Skip to main content

Advertisement

SpringerLink
Log in

Facilitators of Survivorship Care Among Underserved Breast Cancer Survivors: a Qualitative Study

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Research investigating facilitators of survivorship care among underserved breast cancer survivors (BCS) is sparse. This study aimed to explore facilitators of survivorship care among underserved BCS within the first 5 years following chemotherapy, radiation, or surgery for breast cancer. In-depth interviews were conducted, using a semi-structured interview guide, with underserved BCS exploring survivorship care experiences. Content analysis of the verbatim transcripts was applied, and results were summarized according to themes related to facilitators of breast cancer survivorship care. Interviews were conducted with 25 BCS. Eight main themes were identified: coordination of care; positive perceptions of health care providers; communication between patient and health care providers; financial and insurance facilitators; information, classes, and programs provided; assistance provided by organizations and health care professionals; transportation facilitators; and job flexibility. This study provides a comprehensive look at facilitators of survivorship care among underserved BCS. BCS endorsed several facilitators of their survivorship care, mainly at the interpersonal, organizational, and societal level. This study adds to the research literature on catalysts of care among underserved BCS. Results from this study are currently being used to inform a patient navigation intervention to facilitate care among this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. DeSantis CE, Lin CC, Mariotto AB et al (2014) Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 64:252–271

    Article  PubMed  Google Scholar 

  2. Hammond ME, Hayes DF, Dowsett M et al (2010) American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 28:2784–2795

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kukar M, Watroba N, Miller A, Kumar S, Edge SB (2014) Fostering coordinated survivorship care in breast cancer: who is lost to follow-up? J Cancer Surviv 8:199–204

    Article  PubMed  Google Scholar 

  4. National Comprehenive Cancer Network. NCCN Clinical Practice Guideline in Oncology: Survivorship. 2014. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf

  5. Buist DSM, Bosco JLF, Silliman RA et al (2013) Long-term surveillance mammography and mortality in older women with a history of early stage invasive breast cancer. Breast Cancer Res Treat 142:153–163

    Article  PubMed  Google Scholar 

  6. Wirtz HS, Boudreau DM, Gralow JR et al (2014) Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors. Breast Cancer Res Treat 143:541–550

    Article  PubMed  PubMed Central  Google Scholar 

  7. Freedman RA, Virgo KS, He YL et al (2011) The association of race/ethnicity, insurance status, and socioeconomic factors with breast cancer care. Cancer 117:180–189

    Article  PubMed  Google Scholar 

  8. Nurgalieva ZZ, Franzini L, Morgan R, Vernon SW, Liu CC, Du XL (2013) Surveillance mammography use after treatment of primary breast cancer and racial disparities in survival. Med Oncol 30:1–8

    CAS  Google Scholar 

  9. Siegel R, DeSantis C, Virgo K et al (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62:220–241

    Article  PubMed  Google Scholar 

  10. Sprague BL, Trentham-Dietz A, Gangnon RE et al (2011) Socioeconomic status and survival after an invasive breast cancer diagnosis. Cancer 117:1542–1551

    Article  PubMed  Google Scholar 

  11. Wray CJ, Phatak UR, Robinson EK et al (2013) The effect of age on race-related breast cancer survival disparities. Ann Surg Oncol 20:2541–2547

    Article  PubMed  Google Scholar 

  12. Thompson HS, Littles M, Jacob S, Coker C (2006) Posttreatment breast cancer surveillance and follow-up care experiences of breast cancer survivors of African descent: an exploratory qualitative study. Cancer Nurs 29:478–487

    Article  PubMed  Google Scholar 

  13. Virgo KS, Lerro CC, Klabunde CN, Earle C, Ganz PA (2013) Barriers to breast and colorectal cancer survivorship care: perceptions of primary care physicians and medical oncologists in the United States. J Clin Oncol 31:2322–2336

    Article  PubMed  PubMed Central  Google Scholar 

  14. Brennan ME, Butow P, Marven M, Spillane AJ, Boyle FM (2011) Survivorship care after breast cancer treatment: experiences and preferences of Australian women. Breast 20:271–277

    Article  PubMed  Google Scholar 

  15. Brennan ME, Butow P, Spillane AJ, Boyle FM (2014) Patient-reported quality of life, unmet needs and care coordination outcomes: moving toward targeted breast cancer survivorship care planning. Asia Pac J Clin Oncol 1–9

  16. Kantsiper M, McDonald EL, Geller G, Shockney L, Snyder C, Wolff AC (2009) Transitioning to breast cancer survivorship: perspectives of patients, cancer specialists, and primary care providers. J Gen Intern Med 24:459–466

    Article  PubMed Central  Google Scholar 

  17. Mao JJ, Bowman MA, Stricker CT et al (2009) Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol 27:933–938

    Article  PubMed  Google Scholar 

  18. Roorda C, de Bock GH, Scholing C et al (2014) Patients’ preferences for post-treatment breast cancer follow-up in primary care vs. secondary care: a qualitative study. Health Expect 18:1–10

