The race gap in support group participation by breast cancer survivors: real or artifact?

Addressing methodological weaknesses of previous research, this study assesses whether African American women are, in fact, less likely to participate in breast cancer support groups than are White women. Of the breast cancer survivors, 958 (26% African Americans, 73% Caucasian) completed interviews concerning demographic characteristics, other support networks, effects of illness on home and spiritual life, and support group participation. Contrary to previous research, no race difference was found in support group participation. This research suggests more effort needs to be paid to sampling techniques and other methodological factors to adequately reflect the experiences and needs of breast cancer survivors, specifically African American women.     

Why does cancer cluster?

What do Florida sunbathers, midwestern farmers, rural black men, and Long Island women have in common? They all have higher-than-average risks for certain cancers. Researchers know that cancer clusters are usually caused by several factors. As cancer becomes America's leading cause of death, the public will be keenly interested in sorting out the causes and reducing the risks.     

Are mainstream support services meeting the needs of sexual minority women with breast cancer? An exploration of the perspectives and experiences of users of an online support forum

We conducted an inductive content analysis of messages posted to the lesbian-specific discussion board forum found on breastcancer.org for the purpose of examining sexual minority women's experiences of and perspectives on mainstream cancer support services. Our analysis indicated that currently available support services might not be adequately addressing sexual minority women's unique needs. Individuals posting to the lesbian-specific forum reported the presence of homophobia, heterosexual bias, and feelings of exclusion in mainstream breast cancer support services. In contrast, forum users generally perceived nonspecific cancer support groups to be beneficial, yet the majority preferred lesbian-specific support.     

Women's satisfaction with their breast prosthesis: what determines a quality prosthesis?

The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital's usual funding were recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was "very good" or "excellent." Satisfaction was significantly associated with how well the prosthesis fit (1 week, p = .001; 3 months, p = .01), level of comfort (3 months, p=.005), and appearance of the prosthesis when worn (6 months, p = .001). Quality was significantly associated with how well it fit (1 week, p = .001; 3 months, p = .001), how natural it felt (1 week, p = .001; 6 months, p = .01), the weight of the prosthesis (3 months, p = .003), and appearance when worn (6 months, p = .03). The results will be used to improve women's access to a quality prosthesis.     

Making young tumors old: a new weapon against cancer?

As the population of industrial nations ages, the incidence of cancer and cancer mortality is increasing. Intuitively, older organisms may be less able to cope with accumulated damage and thus be more prone to develop cancer. However, so far, the links between aging and cancer have been only partially explored. Strikingly, four recent studies now indicate that premature senescence accompanied by cell cycle arrest occurs in tumors initiated by an oncogenic mutation. Thus, senescence may act as a key tumor suppressor mechanism in young tumors in vivo.     

When people become patients: fluctuations in trust from the cancer patient’s perspective

This study explores the trust relationships between cancer patients and their physicians by discussing the concept of trust and the collection of patients’ medical experiences before and after being diagnosed with cancer. The purpose of the study is to determine changes in patients’ trust during this process. This ethnographic study was conducted from 2009 to 2014 on doctor–patient relationships under the coverage of the National Health Insurance (NHI) in Taiwan. Under the NHI, patients may access physicians and acquire treatment at low cost. In this study, the sample comprised 12 female cancer patients. Data were collected in in-depth interviews with six patients. With the bloggers’ consent, data were collected from six blogs. These data were analyzed to determine how these cancer patients constructed and altered their opinions during their diagnosis and treatment. The results are discussed according to the calculative trust that was constructed based on information collected and/or impressions developed during their initial visits. The findings showed that relational trust was developed and (dis)evolved through interactions and experiences with medical staff. In addition, calculative trust was generated based on the following: eliminating institutions or physicians with which the patients had negative experiences; feeling and perceiving caring and professional competence; yielding to cancer and respecting professional reputations. Relational trust was derived from the following: the doctors’ ability to sooth patients’ anxieties and explain uncertainties; the compatibility of expectations in information sharing between physicians and patients. The results showed that in the early stage of developing a doctor–patient relationship, calculative and relational trusts were intertwined. As the doctor–patient relationship developed, the patients’ relational trust increased. The findings of this study contribute to the knowledge concerning the co-construction of patients’ trust in physicians in medical systems through communication between patients and medical staff.     

A 1,408 km bicycle tour with prostate cancer patients—results of a pilot study

Negative psychological and physical effects of prostate cancer and its medical treatment may persist many years after diagnosis. The influence of a long cycling tour on rehabilitative or health-related effects with prostate cancer patients has not yet been studied. In practice, physicians and therapists rarely recommend cycling to prostate cancer. In May 2010, eight prostate cancer patients rode their bikes for over 1,408 km from Cologne to Marseille within 5 weeks. Endurance test, blood examinations (prostate-specific antigen (PSA), total testosterone, interleukin-6, oxidative stress, and antioxidant capacity) and quality of life questionnaires were completed before and after the tour. All eight subjects reached Marseille. Significant improvements could be observed in physical performance and certain quality of life scores (p?=?0.008), as well as a reduction of total testosterone (p?=?0.19). PSA levels did not change. This pilot study suggests that long bicycle tours with prostate cancer patients are feasible. Due to the missing control group and the small sample size, the results of this pilot study are limited.     

