Supporting Breast Cancer Survivors Through Psychosocial Challenges

Woman hands with breast cancer ribbon. | Image Credit: Konstantin Yuganov - stock.adobe.com

Patients that survived breast cancer should prepare to face psychosocial challenges such as the ongoing impact, uncertainty, identity, isolation, posttraumatic growth, return to work, quality of care, and supportive coping strategies to proactively overcome these.

A meta-review of 25 previously English-published studies from 1998 up to 2020 were further analyzed. Out of the 25 total studies, 8 were qualitative and 17 had mixed methods.

Observations revealed a significant burden of ongoing symptoms such as pain, fatigue, and cognitive issues in breast cancer survivors. Despite being considered healthy, this lingering physical and cognitive impact created a sense of unease. Studies suggested survivors adjust their daily routines to accommodate these limitations, while prioritizing social connections over the disease itself.

The transition from patient to survivor presented challenges of uncertainty about their future health and lifespan. Diminished medical support and patient interaction heightened anxieties, fueling a fear of recurrence and hypervigilance towards any potential symptom. This existential crisis manifested differently, as some embraced a newfound urgency to live life to the fullest, others grappled with mortality, particularly mothers planning for their children's futures.

Beyond physical hurdles, breast cancer survivors confront a multifaceted identity crisis. Body image shifts can trigger feelings of disfigurement and loss of femininity, while scars become badges of courage for others. Intimacy suffers with concerns around sexual desire, early menopause, and physical discomfort. Fertility becomes a complex issue, with some yearning for normalcy through pregnancy, while others worry about the fear of recurrence, genetic risks, and potential health complications for their children.

Many breast cancer survivors, facing the long-term effects of the disease, may feel misunderstood by loved ones. This can lead to isolation as a coping mechanism. Unfortunately, isolating themselves can lead to a loss of support, the very thing they might need most during this challenging time.

Studies highlighted the concept of posttraumatic growth in breast cancer survivors as well. This growth often manifested as a heightened appreciation for life, motivating survivors to live life to the fullest. The experience of cancer also fostered a sense of meaning and purpose as survivors connect and advocate for increased awareness alongside others facing the disease.

Returning to work was a complex issue for survivors. While some saw it as regaining normalcy and support, others faced unsupportive environments or anxieties about cognitive decline. Financial pressures also played a role.

Disparities in survivor experiences underscored the critical role of fostering trust and open communication with health care providers. This emphasis extends beyond clinical expertise to address persistent information gaps and access barriers, including geographic limitations, logistical challenges like transportation, and linguistic considerations.

Breast cancer survivors consistently identified the need for support and various coping strategies. Social support networks encouraged survivors to stay active, engage with their community, share their experiences, and manage the emotional weight of their diagnosis. Spirituality was a prevalent coping mechanism, offering solace and acceptance in the face of uncertainty. Survivors also adopted diverse approaches to manage the long-term effects, with some demonstrating resilience while others employed avoidance or denial as coping strategies.

The study's reliance solely on English-language reviews restricted its ability to capture the full spectrum of survivorship experiences. Systematic reviews are inherently limited by the interpretations and quotation choices made by the reviewers, potentially overlooking nuances in the primary literature. Additionally, the potential for duplicate results and the exclusion of unpublished data raise concerns about the comprehensiveness of the findings.

While breast cancer survivors face a multitude of challenges, including physical limitations, existential anxieties, and identity shifts, the studies also reveal a remarkable capacity for resilience and posttraumatic growth. By fostering open communication with health care providers, prioritizing social support, and exploring healthy coping mechanisms, survivors can navigate this complex journey and reclaim a sense of wellbeing.

Reference

King R, Stafford L, Butow P, Giunta S, Laidsaar-Powell R. Psychosocial experiences of breast cancer survivors: a meta-review. J Cancer Surviv. 2024;18:84-123. doi:10.1007/s11764-023-01336-x