Abstract
Purpose
Cultural values shape a woman’s experience of disease and introduce novel stressors that influence psychosocial needs and adaptation. This literature review examines the psychosocial impact of breast cancer in South Asian women, a large group that has received little attention in this regard.
Methods
We conducted a comprehensive review of the literature published before April 2014 using Ovid MEDLINE, PsychINFO, PubMED, CINHAL, EMBASE, and Sociological Abstracts. We searched for articles about the psychosocial impact of breast cancer in South Asian women. We retained 23 studies for review.
Results
The literature concerning South Asian women’s experiences identified culturally linked themes that play significant roles in shaping the illness experience; e.g., stigma and breast cancer, low priority of women’s health, collective experience of disease, and religion and spirituality.
Conclusion
There is a growing need for culturally sensitive care for South Asian women. By understanding the core cultural values and integrating them into clinical practice, Western healthcare providers may improve the quality of care they deliver and help women to extract the maximum benefit.
Implications for Cancer Survivors
Developing culturally competent support services may enhance effectiveness in addressing the healthcare needs of South Asian women and may serve other ethnic minorities in North America.
Similar content being viewed by others
References
Canadian Cancer Society. Breast cancer statistics at a glance. 2012. http://www.cancer.ca/Canada-wide/About%20cancer/Cancer%20statistics/Stats%20at%20a%20glance/Breast%20cancer.aspx?sc_lang=en. Accessed 2 Jan 2013.
Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10–29.
National Cancer Institute. SEER stat fact sheets: breast cancer. Bethesda, MD: National Cancer Institute. http://seer.cancer.gov/statfacts/html/breast.html Accessed 4 Dec 2014.
Sankaranarayanan R, Ramadas K, Thara S, Muwonge R, Prabhakar J, Augustine P, et al. Clinical breast examination: preliminary results from a cluster randomized controlled trial in India. J Natl Cancer Inst. 2011;103:1476–80.
National Cancer Institute-PDQ Cancer Information Summaries. Breast cancer treatment (PDQ): patient version. 2012. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032825/. Accessed 2 Jan 2013.
Ramanakumar AV, Balakrishna Y, Ramarao G. Coping mechanisms among long-term survivors of breast and cervical cancers in Mumbai, India. Asian Pac J Cancer Prev. 2005;6(2):189–94.
Pandey M, Thomas BC, Ramdas K, Ratheesan K. Early effect of surgery on quality of life in women with operable breast cancer. Jpn J Clin Oncol. 2006;36(7):468–72.
Balneaves LG, Bottorff JL, Grewal SK, Naidu P, Johnson JL, Howard AF. Family support of immigrant Punjabi women with breast cancer. Fam Commun Health. 2007;30(1):16–28.
Ganz PA, Coscarelli A, Fred C, Kahn B, Polinsky ML, Petersen L. Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat. 1996;38(2):183–99.
Karbani G, Lim JN, Hewison J, Atkin K, Horgan K, Lansdown M, et al. Culture, attitude and knowledge about breast cancer and preventive measures: a qualitative study of South Asian breast cancer patients in the UK. Asian Pac J Cancer Prev. 2011;12(6):1619–26.
Bottorff JL, Johnson JL, Bhagat R, Grewal S, Balneaves LG, Clarke H, et al. Beliefs related to breast health practices: the perceptions of South Asian women living in Canada. Soc Sci Med. 1998;47(12):2075–85.
Banning M, Hafeez H. A two-center study of Muslim women’s views of breast cancer and breast health practices in Pakistan and the UK. J Cancer Educ. 2010;25(3):349–53.
Meana M, Bunston T, George U, Wells L, Rosser W. Older immigrant Tamil women and their doctors: attitudes toward breast cancer screening. J Immigr Health. 2001;3(1):5–13.
Raza S, Sajun SZ, Selhorst CC. Breast cancer in Pakistan: identifying local beliefs and knowledge. J Am Coll Radiol. 2012;9(8):571–7.
