The Other Side of Through: Young Breast Cancer Survivors’ Spectrum of Sexual and Reproductive Health Needs

Abstract

The long-term reproductive health impact of cancer treatments is a concern for premenopausal women with a history of breast cancer. This study examined the unmet sexual and reproductive health needs of breast cancer survivors, as well as concordances and discordances in needs by childbearing status and race. We interviewed 17 women diagnosed with breast cancer between the ages of 18 and 45 years and living in North Carolina. To analyze these data, we used the Sort and Sift, Think and Shift© method, a multidimensional qualitative analysis approach. We learned that breast cancer survivors (a) received limited reproductive health information, (b) desired realistic expectations of conceiving postcancer, (c) struggled with adjusting to their altered physical appearance, and (d) had menopause symptoms that led to sexual health and quality of life issues. Breast cancer survivors are in need of and desire more education and resources to address their sexual and reproductive health concerns.

“I Will Not Be Defined by This. I’m Not Going to Live Like a Victim; It Is Not Going to Define My Life”: Exploring Breast Cancer Survivors’ Experiences and Sense of Self

“…The experience of a chronic illness such as cancer and the reaction to it can trigger tremendous levels of anxiety; it alters a person’s self-concept and shifts the previously known identity to a new unknown identity (Phipps, 2018). Cancer is perceived as an invader, feared as incurable and life-threatening, impacts a woman’s physical and psychological well-being, and affects survivors’ womanhood, motherhood, femininity, and sexuality (Baglama & Atak, 2015; Black et al, 2020). During early stages of diagnosis, cancer patients often view themselves as unworthy, victimized, out of control, and at risk of dying (Contrada & Ashmore, 1999).…”

“…Fear is prominent and distressing, associated with the sense of uncertainty and the unknown and impacts the cancer survivors’ lives (Connerty & Knott, 2013). In reappraising their encounter with their mortality, BC survivors faced various types of fears in their cancer journey such as pain, physical mutilation and disfigurement, distorted body image, loss of hair, loss of sexuality, cancer recurrence, uncertainty about the future, and fear of death (Baglama & Atak, 2015; Black et al, 2020; S. Smith et al, 2018; Williams & Jeanetta, 2015).…”

“…Persons often attempt to overcome a traumatic event in their lives by actively searching for and developing coping mechanisms (Engebretsen & Bjorbaekmo, 2020;Srivastava, 2015). Coping mechanisms may be problemfocused or emotion-focused (Lazarus & Folkman, 1984), and the former type is generally consistent with survivors of chronic disease and is associated with a better quality of life (Black et al, 2020;Shakeri et al, 2015;Srivastava, 2015). Problem-focused coping refers to a positive reframing and active reappraisal of behavior to gain control and resolve a crisis (Mehrabi et al, 2015).…”

“…Support from family and friends provides comfort and a source of strength during treatment and post-treatment (Ching et al, 2012; Min et al, 2013; Williams & Jeanetta, 2015). Cancer patients who have strong social support have a better quality of life, are more optimistic, and can enjoy better mental and emotional health (Black et al, 2020; Caprara et al, 2016; Mahdian & Ghaffari, 2016). Therefore, it is important that the cancer patient’s social network as well as care providers are highly vigilant in providing emotional and mental support (Asiedu et al, 2014).…”

And It’ll Come Back Real Baby Fine: Black Women’s Experiences With Hair Loss and Regrowth After Chemotherapy for Breast Cancer Treatment

“…For women, in particular, important social meanings are attached to body parts, especially the secondary sex characteristics like breasts and hair that signal how a woman wears her (pretty) feminine identity (Black et al, 2020; Elson, 2003; Sulik, 2011). Such focus on the physical appearances while women are receiving treatment appeals to traditional notions of femininity, which are steeped in hegemonic norms of the goodness and beauty a woman is supposed to represent (Sulik, 2011).…”