Chinese Immigrant Breast Cancer Survivors at Greater Risk for Emotional Distress

Scarlett GomezChinese immigrant women who are breast cancer survivors – a group that is growing in number as the incidence of breast cancer increases – may face a tougher up-hill battle post-treatment than US-born Chinese and non-Hispanic White women.

A recent study in the journal Gynecologic Oncology, co-authored by CPIC Research Scientist Scarlett Lin Gomez, Ph.D., found that Chinese immigrant women may be less likely to express their needs to their physicians or to challenge their physicians when their needs are not being met. The study recruited 71 breast cancer survivors from the Greater Bay Area Cancer Registry to participate in focus group discussions and one-on-one interviews to discuss their experiences as survivors.

Typically, breast cancer survivors experience pain and side effects from radiation, surgery and hormone therapy, with this type of physical distress often resulting in emotional concerns about recurrence or metastasis. In the study, a majority of the participants consulted a physician about their physical symptoms, but Chinese immigrant survivors were less likely to have their issues resolved than were US-born Chinese and non-Hispanic White women. Of the 16 Chinese immigrant women who visited their doctors only one reported that her physical distress was alleviated. In fact, Chinese immigrant women in the study reported more acceptance of the idea that discomfort was an expected part of the survivorship experience.

While the study did not delve into an in-depth discussion with the participants of emotional distress as a result of physical symptoms, fully 25 percent of study participants reported some level of emotional distress, including fear of side effects from treatments, as well as recurrence. And although rates of emotional distress were constant across the various groups, Chinese immigrant women, when reporting their fears, used language that was much graver than other women.

According to Dr. Gomez, this pilot study is important in that it points to the need for larger-scale cross-cultural research on breast cancer survivors, and possibly medical education for physicians treating immigrants.

CPIC is a leading institute for the study of cancer in Asians in the United States. The research was supported by a Lance Armstrong Young Investigator Award, National Institute of Health, the National Cancer Institute.