Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Holding It All Together: Breast Cancer and Its Impact on Life for Younger Women

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Holding It All Together: Breast Cancer and Its Impact on Life for Younger Women

Article excerpt

INTRODUCTION

The publicity afforded breast cancer is a growing phenomenon especially when it affects the lives of high profile people and their immediate family. Over the last decade efforts to raise funds for research into this troubling disease have heightened public awareness and 'pink ribbons' are now knowingly associated with women and their struggle against this particular cancer. In many cases it is younger women who capture the public's imagination as in recent examples in Australia including a high profile popular singer, Kylie Minogue and Jane McGrath, wife of a national cricketer. Despite recognition of the prevalence of breast cancer; 25% of breast cancer diagnoses are in women under 50 years yet there has been little research that explores the consequences of breast cancer on young women and their families (Dunn & Steginga 2000; Raveis & Pretter 2004). In addition, the literature that is available largely explores the experience of breast cancer from quantifiable survey data lacking therefore a deep authentic perspective on the event as it is lived.

Literature review

Breast cancer is the most common cancer diagnosis among Australian women, affecting approximately 11,791 women in the year 2001 (Australian Institute of Health and Welfare AIHW 2005). While the reported incidence has increased due to improved screening and early detection, treatment has led to an increase in survival. More women with a diagnosis of breast cancer are living longer and the disease has come to be regarded as chronic rather than terminal (AIHW 2005; National Breast Cancer Centre NBCC 2001a).

Up to 25% of women diagnosed with breast cancer are of childbearing age (AIHW 2005; Thewes & White 2005) thus potentially affecting a large number of children and family units. Although all women with breast cancer may share common concerns a number of studies which have included women from the younger age group have shown that younger women experience heightened levels of anxiety and stress with diagnosis than older women (Bloom et al. 2004; Dunn & Steginga 2000; Hoke 2000). A factor attributed to the different psychosocial life stage occupied by younger women (Coyne 2004; Dunn & Steginga 2000).

Young women's lives more commonly involve multiple roles including being mother to dependent children, spousal and domestic duties and participation in paid work. Previous research has identified certain risk factors associated with increased psychosocial vulnerability upon diagnosis of breast cancer. These include being under the age of fifty, being single, living alone, having little social support and having children under the age of 21 years (NBCC 2001b; Parle et al. 2001). A descriptive study by Parle et al. (2001) examined 196 female breast cancer patients with a mean age of 56.4 years. The women filled out a general health questionnaire designed to identify clinical psychological difficulties. The survey showed that over a third of the women experienced significant psychological distress. Parle et al. (2001) compared those findings with a survey of the rate of detection of women's psychological distress by special breast nurses. This arm of the study demonstrated a low rate of detection and referral by breast care nurses, especially of women in the younger age group. The Parle et al. (2001) study highlights the importance of appropriate assessment of psychological sequelae by health professionals especially among younger women.

To date there has been limited research relating specifically to young women with breast cancer (Dunn & Steginga 2000). Most studies that collect data on the younger age group do so as part of examination of a broad age group normally from 25-70 years often with a mean age group around 55 years (Parle et al. 2001; Steginga et al. 1998). Specific concerns identified in earlier research have related to the phase of life of younger women, which is premenopausal. The disruption of ovarian function with resultant clinically induced menopause and infertility and the subsequent psychological sequelae of anxiety and distress are reported consistently in research (Graf & Geller 2003; Knobf 2001). …

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