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Racial differences in symptom management experiences during breast cancer treatment

Abstract

Purpose

Racial disparities in cancer treatment-related symptom burden are well documented and linked to worse treatment outcomes. Yet, little is known about racial differences in patients’ treatment-related symptom management experiences. Such understanding can help identify modifiable drivers of symptom burden inequities. As part of the Cancer Health Accountability for Managing Pain and Symptoms (CHAMPS) study, we examined racial differences in symptom management experiences among Black and White breast cancer survivors (BCS).

Methods

We conducted six focus groups (n = 3 Black BCS groups; n = 3 White BCS groups) with 22 stages I–IV BCS at two cancer centers. Focus groups were audio-recorded and transcribed verbatim. Based on key community-based participatory research principles, our community/academic/medical partner team facilitated focus groups and conducted qualitative analyses.

Results

All BCS described positive symptom management experiences, including clinician attentiveness to symptom concerns and clinician recommendations for pre-emptively managing symptoms. Black BCS commonly reported having to advocate for themselves to get information about treatment-related symptoms, and indicated dissatisfaction regarding clinicians’ failure to disclose potential treatment-related symptoms or provide medications to address symptoms. White BCS often described dissatisfaction regarding inadequate information on symptom origins and clinicians’ failure to offer reassurance.

Conclusions

This study elucidates opportunities for future research aimed at improving equity for cancer treatment-related symptom management. For Black women, warnings about anticipated symptoms and treatment for ongoing symptoms were particular areas of concern. Routine symptom assessment for all women, as well as clinicians’ management of symptoms for racially diverse cancer patients, need to be more thoroughly studied and addressed.

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Funding

This study was conducted with funding support from the National Cancer Institute Award Diversity Supplement Award (grant number: 3 R01 CA150980-04S1).

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Correspondence to Cleo A. Samuel.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cite this article

Samuel, C.A., Schaal, J., Robertson, L. et al. Racial differences in symptom management experiences during breast cancer treatment. Support Care Cancer 26, 1425–1435 (2018). https://doi.org/10.1007/s00520-017-3965-4

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  • DOI: https://doi.org/10.1007/s00520-017-3965-4

Keywords

  • Breast cancer
  • Blacks/African-Americans
  • Symptom management
  • Patient-provider communication