    Google Scholar 

  19. Thompson CA, Stan DL, Nes LS, Jenkins SM, Lackore KA, Pruthi S (2013) Breast cancer survivors’ self-reported needs and preferences of survivorship care. Breast J 20:107–109

    Article  PubMed  Google Scholar 

  20. Wilson SE, Andersen MR, Meischke H (2000) Meeting the needs of rural breast cancer survivors: what still needs to be done? J Womens Health Gend Based Med 9:667–677

    Article  CAS  PubMed  Google Scholar 

  21. Hewitt M, Greenfield S, Stovall E eds (2006) From cancer patient to cancer survivor: lost in transition. Committee on cancer survivorship: improving care and quality of life, institute of medicine and national research council. Washington, DC: The National Academies Press

  22. Patton MQ (2001) Qualitative research and evaluation methods, 3rd edn. SAGE Publications, London

    Google Scholar 

  23. Atlas.ti [computer program] (2015) Berlin: Scientific Sofware Development GmbH

  24. Germino BB, Mishel MH, Crandell J et al (2013) Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors. Oncol Nurs Forum 40:82–92

    Article  PubMed  Google Scholar 

  25. Miller LE (2012) Sources of uncertainty in cancer survivorship. J Cancer Surviv 6:431–440

    Article  PubMed  Google Scholar 

  26. Stanton AL (2012) What happens now? Psychosocial care for cancer survivors after medical treatment completion. J Clin Oncol 30:1215–1220

    Article  PubMed  Google Scholar 

  27. Costanzo ES, Lutgendorf SK, Mattes ML et al (2007) Adjusting to life after treatment: distress and quality of life following treatment for breast cancer. Br J Cancer 97:1625–1631

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Halpern MT, Viswanathan M, Evans TS, Birken SA, Basch E, Mayer DK (2015) Models of cancer survivorship care: overview and summary of current evidence. J Oncol Pract 11:e19–e27

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Authors would like to thank the breast cancer survivors who participated in this study, as well as the following Community Advisory Board members: Ms. Estena Campagna, Dr. John Kiluk, Ms. Valerie Storms, Ms. Mary Catherine Thompson, and Ms. JoEllen Warnke.

Author information

Authors and Affiliations

  1. SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct., Suite 103, San Diego, CA, 92120-4913, USA

    Amy E. Ustjanauskas, Tonya M. Pan & Kristen J. Wells

  2. UC San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA, 92093-1503, USA

    Amy E. Ustjanauskas, Tonya M. Pan & Kristen J. Wells

  3. Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA

    Gwendolyn P. Quinn, Maria Rivera, Richard G. Roetzheim & Christine Laronga

  4. University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL, 33612, USA

    Gwendolyn P. Quinn, Maria Rivera, Coralia Vázquez-Otero, Danielle Ung, Richard G. Roetzheim & Christine Laronga

  5. South County Oncology and Hematology, 769 Medical Center Ct., Suite 202, Chula Vista, CA, 91911-6602, USA

    Kenneth Johnson & Marilyn Norton

  6. SDSU Research Foundation, 6363 Alvarado Court, Suite 250, San Diego, CA, 92120-4913, USA

    Claudia Carrizosa & Dariana Muñoz

  7. Department of Psychology, San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA

    Marissa Goldenstein & Kristen J. Wells

  8. Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA

    Sumayah Nuhaily

Authors
  1. Amy E. Ustjanauskas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gwendolyn P. Quinn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tonya M. Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maria Rivera
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Coralia Vázquez-Otero
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Danielle Ung
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Richard G. Roetzheim
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Christine Laronga
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kenneth Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Marilyn Norton
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Claudia Carrizosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Dariana Muñoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Marissa Goldenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Sumayah Nuhaily
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Kristen J. Wells
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristen J. Wells.

Ethics declarations

Funding

Research reported by authors in this publication was supported by four grants awarded by the National Cancer Institute of the National Institutes of Health (award numbers: R21CA161077 [funding efforts of AU, DU, CC, DM, KW, TP, MR, GQ, CL]; U54 CA132384 [funding efforts of AU, MG, KW]; and U54 CA132379 [funding efforts of AU, KW, MG]) and the Bankhead-Coley Cancer Research Program, Florida Department of Health (award number: 2BN05 [funding efforts of KW, MR, GQ, CL]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Florida Department of Health. Ms. Tonya Pan was additionally funded by the UC San Diego San Diego Fellowship. Ms. Coralia Vázquez-Otero was supported by National Cancer Institute diversity supplement 3R21CA161077-01A1S1.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics Approval and Consent to Participate

This research involved human participants. Informed consent was obtained from all individual participants prior to inclusion in the study. Institutional Review Boards at two universities approved this study prior to implementation. This study involving human participants was approved by the appropriate ethics committee and is therefore in accordance with the ethical standards set forth in the 1964 Declaration of Helsinki and its later amendments.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ustjanauskas, A.E., Quinn, G.P., Pan, T.M. et al. Facilitators of Survivorship Care Among Underserved Breast Cancer Survivors: a Qualitative Study. J Canc Educ 32, 756–763 (2017). https://doi.org/10.1007/s13187-016-1064-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-016-1064-8

Keywords

Search

Navigation