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Explores the hidden costs of the pink ribbon as an industry and analyzes the social impact on women living with breast cancer -- the stereotypes and the stigmas.
Previous research has revealed that 10.4% of breast cancer deaths in white women in the United States occurred in Appalachia (Yao et. al, 2012). Rates of unstaged breast cancer, cancer for which there is not enough medical evidence to classify the disease progression (National Cancer Institute, 2013), are higher in the rural regions compared to the urban regions of Appalachia (Lengerich et. al, 2005). In the United States, the rates of adherence to adjuvant hormone therapy, a standard therapy prescribed for estrogen receptor positive breast cancer cases, are between 70-80%, while the rate of discontinuation of this treatment is 20%. However, in Appalachia, there is a 69% adherence rate and a 30% discontinuation rate to the same adjuvant hormone therapy. A disparity in breast cancer diagnosis and care exists not only between Appalachia and the rest of the United States but also between urban and rural areas of Appalachia (Lengerich et. al, 2005). While biological or environmental differences may contribute to the increased rates in rural Appalachia, there may be psycho-social-cultural barriers that prevent women with breast cancer in Appalachia from receiving equitable diagnosis or care for their cancer. Women in the United States are benefiting from advances in medical treatment for breast cancer (Elkin & Hudis, 2015); however, women in rural Appalachia still seem to suffer from the burden of this disease (Lengerich et. al, 2005; Yao et. al, 2012). They are more likely to be diagnosed with unstaged cancer, more likely to discontinue using critical therapies, and more likely to die of breast cancer than their urban counterparts. To develop effective interventions to increase optimal care in Appalachia, we need to understand why some women receive diagnosis and care for their breast cancer, while some do not. This thesis explores a facet of this complex issue by considering: of women in Appalachia with breast cancer who did receive care, what positively influenced their pursuit of care and treatment? Using the theory of reasoned action (Ajzen & Fishbein, 1980) as a framework, I sought to understand the experiences of women in Appalachia who pursued care for their breast cancer, and how these experiences influenced their entrance and continuation of care. The results of this study revealed consistencies and inconsistencies with the theory of reasoned action, as well as the need for consideration of factors not address by the theory. These findings have practical implications for how cancer centers support and educate patients, and how physicians present treatment plans.
Breast cancer is reaching epidemic levels, especially among black women. This survival guide provides tools that women—black women in particular—can use to identify and combat this all-too-common threat. This "what you need to know" guide is unique in its common sense, "laywoman's" approach and particular relevance to women of color. Its premise is simple: ignorance and lack of education about breast cancer signs and symptoms are still all too prevalent among black women. Many women are not informed about resources available for early detection screening and are not referred for mammography screening. They may also receive significantly delayed treatment—especially black women. For those reasons and more, black women with or at risk for breast cancer need an advocate who speaks for them and tells them the truth. They have that advocate in Cheryl Holloway, PhD—and in this book. A breast cancer survivor and cancer researcher, Dr. Holloway draws on her personal experience and research to offer something far different than the usual medical/oncological works. Her book provides support, current information, and practical advice for confronting and beating the disease. The book is divided into four parts. "Dealing with the Basics" explains how breast cancer hits black women harder and discusses the types of breast cancer they may develop, with an emphasis on the most dangerous. The second section offers practical information, such as how screenings work and the meaning of various breast cancer tests. Part three describes treatments, including surgery, radiation therapy, chemotherapy, hormone therapy, combined therapy, and other options. The final section describes how to stay vigilant after the cancer is gone and also discusses other forms of cancer for which black women are at risk, such as lung cancer, colon cancer, and cervical cancer.
African-American women have a 40% higher mortality rate from breast cancer than White women. While there are many factors contributing to this disparity, the timely initiation of treatment is growing area of interest. Certain treatments are associated with increased survival for women with a breast cancer diagnosis, yet evidence suggests that African American women use these treatments less frequently compared to White women with similar tumor characteristics. An under-explored area of attention for scientific studies is how to identify and engage in care women who do not follow up with treatment following a suspicious finding. To date these women have not been included in research focused on understanding treatment decisions and patient engagement in care decisions. Often these are among the most marginalized women of our society who have some of the highest rates of mortality from many different health related outcomes. This study helps to fill this gap by identifying and engaging these women in research. This study explored in-depth the lived experience of eight African American women, living in a socially and economically isolated environment in a large metropolitan area. In all cases the initiation of treatment was delayed for more than six-months, with a delay in the initiation of treatment of more than a year in three of the eight examples and more than two years in one of the eight examples. In accordance with phenomenological qualitative methodology, the interviews were open-ended, allowing for rich, in-depth data to emerge relatively unbiased by the assumptions and expectations of the researcher. The research questions for this study were: (1) What are the lived experiences of African American women who had not followed up with care for a diagnosis of breast cancer for 6-months or more following a suspicious finding? (2) How does she apply meaning to the process of deciding whether or not to initiate treatment? and (3) Under what socioeconomic circumstances does the phenomenon (a delay in treatment initiation) persist? Key findings suggest that engaging patients in health care decision making necessitates a better understanding of the processes involved in treating breast cancer, the impact that the side-effects may have on her quality of life, and access to patient support services to counter these side-effects. Also, the findings from this study highlight that most of the communication about treatment initiation occurred at the primary care level, prior to initiating contact with oncology services. Primary care proved to be the most important provider-patient relationship for these women. It is where they go with initial concerns about their breasts and where they return for more information about treatments and patient support for side-effects. Furthermore, the context within how they experienced the phenomenon is structured by underlying conceptualizations of chronic traumatic events coupled with community resource deserts. Finally, all of the women reported keeping their illness to themselves and described social and cultural barriers to utilizing available support systems to assist with unmet needs. All of these situations taken together allowed the delay in the initiation of treatment for breast cancer to persist. These results indicate that future interventions focused on engaging women in care decisions and decreasing socioeconomic barriers to the initiation of the treatment for breast cancer should take place between primary care providers, oncologists, and their patients and focus on de-mystifying the process of treatment. Incorporating this information, as a type of barrier-focused community-based intervention, or improved case management services to assist cancer patients in the primary care setting, would impact cancer mortality outcomes.
