Perceptions of Radiation Therapy amongst Black Female Breast Cancer Survivors in Urban Communities

Abstract

<h3>Purpose/Objective(s)</h3> Perceptions of cancer care are impacted by many factors and differ among individuals. Patients generally want consistent support, effective communication, accessible treatments, and information to manage physical, emotional, and psychosocial needs. Black/African American cancer survivors have expressed concerns about providers ignoring the social and financial implications of cancer care and neglecting to address the generations of mistrust between minority communities and the healthcare system. There is limited information about these perceptions as they relate specifically to radiation therapy which we aim to address with this study. <h3>Materials/Methods</h3> Female breast cancer survivors identifying as Black/African American within the metropolitan Milwaukee area were eligible to participate in a semi-structured interview guided by a demographic questionnaire, a life narrative account, and a residential history. Participants were purposively sampled by neighborhood racial and ethnic composition (majority Black, minority Black, and racially diverse communities) to ensure a diversity of experiences. Interviews were transcribed and analyzed using a codebook developed and refined based on a conceptual model. Individuals worked in assigned pairs to open code each transcript. Data coded as "clinical presentation" or "treatment/healthcare" were pulled and reviewed for discussion of radiation therapy. Within these codes, further thematic analysis was performed to breakdown perceptions of this treatment modality. <h3>Results</h3> Fifty Black women were interviewed, 25 from majority, 7 from diverse, and 18 from minority communities. In discussing radiation therapy, six key themes emerged: emotional reactions, logistics of daily treatment, social barriers, side effects, general positive experiences, and general negative experiences. Emotional reactions included feelings of fear, anger, and being overwhelmed. Social barriers related to family obligations, transportation, distance from a treatment center, and racism. Commonly discussed side effects included fatigue, dermatitis, impacts on reconstruction, and long-term cardiotoxicity. Women living in majority Black communities were more likely to discuss side effects and general positive experiences while other themes were more equally explored by majority, minority, and diverse community members alike. <h3>Conclusion</h3> Black women have diverse and varied perspectives of radiation therapy during breast cancer treatment. Anticipated themes surrounding logistics, side effects, and overall emotions of treatment were observed. Unique to their experiences, Black women have faced racism and an increased burden of social barriers during their treatment. Further studies exploring the perspectives of Black female cancer survivors are needed to optimize quality of care and outcomes.