Lost and Found: Cross Cultural Perspectives on Breast Cancer Survivor Work

Abstract

This study provides a Qualitative Research Synthesis of the unique characteristics of women in the survival phase of breast cancer across cultures: African American, Asian, Latina and Caucasian American. Studies included in this review included Women Survivors of Breast Cancer who were at least one year past primary cancer therapy, were currently cancer free, and were between the ages of 30 and 85 years of age. The search criteria excluded Stage IV cancer survivors and those who were receiving adjuvant therapy. Utilizing an apriori research protocol and a process of discovery, iterative review and quality appraisal, an initial identification of 1,946 studies was reduced to a final selection of sixteen articles that met the inclusion / exclusion criteria. The findings of these sixteen studies were synthesized into a new interpretation of the process of breast cancer survivor work. The long time survival combined with the resulting lifelong issues exposed in the research, demonstrate the need for financial, medical, psychological and social support for breast cancer survivors and their families. Furthermore, the transformative nature of breast cancer exposes the excessive time and effort survivors spend doing survivorship. The various aspects of survivorship for breast cancer survivors include Emotion Work, Grief Work and Identity Work, which were previously considered distinct tasks. However, this study observed the integration of these factors in the formation a new model of Survivor Work. This is viewed as a dynamic theory that incorporates the processes of social interactionism in the production of a new identity formation. Additionally, the research revealed the impact of gendered identities and culture and/or ethnicity on the experience of the breast cancer survivor. Culture and/or ethnicity are shown to impact beliefs, socioeconomic status and the resulting perceptions of survivor identities, in the experience of the survivor work of breast cancer. This model may be further extended to other types of cancer and life-threatening illness where long-term survivorship is experienced. This research has implications for policy, intervention and treatment of women survivors of breast cancer, which includes the necessity for social and health policies, ensuring the availability and accessibility of transitional care planning and culturally competent care. This should include targeted recruitment of cross cultural health care providers, and culturally specific support groups targeted towards more focused and specific ethnicities than typical of the currently utilized categories.