Health Communication and Breast Cancer among Black Women: Culture, Identity, Spirituality, and Strength addresses how the discourse of strength constructs the identity of Black women even during times of chronic illness through the lens of Black feminist thought and womanist ideology. In doing so, Madlock Gatison explores how the narratives surrounding pink ribbon awareness and survivorship culture, religion and spirituality, and the myth of the strong Black woman impact Black female breast cancer survivors’ self-perceptions, views others had of them, and their ability to express their needs and concerns including those involving their healthcare. This book will be of interest to scholars of public health, health communication, and sociology.
Although there are numerous technical-scientific books on breast cancer in the global bibliography, such books deal exclusively with the nature of the disease in majority populations of the Western societies, with little or no reference to the nature of the disease in the minority populations in such societies. Similarly, the nature of breast cancer in black women of the less privileged societies, and in women of ethnic groups living in countries of similar socio-economic status, is virtually unknown. For various epidemiological reasons, breast cancer incidence is rapidly increasing in these counties, more so than currently is the case in developed countries. Thus, the global burden of cancer is shifting gradually to these areas of the world, and may equal or even surpass the breast cancer burden in the Western societies within the foreseeable future. This book is unique because it bucks the trend of virtually all other breast cancer books by addressing specifically the breast cancer experience of women of African descent and their lifestyle counterparts in other societies of the world.
Personal stories, medical advice, and honest answers to the questions young women with breast cancer ask.
Vividly showcasing diverse voices and experiences, this book illuminates an all-too-common experience by exploring how women respond to a diagnosis of breast cancer. Drawing from interviews in which women describe their journeys from diagnosis through treatment and recovery, Julia A. Ericksen explores topics ranging from women's trust in their doctors to their feelings about appearance and sexuality. She includes the experiences of women who do not put their faith in traditional medicine as well as those who do, and she takes a look at the long-term consequences of this disease. What emerges from her powerful and often moving account is a compelling picture of how cultural messages about breast cancer shape women's ideas about their illness, how breast cancer affects their relationships with friends and family, why some of them become activists, and more. Ericksen, herself a breast cancer survivor, has written an accessible book that reveals much about the ways in which we narrate our illnesses and about how these narratives shape the paths we travel once diagnosed.
While breast cancer continues to affect the lives of millions, contemporary writers and artists have responded to the ravages of the disease in creative expression. Mary K. DeShazer’s book looks specifically at breast cancer memoirs and photographic narratives, a category she refers to as mammographies, signifying both the imaging technology by which most Western women discover they have this disease and the documentary imperatives that drive their written and visual accounts of it. Mammographies argues that breast cancer narratives of the past ten years differ from their predecessors in their bold address of previously neglected topics such as the link between cancer and environmental carcinogens, the ethics and efficacy of genetic testing and prophylactic mastectomy, and the shifting politics of prosthesis and reconstruction. Mammographies is distinctive among studies of contemporary illness narratives in its exclusive focus on breast cancer, its analysis of both memoirs and photographic texts, its attention to hybrid and collaborative narratives, and its emphasis on ecological, genetic, transnational, queer, and anti-pink discourses. DeShazer’s methodology—best characterized as literary critical, feminist, and interdisciplinary—includes detailed interpretation of the narrative strategies, thematic contours, and visual imagery of a wide range of contemporary breast cancer memoirs and photographic anthologies. The author explores the ways in which the narratives constitute a distinctive testimonial and memorial tradition, a claim supported by close readings and theoretical analysis that demonstrates how these narratives question hegemonic cultural discourses, empower reader-viewers as empathic witnesses, and provide communal sites for mourning, resisting, and remembering.