Lives renewed: the emergence of a breast cancer survivor movement in Ukraine

Advancing Breast Cancer Advocacy in Eastern Europe and Central Asia: Findings From Women's Empowerment Cancer Advocacy Network (WE CAN) Summits

PURPOSE

Breast cancer civil society organizations have emerged in Eastern Europe and Central Asia to raise awareness about cancer as a survivable disease and provide patient support. We explored the experiences and priorities of these organizations with the goal of making recommendations to advance cancer advocacy and improve cancer care.

METHODS

We conducted in-depth interviews and focus group discussions with representatives of civil society organizations attending the 7th Women's Empowerment Cancer Advocacy Network Summit in Romania in 2015. Interviews were audiorecorded, transcribed, coded, and analyzed for key themes. Findings were discussed at the 8th Women's Empowerment Cancer Advocacy Network Summit in Ukraine in 2017 to ensure accuracy.

RESULTS

We conducted nine in-depth interviews and three focus group discussions with a total of 36 participants. Survivor- and oncologist-led organizations played an important role in filling existing gaps in public health care systems through awareness raising, patient support, and advocacy to improve early detection and access to treatment. Barriers to these efforts included persistent stigma, mistrust of patients toward the public health care system, limited access to evidence-based guidelines, difficulty adapting existing best practices to their setting, and insufficient involvement of policymakers. Key facilitators of advocacy efforts included effective local and international partnerships with physicians, like-minded organizations, and policymakers to facilitate access to educational resources, improve breast cancer early detection and care, and catalyze meaningful policy change.

CONCLUSION

Our findings highlight the value of providing opportunities for advocates to connect and share experiences. To advance cancer advocacy and improve cancer care, the following needs were identified: dissemination of resource-adapted information for improving outcomes; needs assessments; improved program-monitoring practices; and fostering and promotion of collaboration between advocates, medical professionals, and local governments.

Brief questions highlight the need for melanoma information campaigns

Melanoma awareness was briefly assessed at walk/runs held simultaneously in Philadelphia PA, Phoenix AZ, and Seattle WA. Of the participants, 75 % (1521) answered short questions during event registration. Among 1,036 respondents aged 14 years and older, 66 % reported knowing melanoma warning signs. Significantly more respondents with melanoma family history reported having a physician-administered skin exam and knowing warning signs. More than one third of walk/run participants reported no definitive melanoma warning sign knowledge. Self-reported melanoma awareness and detection indices were lowest among Phoenix participants; the event city with the greatest annual sun exposure. Educational efforts for melanoma awareness are critically needed. Selected results of this project were presented in a poster forum at the 2006 Congress for Epidemiology meeting held in Seattle, WA (June 2006).

One-to-one volunteer support programs for people with cancer: a review of the literature

OBJECTIVE

To conduct a systematic review of literature reporting on the use of volunteers in support programs for people with cancer.

METHODS

PsycINFO, Medline and CINAHL were used to identify papers published up to April 2007 reporting one-to-one support programs using volunteers. Program data were extracted from the papers, which were rated on research quality and descriptions of the program, volunteers and support recipients.

RESULTS

Twenty-eight papers were reviewed. Nineteen (69%) reported peer-support programs, with four (14%) pertaining to the Reach to Recovery program for women with breast cancer, and eight (28%) describing other peer-support programs for women with breast cancer. Few papers described the programs sufficiently to enable a good understanding of support recipients, volunteers, and what transpired between volunteers and support recipients. Twenty papers (71%) were research studies: 10 (36%) with one group descriptive data, 6 (21%) were non-randomized comparative studies and 4 (14%) were randomized controlled trials.

CONCLUSION

While most papers reported that programs were beneficial, few presented data from studies using rigorous research methodologies to support these claims.

PRACTICE IMPLICATIONS

Using volunteers in cancer care may have merits; however, papers need to provide more information regarding these programs and further evidence is required to determine their effectiveness.

Breast cancer mortality in Russia and Ukraine 1963–2002: an age-period-cohort analysis

OBJECTIVE

To determine the reasons for the steady increase in breast cancer mortality in Russia and Ukraine.

METHODS

Age-period-cohort analysis, supplemented by analysis of historical fertility trends.

RESULTS

Mortality from breast cancer has risen steadily in both countries over the past 40 years, although faster in Russia than in Ukraine. There are strong birth cohort effects, which are consistent with known changes in fertility. Death rates were highest among those born in the first half of the 20th century, declining among those born after the 1950s. There has been a decline in mortality among younger women since the mid 1990s, which may reflect improvements in treatment.

CONCLUSION

The increase in breast cancer mortality in Russia and Ukraine can largely be explained by known changes in fertility, while recent changes may reflect changes in treatment. Observed trends suggest that death rates from female breast cancer in the two countries are likely to stabilize or even decline in the future.