (2001) Women's experiences of ‘being diagnosed’ with a long-term illness. Journal of Advanced Nursing 33, 594–602.
- Landmark B.T., Strandmark M. & Wahl A. (2001) Living with newly diagnosed breast cancer – the meaning of existential issues. Cancer Nursing 24, 220–226.
- Lee J. & Bell K. (2011) The impact of cancer on family relationships among Chinese patients. Journal of Transcultural Nursing 22, 225–234.
- Malik I.A. (2002) Clinico-pathological features of breast cancer in Pakistan. Journal of the Pakistan Medical Association 52, 100–104.
- Miles M. & Huberman M. (1994) Qualitative Data Analysis: An Expanded Source Book. Sage, London, UK.
- Miller D.L., Manne S.L., Taylor K., Keates J. & Dougherty J. (1996) Psychological distress and well being in advanced cancer: the effects of optimism and coping. Journal of Clinical Psychology in Medical Settings 3, 115–130.
-
Morse J.M., Barrett M., Mayan M., Olson K. & Spiers J. (2002) Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods 1, 13–22.
10.1177/160940690200100202 Google Scholar
- Odusanya O.O. & Tayo O.O. (2001) Breast cancer knowledge attitude and practice among nurses in Lagos, Nigeria. Acta Oncologica 40, 844–848.
- Okobia M.N., Bunker C.H., Okonofua F.E. & Osime U. (2006) Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross sectional study. World Journal of Surgical Oncology 1, 4–11.
-
Perreault A. & Bourbonnais F.F. (2005) The experience of suffering as lived by women with breast cancer. International Journal of Palliative Nursing 11, 512–519.
10.12968/ijpn.2005.11.10.19978 Google Scholar
- Pitceathly C. & Maguire P. (2003) The psychological impact of cancer in patient's partners and other key relatives: a review. European Journal of Cancer 39, 1517–1524.
- Rashid M.U., Zaidi A., Torres D., Sultan F. & Benner A. (2006) Prevalence of BRCA1 and BRCA2 mutations in Pakistani breast and ovarian cancer patients. International Journal of Cancer 119, 2832–2839.
- Spiegel D. (1994) Health caring: psychosocial support for patients with cancer. Cancer Supplement 15, 1453–1457.
- Vivar C.G. & McQueen A. (2005) Informational and emotional needs of long-term survivors of breast cancer. Journal of Advanced Nursing 51, 520–528.
- WHO (2008a) The Global Burden of Disease: 2004. Available at: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf
- WHO (2008b) Screening for Breast Cancer. Available at: http://www.who.int/cancer/detection/breastcancer/en
-
Zahlis E.H. & Shands M.E. (1991) Breast cancer: demands of the illness on the patient's partner. Journal of Psychosocial Oncology 9, 75–93.
10.1300/J077v09n01_04 Google Scholar