Black Women Are More Likely to Delay Chemotherapy

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Doctors recommend starting treatment as soon as possible after breast cancer is diagnosed. Timely treatment reduces the risk that the cancer will spread and increases the chances for survival. Still, sometimes women delay treatment for a number of reasons, including cost and scheduling. But if treatment is delayed too long it can affect survival.

Researchers wondered if delaying chemotherapy is part of the reason for differing survival rates in black and white women diagnosed with breast cancer. It’s known that whites and blacks have similar survival rates when they receive chemotherapy, but overall, black women are more likely to die after a breast cancer diagnosis than white women.

The researchers interviewed 151 white women diagnosed with breast cancer and 208 black women diagnosed with breast cancer about their treatment and then reviewed their medical records. The study was published in the May 2013 issue of the journal Breast Cancer Research and Treatment. Read the abstract of “Narrowing racial gaps in breast cancer chemotherapy initiation: the role of the patient-provider relationship.”

All of the women participating in the study were diagnosed with breast cancer that hadn’t spread to parts of the body away from the breast. The women’s doctors thought that chemotherapy would likely get rid of all the cancer.

About 40% of the women chose to receive chemotherapy after surgery. But there were differences in when the women started treatment. Black women waited about 72 days to start chemotherapy and white women waited about 55 days.

Black women were also three times more likely than white women to start chemotherapy more than 90 days after diagnosis. Waiting more than 90 days after diagnosis to start treatment is linked to worse survival rates.

Doctor-patient communication appeared to play an important role in treatment decisions by black women. Black women who weren’t satisfied with their communication with their doctors were more likely to delay chemotherapy. Women who said they had good doctor-patient communication were more likely to start chemotherapy sooner after diagnosis.

Other factors played a role in treatment decisions, too. Black women who said they were religious and single were 3 times more likely than white women to delay treatment for more than 90 days after diagnosis. The researchers think that unmarried women might need more time to set up a support system for help during treatment. Religious women also might want to seek spiritual guidance before starting treatment, which may mean that treatment starts later.

Based on the results, the researchers said that better doctor-patient communication could improve the chances that black women who need chemotherapy to treat breast cancer will start treatment without delays.

If you’ve been diagnosed with breast cancer and your doctor recommends chemotherapy, it makes sense to take the time to do some research to make sure your diagnosis is correct and your treatment plan makes sense. But as this study shows, it also makes sense to start treatment about a month and a half after diagnosis.

If you don’t have insurance or are unemployed, you may be considering delaying your treatment because you’re worried about how you’ll pay for it. Don’t panic and don’t skip any doctor’s visits or delay your surgery. Your life may depend on it. There are resources available to help you.

Someone at your doctor’s office may be able to give you a list of organizations that offer financial assistance for breast cancer treatments and care, as well as local organizations that offer financial assistance for your practical needs, such as transportation, food, and child care.

Also, many hospitals now include patient navigators as part of the breast cancer care team. A patient navigator can help you understand and move through the health care and insurance systems. Patient navigators also can help overcome language and cultural barriers, as well as any biases based on culture, race, or age and can help you and your doctor communicate better. Ask your doctor or nurse for a patient navigator recommendation.

There is only one of you and you deserve the best care possible, given in a timely manner. Don’t let any obstacles get in the way of your treatment!

There’s lots of information about chemotherapy on our website. Visit the Breastcancer.org Chemotherapy pages to learn more about treatment, including Dealing with Chemotherapy Fears and Staying on Track with Chemotherapy.

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