Support Care Cancer. 2017 Nov 18. doi: 10.1007/s00520-017-3965-4. [Epub ahead of print]

Racial differences in symptom management experiences during breast cancer treatment.

Samuel CA1,2, Schaal J3, Robertson L4, Kollie J5, Baker S6, Black K7,8, Mbah O5, Dixon C9, Ellis K7,8, Eng E7,8, Guerrab F10, Jones N11, Kotey A7, Morse C12, Taylor J5, Whitt V11, Cykert S13,14.

Author information

1

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA. cleo_samuel@unc.edu.

2

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27599, USA. cleo_samuel@unc.edu.

3

The Partnership Project, 620 S. Elm St, Suite 381, Greensboro, NC, 27406, USA.

4

Department of Medicine, University of Pittsburgh, 5150 Centre Avenue, POB 2 Room, 438, Pittsburgh, PA, 15232, USA.

5

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA.

6

Department of Public Health Studies, Elon University, Campus Box 2337, Elon, NC, 27224, USA.

7

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.

8

Cancer Health Disparities Training Program, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB#7440, Chapel Hill, NC, 27599-7440, USA.

9

Department of Public Health Education, University of North Carolina at Greensboro, 437 Coleman Building, P.O. Box 26170, Greensboro, NC, 27402-6169, USA.

10

Department of Public Health Education, North Carolina Central University, 1801 Fayetteville St, Durham, NC, 27701, USA.

11

Sisters Network Greensboro, P.O. Box 20304, Greensboro, NC, 27420, USA.

12

Guilford College, 5800 W Friendly Ave, Greensboro, NC, 27410, USA.

13

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27599, USA.

14

School of Medicine, University of North Carolina at Chapel Hill, 5034 Old Clinic Building, CB#7110, Chapel Hill, NC, 27599, USA.

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.