Negotiating cancer alone: A qualitative study exploring care experiences of racially and ethnically diverse women diagnosed with breast cancer during COVID-19

J Health Psychol. 2024 Apr;29(5):367-381. doi: 10.1177/13591053231214517. Epub 2023 Nov 27.

Abstract

COVID-19 has critically impacted cancer care services including reduced screenings, diagnoses, and surgeries; particularly among Black and Latina/x women who already suffer worse outcomes. This qualitative study explored the care experiences of a diverse sample of breast cancer survivors (N = 21; 7 Black, 4 Hispanic, 10 White) undergoing treatment during the pandemic via online semi-structured interviews. Grounded theory analysis yielded the core category "negotiating cancer alone," that included: (1) psychological distress, negotiating the cancer trajectory in isolation; (2) provider/healthcare system diagnostic and treatment delays; (3) heightened anxiety about treatment delays causing cancer progression; (4) supportive care limitations; and (5) disparate experiences of cancer care disruptions. Black and Latina/x women described greater delays in care, financial challenges, treatment complications, and insurance limitations than White women. The study identifies cancer patients' pandemic-related psychological, healthcare system, and health equity challenges and suggests recommendations to support their increased psychological needs during oncologic care disruptions.

Keywords: COVID-19; breast cancer; cancer care disruptions; health disparities; health psychology; qualitative research.

MeSH terms

  • Black or African American / psychology
  • Breast Neoplasms* / psychology
  • COVID-19*
  • Cancer Survivors* / psychology
  • Female
  • Healthcare Disparities
  • Hispanic or Latino / psychology
  • Humans
  • Qualitative Research
  • White / psychology