Academic journal article ABNF Journal

African American Women Share 'Real Talk' Stories about Fatigue Related to Breast Cancer Treatment

Academic journal article ABNF Journal

African American Women Share 'Real Talk' Stories about Fatigue Related to Breast Cancer Treatment

Article excerpt

Introduction

Breast cancer is the second leading cause of cancer deaths among African American women (American Cancer Society (ACS), 2013). African American women have a higher mortality rate for breast cancer than women from other ethnic/racial groups. The poorer breast cancer survival rates among African American have been associated with common factors such as genetic, biological, social, economic, inadequate or lack of treatment modalities, and cultural factors (ACS, 2013; Gerend & Pai,2008; Naeim, Hurria, Leake).

Radiation and chemotherapy are common treatments used for breast cancer (ACS, 2013). Women diagnosed with breast cancer may need single modality treatment, but often they require surgery, chemotherapy, and radiation therapy. African American women often need more aggressive treatment for breast cancer because of various reasons such as late diagnosis, stage of cancer at diagnosis, or tumor type (Gerend & Pai, 2008). Aggressive treatment for breast cancer usually requires combinations of surgery, radiation, hormonal, and chemotherapy treatments (Sturtz, Melley, Mamula, Shriver, & Ellsworth, 2014). Regardless of treatment modality, fatigue is the most common side effect experienced by women undergoing radiation and/or chemotherapy treatment for breast cancer (National Comprehensive Cancer Network CancerRelated Fatigue Guidelines, 2014).

Cancer-related fatigue (CRF) is defined by the National Comprehensive Cancer Network Cancer-Related Fatigue Guidelines [NCCN-CRFG1 (2014) as a "distressing, persistent, subjective sense of tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning." According to the NCCN-CRFG, CRF is more distressing, more severe, and less likely to be relieved by rest as compared to healthy individuals experiencing fatigue. Most often CRF significantly affects daily functioning of patients during cancer treatment and post treatment.

Research indicates relationships between fatigue related to breast cancer treatment and comorbid conditions such as sleep problems, depression, and obesity (Berger, Gerber, & Mayer, 2012; Maly, Liu, Diamant, & Thind, 2013). For example, one study examined the role of sleep quality, depressed mood, stage and age among fatigued breast cancer survivors. There were 70 fatigued breast cancer survivors from a sample of 81% Caucasian, 10% Hispanic, 5.7% African American, 1.4% Asian, and 1.9% other. The majority of the women reported having surgery, chemotherapy, and/or radiation therapy. Sleep quality, depressed mood, stage and age were predictors of five fatigue subtypes: general, mental,emotional, physical, and vigor. The published research has limited data related to fatigue among African Americans.

The few studies that focus on African American women breast cancer survivors indicate that African American women have physical, social, psychological, and even spiritual adjustment issues related to breast cancer treatment (Morgan et al., 2005; Von et al., 2012). Researchers suggest that African American women diagnosed with breast cancer must be provided with logistical and informational support to reduce the negative perceptions of treatment and to provide them with support to complete treatment for survival (Sheppard, Adams, Lamden, & Taylor, 2011). Also, it is important for health care practitioners to recognize common strategies used by African American women to cope with a breast cancer diagnosis such as social support, prayer, and focusing on the positive to provide culturally appropriate care to these women (Umezawa, Lu, You, Kagawa-Singer, Leake, & Maly, 2012; Sheppard et al. 2011). We examined fatigue related to breast cancer and how African American women managed these symptoms. This pilot project was conducted in 2006 to obtain more insight about the fatigue experience of African American women with breast cancer. Since this project was conducted there still remains a dearth of literature focused on this ethnic/racial group regarding fatigue and the management of fatigue related to breast cancer treatment. …

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