Breast cancer is the most common cancer in women worldwide, comprising 16% of all female cancers. It is estimated that 519,000 women died in 2004 due to breast cancer, and although breast cancer is thought to be a disease of the developed world, a majority (69%) of all breast cancer deaths occurs in developing countries (1). An estimated 1.3 million new cases of invasive breast cancer were expected to occur among women in 2007 (2).

For the growing number of women with breast cancer, the psychological, social and physical impact of diagnosis and treatment can be overwhelming. This may include anxiety and depression, fears about self-image and femininity, disruptions in intimate and sexual relationships and physical side effects from treatment and from cultural taboos. Breast cancer has important implications for public health. While women rely on physicians and other health care professionals for treatment and medical care, many of their psychosocial needs can be addressed through peer support given face to face or by telephone or email.

Peer support

When a woman first finds out she has breast cancer, she may feel overwhelmed, vulnerable, and alone. While under this stress, she must also learn about complex medical treatments and choose between them.

No one should have to face breast cancer alone. Peer support describes the help provided by a woman who has already lived through breast cancer to a woman currently undergoing treatment (3). Her own experience uniquely enables the breast cancer survivor to give the newly diagnosed patient encouragement and emotional support. She can help her and her family to understand and cope with breast cancer, because she’s been there too.

Reach to Recovery peer support volunteers are breast cancer survivors who have undergone special training and who give patients and family members an opportunity to express their feelings, talk about fears and concerns, and ask questions of someone who knows about breast cancer in a way that only those who have experienced it personally can do. For women with specific needs or for whom support is difficult to find within their usual social network, the peer support provided by Reach to Recovery volunteers may be a preferred source of support – for example, young women with breast cancer. (4 & 5)

Reach to Recovery International recommends that peer supportive care be made available to breast cancer survivors across the globe.

Evaluation of peer support in breast cancer

An Australian evaluation of peer support in 1999 (6) concluded that it can play an important role in the support of patients with cancer. It underlined three factors to take into account in developing and implementing peer support programmes. Peer visits may be most helpful in the early post-operative period when treatment demands and support needs are greatest. Support is more helpful if patients see the peer support volunteer as similar to them; therefore volunteers should be recruited from a wide range of backgrounds. Finally, peer support needs to work within a broader framework of community services offering more in-depth support when this is needed (7).

An evaluation of the Reach to Recovery and Cansurmount one-on-one peer-support programmes in Canada carried out in 1995 (8 & 9) found that overall participation in the programmes improved the quality of life of the participant and emphasized the need to provide support as close to the time of diagnosis as possible. Support was more effective if visitors were sensitive, empathetic and non-judgemental, established a relationship with the patient, and offered hope and reassurance as well as information.

References

(1) WHO Global Burden of Disease, 2004

(2) Global Cancer Facts and Figures 2007, American Cancer Society

(3) Dunn J, Steginga SK, Rosoman N, Millichap D (2003) A Review of Peer Support in the Context of Cancer. Journal of Psychosocial Oncology 21(2):55–67

(4) Steginga SK, Dunn J (2001) The Young Women’s Network: A Case Study in Community Development. Journal of Community and Applied Social Psychology 11:1-8

(5) Dunn J, Steginga SK (2000) Young women’s experience of breast cancer: Defining Young and Identifying Concerns. Psycho-Oncology 9:127-146

(6) Dunn J, Steginga SK, Occhipinti S, Wilson K (1999) Evaluation of peer support in breast cancer. Journal of Community and Applied Social Psychology 9:13-22

(7) Hutchison S, Steginga SK, Dunn J (2006) The tiered model of psychosocial intervention in cancer: Translating psychosocial care practice guidelines into action. Psycho-Oncology 15(6):541-6.

(8) National Cancer Institute of Canada Centre for Behavioral Research and Programme Evaluation and Canadian Cancer Society (1995). Reach to Recovery and Cansurmount Programme Evaluation, Toronto: NCIC

(9) Cameron C, Ashbury FD, Iverson DC (1997) Perspectives on Reach to Recovery and CanSurmount: Informing the evaluation mode. Prévention & Contrôle en Cancérologie 1(2):102-107

Other articles of interest

Ashbury FD, Cameron C, Mercer SL, Fitch M, Nielsen E (1998) One-on-one peer support and quality of life for breast cancer patients. Patient Education and Counselling 35:89-100

Damen S, Mortelmans D, Van Hove E (2000) Self-help groups in Belgium: Their place in the self care network. Sociology of Health and Illness 22:331-348

Pistrang N, Solomons W, Barker C (1999) Peer support for women with breast cancer: The role of empathy and self-disclosure. Journal of Community and Applied Social Psychology 9:217-229