Breaking the News About Breast Cancer

By Kathleen Doheny
HealthDay Reporter

THURSDAY, Aug. 7 (HealthDay News) — Shelley Volz, now 59, got the news about her breast cancer diagnosis 10 years ago, right before she was headed from San Francisco to New York for the wedding of her younger brother.

After much thought, she decided to tell only her mother before the wedding and to hold off telling other family members. "My mother had a typical mother's reaction, tears and hugs, and we moved on," Volz said. "She really appreciated the fact that I didn't want to steal the limelight there."

Volz waited until after the wedding celebration to calmly tell others. Ten years later, after successful treatment, she is doing fine.

While she says she doesn't think she found it as difficult as many people to disclose the diagnosis, she did think about others' reactions.

In that sense, she is typical, according to a new study. "Even when women are facing a breast cancer diagnosis, they are still concerned about caring for everyone else, especially the emotions of others," said study author Grace J. Yoo, a medical sociologist at San Francisco State University's Biobehavioral Research Center.

She presented the findings Monday at the American Sociological Association annual meeting, in Boston. The research is especially timely, given the recent news that actress Christina Applegate, 36, is being treated for early breast cancer.

Yoo and her team interviewed 164 San Francisco-area breast cancer survivors, average age 57, of different ethnicities to evaluate the "emotion work" involved in telling others about the diagnosis.

In interviews with the researchers, the women talked about their feelings and actions after getting the diagnosis.

"Even telling someone, 'I have breast cancer,' it's well thought out," Yoo said. "They know the statement, to some, can overwhelm." Women react in different ways — stifling their own emotions so they don't appear vulnerable, paying attention to the timing of their news, or sometimes letting it all out, she said.

Women find it somewhat easier to tell friends than family members, she found. "Women are trying to protect older, aging parents and younger children and even their spouses, even during illness. Women are socialized to care about others."

Ideally, Yoo said, women should do less of that at this time. "It's a time they should be caring about themselves, what decisions they should be making about breast cancer. They shouldn't emotionally burn themselves out by caring for others' emotions."

One woman, for instance, told the interviewer that she didn't tell her mother about her breast cancer until after the surgery, because she knew her mother would worry. Many women said once they were told about the diagnosis, they were surprised about the outpouring of help, even from acquaintances. But some feared that if they told, people may not care enough to help.

The findings ring true with what another expert has seen in clinical practice. This has "documented what we have known instinctively," said Lori Worden, an oncology social worker in Grants Pass, Ore.

Her advice to women? "You don't need to tell people today." Feel free to process it yourself first. Practicing what you will say, by saying it out loud to yourself or writing it down, can help, she said.

Yoo's advice: "We tell women to seek out other breast cancer survivors, other women who understand, to increase their resources." And focus more on getting emotional support than giving it.

SOURCES: Grace J. Yoo, Ph.D., M.P.H., medical sociologist, San Francisco State University Biobehavioral Research Center; Lori Worden, M.S.W., L.C.S.W., oncology social worker, Grants Pass, Ore.; Aug. 4, 2008, presentation, American Sociological Association annual meeting, Boston; Shelley Volz, San Francisco

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