(Un)Supportive Messages During a Time of Transition: Younger Women’s Memories of Support During the Re-Entry Phase of Breast Cancer Survivorship

Breast cancer is the most common cancer in women, and the greatest cause of death for women 50 years of age and younger in the United States. Compared to older breast cancer survivors, younger peers (aged 50 and below) are found to exhibit increased distress, depression, greater and sometimes severe fear of cancer recurrence, worse physical and psychological symptoms, heightened concerns about managing everyday life, and a lower quality of life. Furthermore, women within 18 months of primary treatment completion (also described as the “re-entry” period) have been shown to experience increased feelings of fear, stress, heightened physical and psychological symptoms, and an unfamiliar and altered body. Given these difficulties, the current study explored means through which younger women might better cope during re-entry. The current research considered socially supportive messages, communicative messages enacted with the intention of helping others cope with distress, as one method to assist with younger breast cancer survivors’ coping. Little is known about the characteristics of supportive messages that make them more or less supportive regarding breast cancer survivors’ coping during the re-entry period. Using a qualitative descriptive approach and thematic analysis methodology, the purpose of the current research was to describe and better understand the supportiveness and communicative message qualities of support in response to stressors reported by breast cancer survivors in re-entry (N=20) between 25 and 50 years of age. Younger breast cancer survivors noted that helpful supportive messages were those that ultimately acknowledged and validated ongoing challenges and provided comfort to cope with these existing difficulties. Helpful support came in various forms, including the provision of support by other breast cancer survivors, perceptions of available or anticipated network support, unsolicited emotional and tangible support, and validating, or person-centered, emotional support. Unsupportive messages within women’s reentry experiences included support that dismissed, avoided, or misunderstood the survivor’s lived experience. Unsupportive messages included those that displayed incorrect assumptions of the survivor’s experience, pity and discomfort, discouraging informational support, cultivation or affirmation of negative body image, and unaddressed or dismissed medical concerns. Participants noted potential ways in which socially supportive messages might provide increased comfort and coping during this transitional time. Broadly, women explained the value of supportive messages that acknowledged and validated their challenges and experiences, even when others did not fully understand these difficulties. Survivors explained that their cancer experience was not yet finished, citing numerous emotional and physical difficulties in re-entry that inhibited their adjustment. Participants thus recommended that others provide unsolicited emotional and tangible support in re-entry, as these supportive interactions reminded participants that their challenges were acknowledged and that others were thinking of them. Participants recommended that medical providers proactively elicit health concerns from survivors and endeavor to provide relevant information regarding potential symptoms, side-effects and helpful resources to remedy them. Survivors ultimately desired increased informational support from medical providers, citing that this information would greatly improve both physical and emotional adjustment to life in re-entry. The current research provides insight into the challenging time of transition that characterizes the re-entry period of younger breast cancer survivorship, illuminating that survivorship is not an end but rather a point within the cancer continuum