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Health Disparities and Cancer Survivorship



Grant #: CA16672-S1
PI: Mendelsohn, John
Project Leader: Leslie Schover
Title: Reproductive Health in African American Breast Cancer Survivors

Reproductive health symptoms, including sexual problems, hot flashes, infertility, and concern about children's cancer risk are among the most troublesome and persistent sequelae of breast cancer treatment. Although it is clear that women of lower socioeconomic status have more problems with menopausal symptoms, sexuality, and infertility, they are less likely to utilize specialized medical services. The influence of ethnicity in reproductive health after breast cancer has rarely been examined. Peer counseling programs have been successful in enhancing reproductive health for low-income and minority women, and can overcome many barriers that limit women's knowledge and coping in this area. The primary aim of this pilot project is to develop and evaluate a culturally-relevant peer counseling program for the Houston chapter of Sisters Network, Inc. that will 1) improve African-American breast cancer survivors' sexual function, 2) decrease menopausal symptoms, 3) decrease infertility-related distress, and 4) increase women's knowledge about reproductive health after breast cancer. If the pilot is successful, a secondary aim is to create a proposal to disseminate the program nationally through Sisters Network Inc.'s 35 chapters.

Two African-American breast cancer survivors from our local community will be recruited and trained to serve as peer counselors. One will be under age 45. We will also recruit 142 African-American breast cancer survivors from Houston, at least 1 year post-diagnosis, currently free of disease, stage 0 through IIIA. Participants may be taking tamoxifen or another type of hormonal therapy, but should not be under other active treatment for breast cancer. Breast cancer survivors will be randomized to the intervention or a 3-month waiting list. The intervention is a 3 session counseling program delivered by an age-matched peer counselor. The sessions focus on 1) reducing hot flashes and increasing postmenopausal health via relaxation, stress management, and healthy habits 2) Enhancing sexual communication and desire, and treating vaginal atrophy 3) Coping with infertility, understanding genetic cancer risk issues for family. Questionnaires will be completed at baseline, post-waitlist, post-treatment, and at 3-month follow-up.

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