Banning, M

The Breast

English

Brunel University Research Archive

LETTER TO THE EDITOR: The experience of living with breast cancer  Maggi Banning  Breast Journal Published by Elsevier  To the editor: There is no universal experience of living with breast cancer, only individuals that have the experience can relate to it (1). Every woman’s interpretation of the experience of living with the disease will be influenced by factors such as social, racial, cultural, religious, age but also the influence of family members, particularly spouses (2-3). These factors may underpin the types of suffering they endure (4-5). Suffering is ‘an individualized, subjective and complex experience that involves the assignment of an intensely negative meaning to an event or a perceived threat” (6). Suffering occur at all ontological levels. Women with breast cancer experience suffering related to all dimensions of life; physical pain, emotional, psychological, spiritual and social forms of suffering (7-8).    The lived experience of breast cancer commences with the shock of the diagnosis. This is usually unexpected and the journey to diagnosis is transforming event that can cause many women to develop fears and anxieties about receiving chemotherapy and recurrence of the cancer, and trepidation about imminent death (9). This transforming event is associated with emotional chaos (8, 10) and a period of adjustment to the physical and emotional influences of breast cancer but also on feelings of loss of dignity, femininity and sexuality following a mastectomy (2, 11). These feelings may be stronger in younger women who also have fears associated with the potential loss of partners or husbands.    1Living with breast cancer increases a woman’s body consciousness and can result in loss of self-esteem, emotional support and coping with disability, potential disfigurement following surgery (12-13), living with continual uncertainty and the premature onset of the menopause. The early onset of the menopause can be extremely stressful for younger women with fears about careers and personal relationships both of which can be influenced by physical and emotional changes that they have to endure as a result of the disease (14). The psychological adjustment that is central to survival is thought to be based on maintaining a fighting spirit and emotional anger, also possessing continual sense of hope to cope with the illness trajectory (10). Women recall having to deal with the backache associated with having only one breast and being self conscious of wearing breast prosthesis (11).   Professional support is an essential element of the illness trajectory. Women need information about preparing for surgery (15) and adjustment post surgery, cure rates, available treatment options and treatment cycles (4). Women also require information on the possible spread of the disease. Information giving is not only an essential objective of cancer care (16), but is also an important component of the coping strategy that helps women to adjust psychologically to the illness especially after the initial shock of diagnosis. In order for patients to be fully supported throughout the illness trajectory, medical and breast cancer nurse specialists need to provide patients with professional advice on issues pertinent to not only current but also long term pharmacological, non pharmacological and follow up care (17). Understanding the lived experience of women with breast cancer can help nursing and medical practitioners to provide proficient care that meets the continual needs of their patients.  Maggi Banning, EdD.  References  1. Landmark, B.T. & Wahl, A. (2002). Living with newly diagnosed breast cancer: a qualitative study of 10 women with newly diagnosed breast cancer. J.Adv. Nursing, 40, 1: 112-121.   22. Im,. E.O., Lee, E.O., & Park, Y.S. (2002). Korean women’s breast cancer experience. Western J. Nursing Research, 24: 751-771. 3. Taleghani, F., Yekta, Z.P. & Nasarabadi, A.N. (2006). Coping with breast cancer in newly diagnosed Iranian women. J. Adv. Nursing, 54:265-272.  4. Arman, M. & Rehensfeldt, A. (2003). The hidden suffering among breast cancer patients: A qualitative  metasynthesis. Qualitative Health Research, 13: 510-527.  5. Thomas-MacLean, R. (2004). Memories of treatment: The immediacy of breast cancer. Qual. Health Research, 14: 628-643.  6. Rodgers, B.L. & Cowles, K.V. (1997). A conceptual foundation for human suffering in nursing care and research. J. Adv. Nursing, 25: 1048-1053. 7. Arman, M., Rehnsfeldt, A., Lindholm, L. & Hamrin, E. (2002). The face of suffering among women with breast cancer-being in a field of force. Cancer Nursing, 25: 96-103.  8. Perreault, A.& Bourbonnais, F.F. (2005). The experience of suffering as lived by women with breast cancer. Int. J. Palliative Nursing, 11: 512-519. 9. Kralik, D., Brown, M. & Koch, T. (2001). Women’s experiences of ‘being diagnosed’ with a long-term illness. J. Adv. Nursing, 33: 594-602.  10. Landmark, B.T., Strandmark, M. & Wahl, A. (2001).Living with newly diagnosed breast cancer-the meaning of existential issues. Cancer Nursing, 24: 220-226.  11. Davies, M. & Sque, M. (2002). Living on the outside looking in: a theory of living with advanced breast cancer. International J. Palliative Nursing, 8: 583-590. 12. Cohen, M.Z., Kahn, D.L. & Steeves, D.H. (1998). Beyond body image: the experience of breast cancer. Oncology Nursing Forum, 25: 835-841.  13. Brown, M., Koch, T. & Webb, C. (2000). Information needs of women with non-invasive breast cancer. J.Clin. Nursing, 9: 713-722.  14. Knobf, M. (2002). Carrying on the experience of premature menopause in women with early stage breast cancer. Nursing Research, 51: 9-17.  15. Lindop, E. & Cannon, S. (2001). Evaluating the self-assessed support needs of women with breast cancer. J. Adv. Nursing, 34: 760-771.  16. Gysels, M. Richardson,A. & Higginson, I. (2004). Communication training for health professionals who care for patients with cancer: a systematic review of effectiveness. Supportive Care in Cancer 12: 692-700.  317. Vivar, C.G. & McQueen, A. (2005). Informational and emotional needs of long-term survivors of breast cancer. J.Advanced Nursing, 51: 520-528.     4

A conceptual foundation for human suffering in nursing care and research.

Beyond body image: the experience of breast cancer.

Carrying on the experience of premature menopause in women with early stage breast cancer.

Communication training for health professionals who care for patients with cancer: a systematic review of effectiveness. Supportive Care in

Coping with breast cancer in newly diagnosed Iranian women.

Evaluating the self-assessed support needs of women with breast cancer.

Information needs of women with noninvasive breast cancer.

Informational and emotional needs of long-term survivors of breast cancer.

Korean women’s breast cancer experience.

Living on the outside looking in: a theory of living with advanced breast cancer.

Living with newly diagnosed breast cancer: a qualitative study of 10 women with newly diagnosed breast cancer.

Letter to the editor: The experience of living with breast cancer

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