Concerns and recommendations regarding inherited cancer risk: the perspectives of survivors and female relatives

Social Perceptions of Breast Cancer by Women Still Undergoing or Having Completed Therapy: a Qualitative Study

BACKGROUND

Diagnosis and treatment of breast cancer is a crisis situation which effects women's lives physically, socially and spiritually. Investigating women's perceptions of this disease is crucially important for treatment decisions. We therefore determined social perceptions and interpretations of women diagnosed with breast cancer during therapy and in the post-treatment period.

MATERIALS AND METHODS

In the study, focus group and in-depth interviews were made with women still undergoing or having completed breast cancer treatment. Some 25 women were included in the research. Content analysis was used in the analysis of the qualitative data obtained after the focus group and in-depth interviews.

RESULTS

Some of the women demonstrated positive perceptions towards accepting the disease, whereas others had emotions such as rebellion and anger. The loss of a breast is important with different interpretations.

CONCLUSIONS

Women's acceptance or rebellion against the disease varies within their social interpretations after the treatment, as at the stage of diagnosis/treatment. All stages of breast cancer negatively affect the social life of the affected individual as much as her body. Nurses assume crucial roles in coping with these negative effects. Thus, it is necessary to know, and sociologically interpret, what is indicated by the information on what the negative effects concerning the disease are and how they are interpreted.

Breast cancer in the Arctic--changes over the past decades

The purpose of this study is to review the current literatures on breast cancer (BC) in the Arctic, especially the trends in incidence during the last decades and the possible explanations. The design of this study is a literature review. The scientific literature concerning BC were reviewed, especially focusing on the Arctic and the special conditions that exist in this region. Breast cancer incidence is increasing all over the world, including in the Arctic. The enormous transition in health conditions and lifestyle in the Arctic might be contributing to the known risk factors. In Greenland, the age at menarche has diminished by 3 years during the course of 100 years, and the number of children per women as well as the duration of breastfeeding is decreasing. Obesity and intake of saturated fat is increasing and the intake of traditional food rich in unsaturated fat and vitamin D decreasing. Smoking and alcohol consumption in the Arctic has been relatively high but is now decreasing. More focus on genetic susceptibility in relation to BC has identified the specific BRCA1 founder mutation in the Greenlandic population, which might appear to be an important risk factor. However, the known established risk factors alone cannot account for the increasing trend observed. Studies suggest that environmental contaminants such as persistent organic pollutants (POPs) including perfluorinated compounds increase the risk of BC possibly in conjunction with certain genetic polymorphisms involved in carcinogen activation. The lipophilic POPs such as polychlorinated biphenyls and organochlorine pesticides are found at very high levels in the Arctic population. Several factors can explain the increasing incidence of BC in the Arctic. The transition in lifestyle and health conditions unfortunately increases the known risk factors of BC. Moreover, the population of the Arctic might show up to be especially vulnerable because of the contemporary high burden of POPs and genetic susceptibility.

Perceived intrafamily melanoma risk communication

Melanoma is a skin cancer that can be deadly. Members of families with a strong history of melanoma have a high risk of melanoma occurrence or recurrence. Enhanced survival in these family members could be influenced by their knowledge of melanoma risk and by simple behaviors to decrease their risk or detect melanoma in its early, most curable, stage. Yet, there is minimal exploration on communication of risk or risk-modifying behaviors in melanoma at-risk families. In this study, we describe perceived intrafamily communication of melanoma risk. Using a qualitative descriptive approach, we examined in-depth interviews with 22 members of 8 families having 2 or more cases of melanoma. We identified 4 major themes: (1) awareness and understanding of risk, (2) families facilitate and hinder communication, (3) promoting melanoma prevention and detection in the family, and (4) an obligation to tell others. We discuss these findings in the context of extant knowledge of cancer risk communication in families at high risk for other cancers, impediments to cancer risk communication, remaining gaps in knowledge of this phenomenon, suggestions for hypothesis-driven research, and clinical implications that are applicable to these and other at-risk families.