Feminist Understandings of Embodiment and Disability: A "Material-Discursive" Approach to Breast Cancer Related Lymphedema

Breast cancer related lymphedema (BCRL) is a disability related to breast cancer treatment which may significantly affect women's everyday lives. We used a "material discursive" lens to analyze women's accounts of BCRL. Themes which emerged are: 1) moving beyond breast loss; 2) implications of disability; and 3) beyond limitations.Le lymphoedème relié au cancer du sein (LRCS) est une invalidité reliée au traitement du cancer qui peut affecter de manière significative la vie quotidienne des femmes. Nous nous sommes servies d'une lentille de "matériel discursif" pour analyser les comptes-rendus des femmes sur le LRCS. Les thèmes qui en sont découlés sont: 1) aller au delà de la perte; 2) lesrépercussions de l'invalidité; et 3) au -delà des limites

A Critical Analysis of the Delivery of a Psychosocial Workshop for Cancer Survivors with Lymphedema

Secondary lymphedema is a chronic condition that can develop after the treatment of cancer and can often lead to negative psychological and social impairments. When dealing with chronic illness, hoping and coping are interdependent. Previous research has assessed the outcomes of workshops designed to enhance hope but has not examined the workshop itself to determine how those outcomes were achieved. This study deconstructs the Living Hopefully with Lymphedema workshop to identify (1) what aspects of the workshop facilitated or interfered with therapeutic progress, (2) key aspects of facilitation that contributed to the functioning of the workshop, and (3) how participants responded to the workshop. Two three-day workshops were attended by a total of 19 participants. All sessions were audio taped and the recordings analyzed. Theoretical coding revealed a central theme focused on the importance of a safe environment within the workshop. Facilitators and participants worked together to co-create, maintain, and protect a safe space in which to engage in therapy. Findings are discussed in relation to key aspects of facilitation and the participants’ response to the workshops. Recommendations for future workshop development are presented

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Envisioning the Future with Aboriginal Breast Cancer Survivors

Photovoice is a newly emerging participatory method of research. In this article, we discuss findings resulting from a photovoice project completed with young Aboriginal women who had experienced breast cancer. Three key interrelated themes linked to ethnicity, age, and identity, were particularly salient for the research participants. These are conceptualized as: (1) shame and silence; (2) resilience and strength; and (3) support. Résumé La photo-voix est une nouvelle technologie participative de recherche émergente. Dans cet article, nous discutons des conclusions qui résultent du projet de photo-voix complété par une jeune autochtone qui a souffert du cancer du sein. Trois thèmesclés étroitement liés à l'ethnicité, l'âge, et l'identité, étaient saillants pour les participantes à la recherche. Les trois sont conceptualisés ainsi: (1) la honte et le silence; (2) la résistance et la force; (3) le support

Understanding breast cancer stories via Frank's narrative types

While breast cancer narratives have become prevalent in Western culture, few researchers have explored the structure of such narratives, relying instead on some form of thematic analysis based upon content. Although such analyses are valuable, Arthur Frank (The Wounded Storyteller, The University of Chicago Press, Chicago, 1995) provides researchers with an additional means of studying stories of illness, through the examination of their structures. In this article, the author applies Frank's work to a phenomenological study of embodiment after breast cancer. Frank's three narrative types are used to enhance understanding of the ways in which stories are culturally constructed, using data collected through one focus group discussion and two in-depth interviews with each of 12 women who had experienced breast cancer. The author then conveys the significance of this form of analysis for future research.Breast cancer Qualitative and narrative

Widening the Circle of Care : Digital Stories of Community-Based Caregiving in a Mohawk First Nation

Caregiving has various connotations within diverse social and cultural settings. Within First Nations communities, caregiving may be understood as a central practice of reclaiming cultural identity and teachings from colonial systems of healthcare. Our community-based participatory research project explored the experiences, needs, and strengths of caregivers within the Mohawk Nation of Kahnawake in what is currently called Canada. Through a partnership with a local cancer support group and a local hospital, we recruited six caregivers to create digital stories of caring for others living with cancer in the community. We then screened and discussed the significance of the digital stories with community members at a world café event. The resulting themes of caregiving emerged from community responses: (1) gifts and teachings, (2) being there, being present, and (3) circle(s) of care. We discuss these themes and the community’s recommendations for strengthening and sustaining community-based caregiving in Kahnawake

Les bienfaits de l’écriture : étude qualitative portant sur les ateliers communautaires destinés aux survivantes du cancer du sein

Survivre au cancer du sein peut s’avérer difficile vu le peu de soutien communautaire disponible dans ce domaine. En ce sens, l’écriture constitue une intervention psychosociale prometteuse, mais la plupart des études n’ont évalué cette activité que du point de vue individuel. Pour faire contrepoint, notre étude qualitative (n = 12) a analysé l’expérience vécue par des femmes ayant participé à un atelier d’écriture communautaire. L’analyse des entrevues effectuées dans le cadre de l’étude, ainsi que des carnets d’écriture tenus par les participantes et des enregistrements de l’atelier a mis en évidence trois thèmes : a) avoir un endroit rassurant pour se confier; b) se donner le droit de penser à soi et chercher à retrouver son équilibre; c) surmonter ses craintes et combattre l’incertitude. Ces thèmes illustrent les besoins non comblés liés à l’impact émotionnel du cancer du sein, ainsi que le pouvoir de l’écriture en groupe en vue de favoriser le bien-être. Les programmes (communautaires) peuvent pallier aux lacunes présentes dans les soins offerts aux survivants du cancer, en créant des endroits rassurants pour l’expression des émotions, tout en soutenant les participantes dans la rédaction de nouveaux récits axés sur le bien-être et la tenue d’un journal