Hoeffel E, Rastogi S, Kim M, Shahid H. The Asian Population: 2010, 2010 Census briefs. 2012. http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf. Accessed 7 Jan 2013.
Humes K, Jones N, Ramirez R. Overview of race and Hispanic origin: 2010, 2010 census briefs. 2011. http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf. Accessed 7 Jan 2013.
Statistics Canada. Visible minority groups, percentage distribution for Canada, provinces and territories—20% sample data (table). Ethnocultural portrait of Canada highlight tables. 2006 Census. http://www12.statcan.ca/census-recensement/2006/dp-pd/hlt/97-562/pages/page.cfm?Lang=E&Geo=PR&Code=01&Table=1&Data=Count&StartRec=1&Sort=2&Display=Page. Accessed 7 Jan 2013.
Islam N, Kwon SC, Senie R, Kathuria N. Breast and cervical cancer screening among South Asian women in New York City. J Immigr Minor Health. 2006;8(3):211–21.
Ahmad F, Cameron JI, Stewart DE. A tailored intervention to promote breast cancer screening among South Asian immigrant women. Soc Sci Med. 2005;60(3):575–86.
Choudhry UK, Srivastava R, Fitch MI. Breast cancer detection practices of south Asian women: knowledge, attitudes, and beliefs. Oncol Nurs Forum. 1998;25(10):1693–701.
Kruper L, Holt A, Xu XX, Duan L, Henderson K, Bernstein L, et al. Disparities in reconstruction rates after mastectomy: patterns of care and factors associated with the use of breast reconstruction in Southern California. Ann Surg Oncol. 2011;18(8):2158–65.
Tseng JF, Kronowitz SJ, Sun CC, Perry AC, Hunt KK, Babiera GV, et al. The effect of ethnicity on immediate reconstruction rates after mastectomy for breast cancer. Cancer. 2004;101(7):1514–23.
Hermans H, Kempen H. Moving cultures: the perilous problems of cultural dichotomies in a globalizing society. Am Psychol. 1998;53(10):1111–20.
Ritzer G. Rethinking globalization: glocalization/grobalization and something/nothing. Sociol Theory. 2003;21(3):193–209.
Redfield R, Linton R, Herskovits MJ. A memorandum for the study of acculturation. Am Anthropol. 1936;16:149–52.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):1–6.
Bottorff JL, Grewal SK, Balneaves LG, Naidu P, Johnson JL, Sawhney R. Punjabi women’s stories of breast cancer symptoms: Gulti (lumps), bumps, and Darad (pain). Cancer Nurs. 2007;30(4):E36–45.
Gurm BK, Stephen J, MacKenzie G, Doll R, Barroetavena MC, Cadell S. Understanding Canadian Punjabi-speaking South Asian women’s experience of breast cancer: a qualitative study. Int J Nurs Stud. 2008;45(2):266–76.
Howard AF, Bottorff JL, Balneaves LG, Grewal SK. Punjabi immigrant women’s breast cancer stories. J Immigr Minor Health. 2007;9(4):269–79.
Banning M, Hafeez H, Faisal S, Hassan M, Zafar A. The impact of culture and sociological and psychological issues on Muslim patients with breast cancer in Pakistan. Cancer Nurs. 2009;32(4):317–24.
Banning M, Hassan M, Faisal S, Hafeez H. Cultural interrelationships and the lived experience of Pakistani breast cancer patients. Eur J Oncol Nurs. 2010;14(4):304–9.
Banning M, Tanzeen T. Living with advanced breast cancer: perceptions of Pakistani women on life expectations and fears. Cancer Nurs. 2014;37(1):E12–8.
Banning M, Tanzeem T. Managing the illness experience of women with advanced breast cancer: hopes and fears of cancer-related insecurity. Eur J Cancer Care (Engl). 2013;22(2):253–60.
Braun CM, Itano JK. Cancer care in Nepal: variables that affect diagnosis, treatment, and prognosis: a case study. Cancer Nurs. 2001;24(2):137–42.
