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

Abstract: Fatigue is the most common side effect experienced by women undergoing treatment for breast cancer. The fatigue experience of African American (AA) women who undergo breast cancer treatment has been understudied. The purpose of this qualitative exploratory study is to share stories of 10 AA women who experienced fatigue related to breast cancer treatment. AA women provided real talk descriptors of fatigue. Women expressed how physicians were supportive of their exercising to manage their fatigue. However, many women describe the medications prescribedfor fatigue as not very helpful or even making them feel worse. Women shared use of complementary treatment approaches and that their physicians approved of such complementary treatment use. All the participants described how they relied on prayer for their spiritual strength to deal with the overwhelming effects of fatigue on their daily lives. An understanding by health care practitioners of the fatigue and coping experiences related to breast cancer among AA women can provide better ways for health care practitioners to treat and help their A A patients address fatigue symptoms.

Keywords: African American Women, Breast Cancer, Fatigue

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. …

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