“The risk of age”? Early detection test,prostate cancer and practices of self

Drawing on Rose and Novas’s concept of “biological citizenship” and Michel Foucault's "practices of self", this paper reflects on how men become agents of their own therapeutic regimens, and yet internalise messages of risk and practices of self within early detection of prostate cancer discourses in the late 20th century. In doing so, it traces the ways in which concepts of age, gender and risk converge at the problematic site of prostate cancer and preventative health strategies, both of the state and the medical profession. Analysing how insecurities have simultaneously resulted in over-promoting and over-diagnosing risk, thereby blurring the lines between normal and pathological states of health and aging, the paper finishes with a critical discussion on how men have adopted self-surveying and attuned themselves to risk discourses. Suggestions are made for future research on comparative gender studies on embodied concepts of self and cancer screening and the relation between differential aging, risk management and the concept of the body.     

An ‘unholy alliance’ of existential proportions: Negotiating discourses with men's experiences of cancer and aging

Little is understood about how experiencing cancer and aging together can disrupt people's socio-personal worlds and lead to existential questions about identity, life ambiguity, and death. Toward this end, we interpreted the metaphors that three aging men with cancer used in a focus group to describe their existential concerns. We also considered how two dominant cultural discourses around cancer and aging, generally referred to as discourses of “progress” and “decline”, figured into the participants' meanings. Finally, we compared the men's attitudes toward cancer and aging to dominant ideas about how men respond to these life events. Through interpretative phenomenological analysis, informed by critical phenomenology, we came to three conclusions. First, the men's interpretations of cancer and aging shared similar existential themes of tragedy and transcendence. Second, these existential concerns were informed by dominant discourses of cancer and aging, in that they followed the culturally constructed trajectories of decline and progress, respectively. The men's metaphors point to a negotiation of these two discourses. A third and related point is that the men predominantly contradicted gendered assumptions about dealing with life adversity but in some ways repeated them. This research indicates that people interpret cancer and aging in somewhat shared ways, via dominant cultural discourses, but also in individual ways depending on personal life histories. As discourses and life histories seem to influence how people make sense of aging life with cancer, it may be useful to be aware of these contexts when providing psycho-social care to aging cancer patients.     

Thirty years of physical activity in oncology in Germany—from the birth of the first rehabilitative cancer sports group until today

Since 1978, exercise and sport therapy for oncological patients is a research and education focus at the German Sport University of Cologne. Back then, the top priority for almost all oncological patients was to “rest”. Therefore, uncharted territory was entered. Aside from acute care hospitals, rehabilitation hospitals especially for oncological patients exist in Germany. In terms of the rehabilitation chain, which consists of acute care hospital, rehabilitation center, and home-based training, and the aspect of exercise therapy for breast cancer patients, the following progress could be observed in the last 30 years: In the 1980s, less than 50 % of the breast cancer patients received supervised exercise therapy during their 2- to 3-week hospital stay. Today, the length of hospital stay was reduced to 4 to 6 days and some hospitals have gym equipment to increase strength and endurance. In the beginning of the 1980s, passive applications (physiotherapy, massages, bubble baths, short hikes) were still dominant. While the rehabilitation stay took 6 weeks back then, it was reduced to 3 weeks today. Further, mainly group-based and active measures are applied today. The aim is to encourage and motivate patients to long-term physical exercise. In the meantime, mainly exercise and sports therapists are employed, in order to meet the holistic bio-psychosocial requirements. The first cancer sports groups for breast cancer patients in the aftercare were founded in 1981 in Germany. Today, nearly 1,000 groups exist. Breast cancer and 15 other entities are represented, however mainly women take part. In the early days, research focused on the influence of physical activities on psychosocial aspects. Lately the effects on molecular, biological, and immunological parameters are also examined, in order to explore canceroprotective mechanisms.     

Genetic variants in ATP6 and ND3 mitochondrial genes are not associated with aggressive prostate cancer in Mexican–Mestizo men with overweight or obesity

Mitochondrial defects have been related to obesity and prostate cancer. We investigated if Mexican–Mestizo men presenting this type of cancer, exhibited somatic mutations of ATP6 and/or ND3.Body mass index (BMI) was determined; the degree of prostate cancer aggressiveness was demarcated by the Gleason score. DNA from tumor tissue and from blood leukocytes was amplified by the polymerase chain reaction and ATP6 and ND3 were sequenced. We included 77 men: 20 had normal BMI, 38 were overweight and 19 had obesity; ages ranged from 52 to 83. After sequencing ATP6 and ND3, from DNA obtained from leukocytes and tumor tissue, we did not find any somatic mutations. All changes observed, in both genes, were polymorphisms. In ATP6 we identified, in six patients, two non-synonymous nucleotide changes and in ND3 we observed that twelve patients presented non-synonymous polymorphisms. To our knowledge, this constitutes the first report where the complete sequences of the ATP6 and ND3 have been analyzed in Mexican–Mestizo men with prostate cancer and diverse BMI. Our results differ with those reported in Caucasian populations, possibly due to ethnic differences.     

‘[S]he could … spare one ample breast for the profit of her owner’: white mothers and enslaved wet nurses’ invisible labor in American slave markets

ABSTRACT

This essay examines the market that white mothers created for enslaved wet nurses, the intimate labor that they performed in southern households, and the ways that this market intersected with slave marketplaces in the antebellum era. It argues that white mothers’ desires and demands for enslaved wet nurses transformed bondwomen’s ability to suckle into a largely invisible, yet skilled form of labor, and created a niche sector of the slave market. In these ways, white mothers were crucial to the commodification of enslaved women’s reproductive bodies, their breast milk, and the nutritive and maternal care they provided to white children.