Skip to main content
Top
Published in: Supportive Care in Cancer 5/2018

01-05-2018 | Original Article

Racial differences in symptom management experiences during breast cancer treatment

Authors: Cleo A. Samuel, Jennifer Schaal, Linda Robertson, Jemeia Kollie, Stephanie Baker, Kristin Black, Olive Mbah, Crystal Dixon, Katrina Ellis, Eugenia Eng, Fatima Guerrab, Nora Jones, Amanda Kotey, Claire Morse, Jessica Taylor, Vickie Whitt, Samuel Cykert

Published in: Supportive Care in Cancer | Issue 5/2018

Login to get access

Abstract

Purpose

Racial disparities in cancer treatment-related symptom burden are well documented and linked to worse treatment outcomes. Yet, little is known about racial differences in patients’ treatment-related symptom management experiences. Such understanding can help identify modifiable drivers of symptom burden inequities. As part of the Cancer Health Accountability for Managing Pain and Symptoms (CHAMPS) study, we examined racial differences in symptom management experiences among Black and White breast cancer survivors (BCS).

Methods

We conducted six focus groups (n = 3 Black BCS groups; n = 3 White BCS groups) with 22 stages I–IV BCS at two cancer centers. Focus groups were audio-recorded and transcribed verbatim. Based on key community-based participatory research principles, our community/academic/medical partner team facilitated focus groups and conducted qualitative analyses.

Results

All BCS described positive symptom management experiences, including clinician attentiveness to symptom concerns and clinician recommendations for pre-emptively managing symptoms. Black BCS commonly reported having to advocate for themselves to get information about treatment-related symptoms, and indicated dissatisfaction regarding clinicians’ failure to disclose potential treatment-related symptoms or provide medications to address symptoms. White BCS often described dissatisfaction regarding inadequate information on symptom origins and clinicians’ failure to offer reassurance.

