Cancer's Impact on Social Roles

Abstract

assisted with specific physical therapy programs focused on treatment side effects, and ran supportive group activities. Additionally, a strong component of the program involved re-engaging patients in society through such activities as volunteer work, role exchanges, and bike tours. It is quite fascinating to see the types of activities Xiaomei and colleagues chose for this rehabilitation activity, which have both similarities and differences with the activities typical of integrative oncology in North America and Europe. By its use of activities directed toward re-engaging with society, this study also emphasizes the need of cancer patients to feel that they are active, contributing, and worthwhile members of their families and larger communities. Xiaomei and colleagues see retrogression in social and family functioning as a major component of the decreased quality of life that cancer patients experience. In fact, they state that the extent of damage to social functions is even worse than the damage to the body or the mind. As I have told patients for many years, cancer involves a major alteration in one’s biography as well as an alteration in biology. Changes in social roles follow from cancer symptoms, treatment side effects, disfigurement, fatigue, problems with activities of daily living, worries about recurrence, and concerns with being a burden on loved ones. These changes in social roles and possibilities are a concern for patients around the globe. Nearly 40% of Danish cancer patients in a recent survey reported high levels of distress, primarily from worries about spouses, household duties, and financial problems, as well as lack of collaboration between health care and social services. 1 About a fifth of this group required assistance in emotional, legal, financial, and practical problems in the home. A study of a multiethnic group of breast cancer patients in the United States found that among all the different ethnic groups, concerns with burdening families, worry about children, changes in gender roles, and balancing obligations of self-sacrifice for the sake of family with the need for self-care as a cancer patient were very real issues that impacted health-related quality of life. 2