16 Feb For African American Women, Breast Cancer Symptoms Worsen During Initial Treatments
MedicalResearch.com Interview with::
Margaret Q. Rosenzweig PhD, CRNP-C, AOCNP, FAAN
Acute and Tertiary Care Department
University of Pittsburgh School of Nursing
MedicalResearch.com: What is the background for this study?
Response: A significant survival disparity still exists between African American and non-Hispanic white women diagnosed with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer-related distress may be unexplored, important contributing factors. The current study was a secondary, exploratory aim from the Attitudes, Communication, Treatment, and Support (ACTS) Intervention to Reduce Breast Cancer Treatment Disparity study, which is a randomized controlled trial of a psychoeducational intervention to encourage acceptance and adherence to chemotherapy compared with usual care for African American women with breast cancer. The purpose of the current study was to:
1) describe and compare the number of chemotherapy-related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and
2) to describe the relationship between the number of chemotherapy-related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe.
MedicalResearch.com: What are the main findings?
Response: The main findings of the current study are that African American women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with an inability to receive timely, full dose of prescribed chemotherapy
MedicalResearch.com: What should readers take away from your report?
Response: To the best of our knowledge, the current study is the first to report that an increased level of symptom incidence and distress correlates with a worse ability to receive prescribed breast cancer chemotherapy among African American women. The symptom incidence and distress appears to deteriorate from baseline to the midpoint and then stabilizes from the midpoint of chemotherapy to the end of treatment. Better understanding the role that symptoms play in overall racial treatment disparity in breast cancer therapy may contribute to the breast cancer survival disparity that exists between AA women and non-Hispanic white women.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The incidence and management of physical and emotional symptoms may be contributing to breast cancer dose disparity and should be explored further. The reporting of symptoms and the clinical interaction between African American women and predominantly white providers may be another area for exploration. Improvements in symptom communication and management may be a potential target for an intervention to mitigate this potential racial disparity in women with breast cancer.
MedicalResearch.com: Is there anything else you would like to add?
Response: It is interesting to note the relative stabilization of symptom and cancer-related distress from the midpoint until the end of chemotherapy after an initial deterioration from baseline.
Previous literature supports these findings, which demonstrate a pattern of longitudinal symptom variability among many patients undergoing cancer therapy. It is presumed that an adaptation occurs as women experience chemotherapy and learn self-management and coping skills for troubling symptoms. These self-management and coping skills are key to symptom mitigation. Therefore, culturally sensitive patient education and counseling could be important interventional targets.
The American Cancer Society funded the Attitudes, Communication, Treatment, and Support (ACTS) Intervention to Reduce Breast Cancer Treatment Disparity study (grant RSGT-09-150-01-CPHPS)
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Melissa K. Yee, Susan M. Sereika, Catherine M. Bender, Adam M. Brufsky, Mary C. Connolly and Margaret Q. Rosenzweig
Version of Record online: 15 FEB 2017 | DOI: 10.1002/cncr.30575
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