How the Diagnosis of Breast Or Cervical Cancer Affects Black Women: A Nurse’s Perspective

Breast cancer awareness. By Klaus Nielsen

Cancer was a word whispered amongst adults when I was a young girl.

I could sense the fear in the air as my group of adult women paused their hushed tones when I walked into the room.  Their eyes followed me as I searched and peered into their faces looking for what I couldn't remember. Their subdued tones piqued my interest, they were talking about someone I liked. To me, she was kind, and once rescued me from the only whipping I ever received from my dad. She also prepared the most delicious meals.

I hastily made a quick retreat and closed the door behind me. I stood at the door’s entrance hoping they would continue their hushed conversation. Immediately someone called out my name and I quickly backed away. I had to leave for real this time before they realized that I was still standing at the door.

My final memory of her was of one of my final weekends on my island, it was spent at her home. That Saturday night we played games, laughed and drank. Then on Sunday the women cooked, we all ate and laughed so much more, and then it was time to leave. I left the island a couple of weeks later, so I never saw her again.  She still didn't appear sick, years later my eldest sister, her goddaughter, explained that she had died from breast cancer shortly after my departure.

Years later, as a Maternal Child Nurse, I ended up in Breast Oncology. I realized that breast cancer has a face. It could be me or any woman that I encounter in the grocery store, in a restaurant, or on an airplane. It was there that I saw that cancer doesn't discriminate. It affected all races, ages, classes, and ethnicities.

Later, as I managed the collection of data for a Breast and Cervical Cancer Program, it allowed me a close and personal look at the lives of patients diagnosed with breast and cervical cancer or who had abnormal results. My work has provided a clear picture of the diagnosis and effects of cancer on the patient, their families, friends, and caregivers.

I now understand how receiving a breast, cervical or ovarian cancer diagnosis can impact the lives of individuals and be a death sentence. It has shown me the value of life even more. As a healthcare provider and a woman, it is difficult having to share the news that their mammogram was abnormal, and they needed more intensive workup. I am sure sitting in the opposite chair hearing those words can be devastating both emotionally and mentally.

I can hear the fear in the voices and see it on their faces, their shoulders usually drop, and they hang their heads as they ask questions about the procedure. There are times when I have to repeat the instructions multiple times, this news is life-changing and can be difficult to accept. Some people just disappear and never answer their phones or respond to mail. It hurts even more when we have to reinforce the unwelcome news.

I see the importance of educating ourselves, family, and community about the disparities in health that we face and how we can work together as a team to address those challenges.

Especially those who are already marginalized, college students, uninsured, and the underinsured. A lack of insurance and not having an income determines how quickly you access quality care, information (provider), research, and clinical trials.

Receiving bad news from the doctor is never easy. By Francisco Venâncio.

For the marginalized, the information given is often not enough to help make decisions that would prolong their lives. For them and others, survival depends on quickly accessing treatment. Connecting to a breast cancer treatment center in a timely manner is important. Not having insurance or the money to pay for the cost of treatment can be a hindrance.

Although there are many national and state agencies whose primary focus is breast cancer awareness research and assistance, a large number of marginalized patients do not have access to computers and do not know how to navigate the internet even on their mobile phones well enough to use it to find help. A lack of community resources, knowledge of available resources, being homeless, unemployed, and a lack of support is a deterrent to expeditious connection to care.

It's even more cumbersome for undocumented aliens. There are very few facilities that accommodate them. Actually, trying to find those facilities is tiresome and almost impossible for those for whom English is not their first language.

As a nurse and a woman, you can hear and even feel the despair of your patients. What do you tell a patient that because she used the program less than two years ago, even though her cancer has returned she has to wait three more weeks before she can be re-enrolled into the state and federal cancer program?

You just listen supportively. What do you say to a young woman who has never been married or has any children after she has shared her concerns about the lack of conversation between her and her medical provider about her fertility and future plans for pregnancy?

Being Black while seeking out empathic, equitable, and unbiased care takes attention, time, and intention. All women are entitled to health care providers who will listen to them and assure them that their concerns are being heard — providers who will respond with care, compassion, and evidence-based advice specific to them and their family’s health needs. Providers should refer Black women and their family members to specialists when needed.

Black women must be taught how to become drivers of their own health care. As leaders in our communities, we need to advocate and educate others about bias and inequities. Everyone needs to know that historically health care has been biased toward men and women of color. We are neglected by the health care system which leads to worse health outcomes.

Another change that we should advocate for and support are providers that look like us and live in our communities. We need more black nurses, doctors, dentists, we need more efficient safe, and quality health centers.

Growth begins with us. By Leighann Blackwood

In order to support ourselves, we have to invest in and recreate our own communities. We can begin by promoting and encouraging more black-owned businesses such as food stores, community gardens, green spaces, safe and affordable housing.

We must:

  1. Research our healthcare providers

  2. Learn how to ask questions and get evidence-based responses.

  3. Learn how to demand further medical support when a treatment or intervention is necessary.

  4. Learn how to document interactions with medical staff and care providers.

  5. Learn how to encourage strong advocacy for yourself or have someone who is knowledgeable that can speak for you.

  6. Look for support groups

I can't stress enough the importance of self-breast exams, that's how most women find out and regular screening mammograms. Once diagnosed... seek early care. Ask many questions, write them down, read reports, and know the process. Stay informed! Seek family or friend support! 

 For additional information and similar content on health inequities and their effects on Black Women visit our website www.thebeacademy.org.

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