Research suggests that African American women have a higher level of stressful reactions to a breast cancer diagnosis than women of other ethnicities. Many of these behaviors can have a detrimental impact on their help seeking behaviors, while the tumor is at an early stage and easier to treat. The consequence of these behaviors can result in the tumors growing and the women having fewer treatment options.
African American women’s coping behaviors with breast cancer:
1. African American women experience significant cancer anxiety and a high degree of fatalism because of a lack of knowledge, lack of trust in the medical system, and concerns about emotional support.
2. African American women were significantly more likely than Caucasian women to report heightened perceptions of personal risk after their relatives were diagnosed with breast cancer.[ii]
3. In a 1987 study, 52% of African American women, versus 4% of Caucasian women, were more likely to delay treatment six months or longer following initial recognition of symptoms.[iii]
4. African American women are more likely to ignore their illnesses because of work and family responsibilties. African American women scored higher than Caucasian women on a measure of avoidance of breast cancer thoughts and feelings.[iv] When forced to consider their disease, they often experienced heightened psychological distress associated with the effect of rehabilitation on their employment stability.[v]
5. African American women who delayed seeking treatment for breast cancer had significant concerns related to femininity (i.e., loss of hair, breasts, and being sexually attractive to men).[vi] Many had concerns about the disease affecting their sexual lives, may be compounded by African American women having lower rates of marriage than Caucasian women. In marital relationships, the spouse is expected to remain in the relationship after the breast cancer diagnosis.[vii]
6. African American women experience resilience through their relationship with God and rely more strongly on religious or spiritual sources of support than husbands or family.[viii]
7. African American women demonstrate higher tolerance of symptoms and are more likely to assume responsibility for their conditions and recovery than to seek and cooperate with experts.[ix] Other research has suggested that inadequate support and information after the initial diagnosis and treatment compromised the patient receiving a healthy prognosis.[x]
Healthy coping behaviors to be encouraged:
A) African American women should feel empowered to ask questions of their physicians or surgeons about their cancer and treatment options. If needed, get a second opinion or get a new provider.
B) Having concern about a family member being diagnosed with breast cancer is normal. The concerned woman should speak to her physician about her own risks and get screened for breast cancer.
C) Any African American woman with a breast cancer diagnosis should speak to her surgeon immediately. Delaying treatment increases the chances of the tumor growing and metastasizing, which decreases treatment options and chances of survival.
D) African American women should ask other family members for help, find support groups (church or organizations), and other resources to help with obligations of caring for family members. Social services may be able to find help for women while they manage their breast cancer diagnosis.
E) If an African American woman is concerned about her physical appearance and using it as a deterrent to seeking treatment, it may be helpful for her to speak to a mental health professional about her concerns or connect with support groups who celebrate life, instead of focusing on her losses.
F) Psychological well being (e.g., purpose in life, positive relations with others) for African American women has a strong correlation with their spiritual community; and for many African American women coping with breast cancer, spirituality appears salient to their ability to cope. Research with spirituality has shown many benefits in patients with chronic illnesses because of their feelings of being connected and protected by God or Higher Power. The benefits include: healthier behaviors, more optimistic outlook on life, and a connection with someone more powerful than themselves.
G) Any woman diagnosed with breast cancer should seek medical advice immediately, and comply with the medical advice given, or seek another physician/surgeon if she is not satisfied with the care from her provider.[i]Miller, L. Y., & Hailey, B. J. (1994). Cancer anxiety and breast cancer screening in African American women: A preliminary study. The Jacobs Institute of Women’s Health, 4, 170-174.;
Ashing – Giwa, K. (1999). Quality of life and psychosocial outcomes in long-term survivors of breast cancer: A focus on African American women. Journal of Psychosocial Oncology, 17, 47-62.
Ashing-Giwa, K., & Ganz, P. A. (1997). Understanding the breast cancer experience of African American women. Journal of Psychosocial Oncology, 15, 19-35.[ii]Hughes, C., Lerman, C., & Lustbader, E. (1996). Ethnic differences in risk perception among women at increased risk for breast cancer. Breast Cancer Research and Treatment, 40, 25-35. [iii] Long, (1993). Breast cancer in African American women: Review of the literature. Cancer Nursing, 16, 1- 24. [iv] Ashing-Giwa, K., & Ganz, P. A. (1997). Understanding the breast cancer experience of African American women. Journal of Psychosocial Oncology, 15, 19-35. [v] Ashing-Giwa, K., & Ganz, P. A. (1997). Understanding the breast cancer experience of African American women. Journal of Psychosocial Oncology, 15, 19-35. [vi]Lackey, N. R., Gates, M. F., & Brown, G. (2001). African American women’s experiences with the initial discovery, diagnosis, and treatment of breast cancer. Oncology Nursing Forum, 28, 519-526. [vii] Ashing-Giwa, K. (1999). Quality of life and psychosocial outcomes in long-term survivors of breast cancer: A focus on African American women. Journal of Psychosocial Oncology, 17, 47-62. [viii] Bourjolly, J. N., & Hirschman, K. B. (2001). Similarities in coping strategies but differences in sources of support among African American and White women coping with breast cancer. Journal of Psychosocial Oncology, 19, 17 – 37. [ix] Long, (1993). Breast cancer in African American women: Review of the literature. Cancer Nursing, 16, 1- 24. [x] Ashing-Giwa, K., & Ganz, P. A. (1997). Understanding the breast cancer experience of African American women. Journal of Psychosocial Oncology, 15, 19-35.