Life after breast cancer: ‘Being’ a young African American survivor

ABSTRACT

Objective: In the United States, 26,534 young women (≤45 years) were diagnosed with breast cancer in 2017. Young African American (AA) women have higher incidence and mortality rates than Whites and Hispanics. Yet, few published studies describe survivorship (life after breast cancer diagnosis) experiences among this group. Here, we explore the lived experience of young AA breast cancer survivorship (via quality of life [QOL]).

Design: This phenomenological study was framed by the QOL Applied to Breast Cancer model. Fifteen young AA survivors from the Southern U. S. participated in two semi-structured interviews. Methods of transcendental phenomenology were used for data collection and analysis.

Results: Five themes emerged from participants’ (mean age = 35 years; survivorship = 4 years) descriptions of survivorship experience: (1) actively managing spiritual self, (2) actively managing physical self, (3) actively managing psychological self, (4) actively managing social self, and (5) seeking survivorship knowledge. Participants perceived survivorship as a labile ‘new normal’ and ‘ongoing struggle,’ in which spirituality and survivorship knowledge were key to restructuring their lives.

Conclusions: Survivorship among young AA survivors was more fluid and complex than the QOL model explained. Findings describe young AA breast cancer survivorship and indicate areas of potential strengths and distress. Healthcare providers and ancillary staff must exercise cultural competence to assess and anticipate young AA survivors’ needs and concerns. Implementing targeted survivorship interventions, accounting for cultural contexts (e.g. high spirituality) and need for age-specific survivorship information, may improve QOL among young AA survivors.

KEYWORDS:

• Breast cancer survivorship
• young survivors
• African American
• intervention
• quality of life
• phenomenology

Acknowledgements

We fully acknowledge the support of the Young Breast Cancer Survivorship Network, Gulf States Young Breast Cancer Survivorship Network, and their community partners in addition to funding from American Cancer Society Doctoral Degree in Nursing Scholarship (DSCN-15-073-01), Susan G. Komen Graduate Traineeship in Disparities Research (GTDR15329376; MPIs: Drs. Karen Meneses and Wendy Demark-Wahnefried), and a Jonas Center for Nursing and Veterans Healthcare Nurse Leader Scholarship. The authors have no other funding or conflicts of interest to disclose.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by American Cancer Society [grant number Doctoral Degree in Nursing Scholarship / DSCN-15-073-01]; Jonas Philanthropies [grant number Jonas Center for Nursing and Veterans Healthcare N]; Susan G. Komen for the Cure [grant number Graduate Traineeship in Disparities Research / GTDR-15329376].