Cancer stage related to degree of depression in young African American women

Young African American women with breast cancer report more symptoms of depression than their healthy peers, even when they have good social support systems and an ability to adapt to new environments or situations, a study published in the Journal of Cancer Survivorship shows. In addition, those with a later stage of breast cancer experience more severe symptoms of depression than those with earlier-stage disease.

Yet, resources do exist to help women cope with symptoms of depression, can be easily accessed in most cancer centers, and can significantly improve mental health and well-being.

Background

Depression is common among all races of women diagnosed with breast cancer and may impact whether a woman starts or continues treatment as directed by her doctor. Though some past studies suggested the rate of depression may vary by race or ethnicity, overall, few assessed the relation between the two.

Researchers do know that African American women are more likely to be diagnosed at younger ages than women of other races, allowing for the possibility of a longer survivorship period. Survivorship is the time from the end of cancer treatment until the end of life and involves adjusting to life after cancer, including follow-up care, fear of recurrence, and maintaining preventive care.

In this study, the trial team explored the levels of depression reported by young African American women with versus without breast cancer; what factors influenced the severity of the symptoms; and to what extent stage of breast cancer, a strong ability to adapt to new challenges and a good social support system affected the level of depression reported.

Design

Seventy-six women with all stages of breast cancer were recruited by mail and 76 women without breast cancer were recruited from health fairs focused on preventive screening for breast cancer in the Washington, DC metro area. The women were between 40 and 50 years old, were not using illegal drugs, or being treated for mental illness or depression. Those with breast cancer were diagnosed within 12 months of joining the study; those without breast cancer had mammograms with no evidence of cancer within the 12 months before joining.

Both groups of women were asked to complete a 90-minute survey with questions assessing:

• how well they adapted to new situations, challenges or environments
• the size and quality of their social support network (how many friends or family members provided emotional or other support, how long they’ve known them, how often they are in contact, and the degree of support given)
• the occurrence of motivational and behavioral symptoms of depression

Data were collected on age, relationship status, income, education, family history of breast cancer, job, and stage of disease.

Results

The survey data revealed

• African American women with breast cancer reported higher levels of depression than those without breast cancer
• those with later stages of disease, as compared with early stages, reported more depression
• older women reported more depression than younger women; however, the range of participant ages was very small
• ability to adapt and the quality and size of the social support system was not associated with the level of depression reported by women with breast cancer

Limitations

The ages of the study participants represent a small range of the ages at which women are typically affected by breast cancer, so findings may not be meaningful to women who are younger than 40 or older than 50. In some cases, the survey tools used may have excluded important information. For example, those assessing social support networks may not have explored the use of religious communities, and may ignore informational support, such as access to educational resources, or the importance of these factors to African American women, specifically.

What This Means for You

While it is known that many women diagnosed with breast cancer experience depression or its symptoms, this study offers data exclusively on the experience of young African American women. In general, fewer studies exist that report on individual race or ethnic groups and emotional response to breast cancer diagnosis, and this research adds to what is available.

Know that feelings of sadness, numbness, or uncertainty are normal after a breast cancer diagnosis, and that experiencing them does not always mean you are depressed. However, if these feelings last for a long time, make it hard for you to enjoy your favorite activities, or interrupt your daily life on a regular basis, talk with a social worker, psychologist or other members of your healthcare team about obtaining their professional help.

If you are worried about becoming depressed as you move through treatment, share these concerns with your healthcare team. Ask about ways to cope and avoid depression. A social worker or nurse navigator may be able to help.

LBBC offers resources specific to both Black women and young women. If you are experiencing symptoms of depression and need to speak with someone who’s been there, contact our Breast Cancer Helpline at (888) 753-LBBC (5222).

Sheppard V B, Llanos A A, Hurtado-de-Mendoza A, Taylor, T R, Adams-Campbell, L L. Correlates of depressive symptomatology in African-American breast cancer patients. Journal of Cancer Survivorship; 2013; 7(3): 292-299.