Conclusions

This study elucidates opportunities for future research aimed at improving equity for cancer treatment-related symptom management. For Black women, warnings about anticipated symptoms and treatment for ongoing symptoms were particular areas of concern. Routine symptom assessment for all women, as well as clinicians’ management of symptoms for racially diverse cancer patients, need to be more thoroughly studied and addressed.
Literature
4.
go back to reference Coyle N, Adelhardt J, Foley KM, Portenoy RK (1990) Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manag 5(2):83–93CrossRef Coyle N, Adelhardt J, Foley KM, Portenoy RK (1990) Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manag 5(2):83–93CrossRef
6.
go back to reference Huang IC, Brinkman TM, Kenzik K, Gurney JG, Ness KK, Lanctot J et al (2013) Association between the prevalence of symptoms and health-related quality of life in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 31(33):4242–4251. https://doi.org/10.1200/JCO.2012.47.8867 CrossRef Huang IC, Brinkman TM, Kenzik K, Gurney JG, Ness KK, Lanctot J et al (2013) Association between the prevalence of symptoms and health-related quality of life in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 31(33):4242–4251. https://​doi.​org/​10.​1200/​JCO.​2012.​47.​8867 CrossRef
9.
go back to reference Yee MK, Sereika SM, Bender CM, Brufsky AM, Connolly MC, Rosenzweig MQ (2017) Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer. Cancer. https://doi.org/10.1002/cncr.30575 Yee MK, Sereika SM, Bender CM, Brufsky AM, Connolly MC, Rosenzweig MQ (2017) Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer. Cancer. https://​doi.​org/​10.​1002/​cncr.​30575
11.
go back to reference Cleeland CS, Gonin R, Baez L, Loehrer P, Pandya KJ (1997) Pain and treatment of pain in minority patients with cancer. The Eastern Cooperative Oncology Group Minority Outpatient Pain Study. Ann Intern Med 127(9):813–816CrossRefPubMed Cleeland CS, Gonin R, Baez L, Loehrer P, Pandya KJ (1997) Pain and treatment of pain in minority patients with cancer. The Eastern Cooperative Oncology Group Minority Outpatient Pain Study. Ann Intern Med 127(9):813–816CrossRefPubMed
20.
go back to reference Mandelblatt JS, Yabroff KR, Kerner JF (1999) Equitable access to cancer services: a review of barriers to quality care. Cancer 86(11):2378–2390CrossRefPubMed Mandelblatt JS, Yabroff KR, Kerner JF (1999) Equitable access to cancer services: a review of barriers to quality care. Cancer 86(11):2378–2390CrossRefPubMed
21.
go back to reference Fortner BV, Okon TA, Portenoy RK (2002) A survey of pain-related hospitalizations, emergency department visits, and physician office visits reported by cancer patients with and without history of breakthrough pain. The Journal of Pain: Official Journal of the American Pain Society 3(1):38–44CrossRef Fortner BV, Okon TA, Portenoy RK (2002) A survey of pain-related hospitalizations, emergency department visits, and physician office visits reported by cancer patients with and without history of breakthrough pain. The Journal of Pain: Official Journal of the American Pain Society 3(1):38–44CrossRef
22.
25.
go back to reference Krueger RA, Casey MA (2015) Participants in a focus group focus groups: a practical guide for applied research, 5ed edn. SAGE Publications, Inc. Krueger RA, Casey MA (2015) Participants in a focus group focus groups: a practical guide for applied research, 5ed edn. SAGE Publications, Inc.
26.
go back to reference Boyatzis RE (1998) Transforming qualitative information: thematic analysis and code development. London, & New Delhi SAGE Publications, Thousand Oaks Boyatzis RE (1998) Transforming qualitative information: thematic analysis and code development. London, & New Delhi SAGE Publications, Thousand Oaks
27.
go back to reference Patton MQ (1990) Qualitative evaluation and research methods 2ed. Newbury Park Sage Publications Patton MQ (1990) Qualitative evaluation and research methods 2ed. Newbury Park Sage Publications
28.
go back to reference Saldana J (2009) An introduction to codes and coding the coding manual for qualitative reserachers. SAGE Publications, Los Angeles, CA Saldana J (2009) An introduction to codes and coding the coding manual for qualitative reserachers. SAGE Publications, Los Angeles, CA
30.
go back to reference Fisch MJ, Lee JW, Weiss M, Wagner LI, Chang VT, Cella D et al (2012) Prospective, observational study of pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 30(16):1980–1988. https://doi.org/10.1200/JCO.2011.39.2381 CrossRef Fisch MJ, Lee JW, Weiss M, Wagner LI, Chang VT, Cella D et al (2012) Prospective, observational study of pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 30(16):1980–1988. https://​doi.​org/​10.​1200/​JCO.​2011.​39.​2381 CrossRef
35.
go back to reference Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM et al (2017) Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 35(1):96–112. https://doi.org/10.1200/jco.2016.70.1474 CrossRef Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM et al (2017) Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 35(1):96–112. https://​doi.​org/​10.​1200/​jco.​2016.​70.​1474 CrossRef
36.
go back to reference Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM et al (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 30(8):880–887. https://doi.org/10.1200/jco.2011.38.5161 CrossRef Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM et al (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 30(8):880–887. https://​doi.​org/​10.​1200/​jco.​2011.​38.​5161 CrossRef
37.
go back to reference Institute of Medicine (IOM) (2008) Cancer care for the whole patient: meeting psychosocial health needs. National Academies Press (US), Washington, DC Institute of Medicine (IOM) (2008) Cancer care for the whole patient: meeting psychosocial health needs. National Academies Press (US), Washington, DC
38.
go back to reference Anderson KO, Mendoza TR, Valero V, Richman SP, Russell C, Hurley J et al (2000) Minority cancer patients and their providers: pain management attitudes and practice. Cancer 88(8):1929–1938CrossRefPubMed Anderson KO, Mendoza TR, Valero V, Richman SP, Russell C, Hurley J et al (2000) Minority cancer patients and their providers: pain management attitudes and practice. Cancer 88(8):1929–1938CrossRefPubMed
39.
go back to reference Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P et al (2016) Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 34(6):557–565. https://doi.org/10.1200/JCO.2015.63.0830 CrossRef Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P et al (2016) Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 34(6):557–565. https://​doi.​org/​10.​1200/​JCO.​2015.​63.​0830 CrossRef
40.
go back to reference Cleeland CS, Wang XS, Shi Q, Mendoza TR, Wright SL, Berry MD et al (2011) Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 29(8):994–1000. https://doi.org/10.1200/JCO.2010.29.8315 CrossRef Cleeland CS, Wang XS, Shi Q, Mendoza TR, Wright SL, Berry MD et al (2011) Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 29(8):994–1000. https://​doi.​org/​10.​1200/​JCO.​2010.​29.​8315 CrossRef
41.
go back to reference Berry DL, Blumenstein BA, Halpenny B, Wolpin S, Fann JR, Austin-Seymour M et al (2011) Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 29(8):1029–1035. https://doi.org/10.1200/JCO.2010.30.3909 CrossRef Berry DL, Blumenstein BA, Halpenny B, Wolpin S, Fann JR, Austin-Seymour M et al (2011) Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 29(8):1029–1035. https://​doi.​org/​10.​1200/​JCO.​2010.​30.​3909 CrossRef
Metadata
Title
Racial differences in symptom management experiences during breast cancer treatment
Authors
Cleo A. Samuel
Jennifer Schaal
Linda Robertson
Jemeia Kollie
Stephanie Baker
Kristin Black
Olive Mbah
Crystal Dixon
Katrina Ellis
Eugenia Eng
Fatima Guerrab
Nora Jones
Amanda Kotey
Claire Morse
Jessica Taylor
Vickie Whitt
Samuel Cykert
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 5/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-017-3965-4

Other articles of this Issue 5/2018

Supportive Care in Cancer 5/2018 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine