Older Women With Breast Cancer: New Understandings Through Grounded Theory Research

Abstract

Breast cancer incidence increases by decade of life, significantly affecting the lives and well-being of older women. In a critical analysis of three decades of quantitative and qualitative research literature. I found an indication that something changed over the course of time that allowed women to adjust to breast cancer and resolve emotional turmoil. However, it was not clear what was "adjusted," or what constituted the process that allowed women to restore meaning within illness. In this paper I discuss the benefits of using a grounded theory approach in the study of older women with breast cancer. A brief overview of the study is given for context. The main focus of this paper is on the contributions of grounded theory research to new understandings of the cancer experience for older women. Contrary to findings in the quantitative literature, this study raised awareness of several issues: the myth of burden in researching older women, willingness to participate in decision making around treatment, ageism, and positive collusion in communication with health professionals.

Living into old age with the consequences of breast cancer

“…The women in this study reported a number of physical problems which pre-existed their breast cancer but, in common with the study by Crooks (Crooks 2001), there seemed to be little discussion of these with the women prior to surgery or through rehabilitation. The findings also suggest that older women may sometimes have difficulty distinguishing between the effects of breast cancer or breast cancer treatment and the effects of other co-morbidities, particularly arthritis, which may have implications for the detection of recurrent disease.…”

“…As a consequence the number of older women in the population living with the long-term consequences of breast cancer is also increasing as women survive longer and as the population continues to age. Although there is a growing body of research into living with breast cancer (Crooks 2001;Liang, Burnett et al 2002;Ballantyne 2004;Maly, Leake et al 2004) the experiences of older women have been relatively neglected.…”

“…Reduced quality of life may be because chronic disease is associated with a variety of common non-specific symptoms such as pain, fatigue, loss of appetite, depression, anxiety and functional decline (Vacek, Winstead-Fry et al 2003;Walke, Gallo et al 2004). Despite this, a study of older women with breast cancer found that few had their physical needs or physical function assessed or had been asked how they *Manuscript (without author details) were managing at home (Crooks 2001). Furthermore, Perkins et al (Perkins, Small et al 2007) report considerable variability in the well-being of older breast cancer survivors.…”

“…Physicians have been reported to spend less time with older women, and provide better information and support and more choice to younger patients (Cawley, Kostic et al 1990;Crooks 2001;Liang, Burnett et al 2002). Studies have shown that an increase in communication between doctors and older women resulted in increased knowledge about breast cancer, increased patient satisfaction, a reduction in treatment delay, an increase in the ability to make decisions, and the uptake of optimal treatment (Maly, Leake et al 2004), especially in those aged over 80 (Liang, Burnett et al 2002).…”

“…Furthermore, being offered written information without adequate verbal explanation is suggested to indicate a lack of interest in them as people (Crooks 2001). Sources of information and support through the Internet are less likely to be accessed by older people, particularly the very old.…”