Singh U, Verma N. Psychopathology among female breast cancer patients. J Indian Academy Appl Psychol. 2007;33(1):61–71.
David AJ, Roul RK, Kuruvilla J. Lessons of self-help for Indian women with breast cancer. Cancer Nurs. 1988;11(5):283–7.
Agrawal S, Goel AK, Lal P. Participation in decision making regarding type of surgery and treatment-related satisfaction in North Indian women with early breast cancer. J Cancer Res Ther. 2012;8(2):222–5.
Khan MA, Bahadur AK, Agarwal PN, Sehgal A, Das BC. Psychosocial disorders in women undergoing postoperative radiation and chemotherapy for breast cancer in India. Indian J Cancer. 2010;47(3):296–303.
Nausheen B, Kamal A. Familial social support and depression in breast cancer: an exploratory study on a Pakistani sample. Psychooncology. 2007;16(9):859–62.
Story HL, Love RR, Salim R, Roberto AJ, Krieger JL, Ginsburg OM. Improving outcomes from breast cancer in a low-income country: lessons from Bangladesh. Int J Breast Cancer. 2012;2012:423562.
Banning M, Hafeez H. Perceptions of breast health practices in Pakistani Muslim women. Asian Pac J Cancer Prev. 2009;10(5):841–7.
Johnson JL, Bottorff JL, Balneaves LG, Grewal S, Bhagat R, Hilton BA, et al. South Asian women’s views on the causes of breast cancer: images and explanations. Patient Educ Couns. 1999;37(3):243–54.
Carey MA. The group effect in focus groups: planning, implementing, and interpreting focus group research. In: Morse JM, editor. Critical issues in qualitative research methods. California: Sage; 1994. p. 225–41.
Tracy SJ. Qualitative research methods: connecting evidence, crafting analysis, communicating impact. Malden: Wiley-Blackwell; 2013.
Lederman LC. Assessing educational effectiveness: the focus group interview as a technique for data collection. Commun Educ. 1990;39(2):117–27.
Nausheen B, Kamal A. Familial social support scale for breast cancer patients: development and validation. Pak J Psychol Res. 2003;18:119–30.
Siddiqui S, Shah A. Siddiqui-Shah depression scale (SSDS): development and validation. Psychol Dev Soc. 1997;2:245–62.
Grewal S, Bottorff JL, Hilton BA. The influence of family on immigrant South Asian women’s health. J Fam Nurs. 2005;11(3):242–63.
Kohli N, Dalal AK. Culture as a factor in causal understanding of illness: a study of cancer patients. Psychol Dev Soc. 1998;10(2):115–29.
Markus HR, Kitayama S. Culture and self: implications for cognition, emotion, and motivation. Psychol Rev. 1991;98:224–53.
Straughan PT, Seow A. Fatalism reconceptualized: a concept to predict health-screening behavior. J Gend Cult Health. 1998;3(2):85–100.
Jandt FE. Defining culture and identities. An introduction to intercultural communication: identities in a glocal community. 7th ed. San Bernardino: Sage Publications Inc; 2012. p. 5–33.
Nilchaikovit T, Hill JM, Holland JC. The effects of culture on illness behavior and medical care. Asian and American differences. Gen Hosp Psychiatry. 1993;15(1):41–50.
Uba L. Cultural barriers to health care for Southeast Asian refugees. Public Health Rep. 1992;107(5):544–8.
Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55 Suppl 2:S299–309.
Whitman SM. Pain and suffering as viewed by the Hindu religion. J Pain. 2007;8(8):607–13.
Searight HR, Gafford J. Cultural diversity at the end of life: issues and guidelines for family physicians. Am Fam Phys. 2005;71(3):515–22.
Kozikowski D. “A dirty crab eating away at the breast”: the stigma of cancer in post-socialist Czech Republic. Anthropol East Eur Rev. 2010;23(1):63–78.
