Triggers of uncertainty about recurrence and long-term treatment side effects in older African American and Caucasian breast cancer survivors

Oncol Nurs Forum. 2004 May;31(3):633-9. doi: 10.1188/04.onf.633-639.


Purpose/objectives: To examine the sources of uncertainty in older African American and Caucasian long-term breast cancer survivors by focusing on frequency of triggers of uncertainty about cancer recurrence and physical symptoms linked to long-term treatment side effects.

Design: In the context of a larger randomized, controlled treatment-outcome study, data were gathered from 10 monthly follow-up telephone calls by nurses.

Setting: Rural and urban regions of North Carolina.

Sample: 244 older women (mean age = 64 years); 73 African American women and 171 Caucasian women who were five to nine years after breast cancer diagnosis.

Findings: The most frequent triggers were hearing about someone else's cancer and new aches and pains. The most frequent symptoms were fatigue, joint stiffness, and pain. Although no ethnic differences occurred in the experience of symptoms, Caucasian women were more likely than African American women to report that their fears of recurrence were triggered by hearing about someone else's cancer, environmental triggers, and information or controversy about breast cancer discussed in the media.

Conclusions: Illness uncertainty persisted long after cancer diagnosis and treatment, with most women experiencing multiple triggers of uncertainty about recurrence and a range of symptoms and treatment side effects.

Implications for nursing: Nurses can help cancer survivors to identify, monitor, and manage illness uncertainty and emotional distress.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Black or African American / statistics & numerical data*
  • Breast Neoplasms / ethnology*
  • Breast Neoplasms / nursing*
  • Comorbidity
  • Fatigue / epidemiology
  • Female
  • Follow-Up Studies
  • Health Behavior / ethnology
  • Humans
  • Imagery, Psychotherapy / methods
  • Lymphedema / epidemiology
  • Middle Aged
  • Neoplasm Recurrence, Local / ethnology
  • Neoplasm Recurrence, Local / nursing*
  • Neoplasm Recurrence, Local / psychology
  • North Carolina / epidemiology
  • Pain / epidemiology
  • Prevalence
  • Relaxation Therapy
  • Retrospective Studies
  • Social Support
  • Survivors / classification
  • Survivors / psychology*
  • Uncertainty*
  • White People / statistics & numerical data*