Ethnicity and persistent symptom burden in breast cancer survivors

Abstract

Introduction Relatively few studies of breast cancer survivors have included nonwhite women or women who do not speak English. Methods We administered a survey to patients who were ≥3 months post-completion of their adjuvant treatment for stage 0–III breast cancer at Columbia University Medical Center in order to assess the prevalence of 16 physical and emotional symptoms and identify sociodemographic factors associated with these symptoms. Univariate analysis, factor analysis, ANOVA, and multiple linear regression analysis were performed. Results Of 139 patients surveyed, 58 were white, 63 Hispanic, and 18 black. The symptom most commonly reported was fatigue(76%), and the most common severe symptom was muscle aches(40%). Most patients(70%) complained of ≥6 symptoms. Hispanic women were more likely to report >10 symptoms (p<0.05). Factor analysis reduced the 16 symptoms to 4 underlying symptom clusters that we categorized as ‘depression’, ‘chemotherapy’, ‘hormone’, and ‘pain’-related. In the multiple linear regression models, Hispanic women were more likely to report chemotherapy-related symptoms (p<0.05) and pain-related symptoms (p<0.05). Unemployed women were more likely to report chemotherapy-related symptoms (p<0.05). Women <45 years old were less likely to report chemotherapy (p<0.05) and pain-related symptoms (p<0.05). Conclusions The majority of women in this study, particularly those who were Hispanic, elderly, or unemployed, experienced persistent symptoms, most commonly fatigue and muscle aches. Implications for cancer survivors Because Hispanic, elderly, or unemployed women experience greater symptom burden, efforts should made to address their unique needs.

Posttreatment survivorship care needs of Spanish-speaking Latinas with breast cancer

“…17 Results of two studies that included white, African American and Latina breast cancer survivors were consistent with ours in finding that pain and fatigue were among the most persistent symptoms; in both studies, Latinas were more likely to report pain and a higher number of symptoms. 7,18 The prevalence of sleep problems in our sample was identical to that reported in a sample of African American breast cancer survivors. 19 Our findings of a high need for symptom management information and support, social support from family and friends, and self-management resources were similar to studies of other vulnerable breast cancer survivors.…”

Subgroups of chemotherapy patients with distinct morning and evening fatigue trajectories

“…Specifically, compared to the High Evening Fatigue class, a higher percentage of White patients belonged to the Very High Evening Fatigue class. Findings regarding ethnic differences in the occurrence and severity of symptoms in oncology patients are inconsistent [43,44] and warrant additional investigation.…”

Breast Cancer Among Special Populations: Disparities in Care Across the Cancer Control Continuum

“…Hispanic women have been found to suffer more from pain, fatigue, depression, and fi nancial hardship related to treatment compared to non-Hispanic women (Fu et al 2009 ;Graves et al 2012 ). American Indian/Alaskan Native women also report problems related to pain, fatigue, depression and hair loss (Burhansstipanov et al 2010 ).…”