Kaiser K. The meaning of the survivorship identity for women with breast cancer. Soc Sci Med. 2008;67(1):79–87.
Bartley SJ, Blaton PW, Gilliard JL. Husbands and wives in dual-earner marriages: decision-making, gender role attitudes, division of household labor, and equity. Marriage Fam Rev. 2005;37(4):69–94.
Blair SL, Lichter DT. Measuring the division of household labor: gender segregation of housework among American couples. J Fam Issues. 1991;12(1):91–113.
Parsons T. The social system. London: Routledge & Kegan Paul; 1951.
Hoeman SP, Ku YL, Ohl DR. Health beliefs and early detection among Chinese women. West J Nurs Res. 1996;18:518–33.
Mo B. Modesty, sexuality and breast health in Chinese-American women. West J Nurs Res. 1992;157:260–4.
Salazar MK. Hispanic women’s beliefs about breast cancer and mammography. Cancer Nurs. 1996;19:437–45.
Rutledge DN, Hartmann WH, Kinman PO, Winfield AC. Exploration of factors affecting mammography behaviors. Prev Med. 1988;17:412–22.
Rimer BK, Keintz MK, Kessier HB, Engstrom PF, Rosan JR. Why women resist screening mammography: patient-related barriers. Radiology. 1989;172:243–6.
Ahmad F, Jandu B, Albagli A, Angus JE, Ginsburg O. Exploring ways to overcome barriers to mammography uptake and retention among South Asian immigrant women. Health Soc Care Community. 2013;21(1):88–97.
Pack GT, Gallo JS. The culpability for delay in the treatment of cancer. Am J Cancer. 1938;33:443–62.
Talley A, Molix L, Schlegel RJ, Bettencourt A. The influence of breast cancer survivors’ perceived partner social support and need satisfaction on depressive symptoms: a longitudinal analysis. Psychol Health. 2010;24(4):433–49.
Gill A. Voicing the silent fear: South Asian women’s experiences of domestic violence. Howard J Crim Justice. 2004;43(5):465–83.
Mehrotra M. The social construction of wife abuse: experience of Asian Indian women in the Unites States. Violence Against Women. 1999;5(6):619–40.
Raj A, Silverman J. Intimate partner violence against South Asian women in greater Boston. J Am Med Womens Assoc. 2002;57(2):111–4.
Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, et al. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004;170(12):1795–801.
Degner LF, Kristjanson LJ, Bowman D, Sloan JA, Carriere KC, O’Neil J, et al. Information needs and decisional preferences in women with breast cancer. JAMA. 1997;277(18):1485–92.
Gall TL, Charbonneau C, Clarke NH, Grant K. Understanding the nature and role of spirituality in relation to coping and health: a conceptual framework. Can Psychol. 2005;46(2):88–104.
Best M, Butow P, Olver I. Spiritual support of cancer patients and the role of the doctor. Support Care Cancer. 2014;22(5):1333–9.
Puchalski CM. Spirituality in the cancer trajectory. Ann Oncol. 2012;23 Suppl 3:49–55.
Ferrell B, Otis-Green S, Economou D. Spirituality in cancer care at the end of life. Cancer J. 2013;19(5):431–7.
Levine EG, Aviv C, Yoo G, Ewing C, Au A. The benefits of prayer on mood and well-being of breast cancer survivors. Support Care Cancer. 2009;17(3):295–306.
Lord K, Ibrahim K, Kumar S, Mitchell AJ, Rudd N, Symonds RP. Are depressive symptoms more common among British South Asian patients compared with British White patients with cancer? A cross-sectional survey. BMJ Open. 2013;3(6):1–11.
Conflict of interest
Manveen Bedi and Gerald M. Devins declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bedi, M., Devins, G.M. Cultural considerations for South Asian women with breast cancer. J Cancer Surviv 10, 31–50 (2016). https://doi.org/10.1007/s11764-015-0449-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11764-015-0449-8