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Perpetuating the cycle of silence: the intersection of uncertainty and sexual health communication among couples after breast cancer treatment

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Abstract

Purpose

The aims of this study are (1) to identify sources of uncertainty breast cancer survivors and partners of breast cancer survivors (BCS) report as a result of sexual health changes after primary treatment and (2) to investigate the challenges they experience when attempting to communicate about sexual health-related uncertainty.

Methods

Forty BCS and 13 partners completed written reflections and participated in semi-structured interviews.

Results

Analyses revealed five predominant sources of uncertainty for BCS and partners: perceptions of post-treatment body, worry about effects on relational partners, ethical concerns about dissatisfaction with sexual relationship (partners only), fears about future of the relationship, and apprehension about SH treatment futility. These concerns are linked to communication challenges for couples: supporting survivors’ body esteem, navigating potentially hurtful disclosures, responding to partners’ “obstructive behavior,” and believing communication is futile.

Conclusions

Findings suggest women and partners find themselves caught in a destructive cycle that reinforces uncertainty and inadvertently perpetuates silence and relational distress. To disrupt the cycle of silence, BCS and partners need to know that their interpretation of the other person’s behaviors/needs is not always accurate. Strategies are required to help women and their partners express uncomfortable thoughts and feelings in safe and supportive environments. Practitioners should be conscious of potential SH issues, be familiar with existing support resources for survivors, and be prepared to disseminate information that will empower women and their partners.

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Authors and Affiliations

  1. Department of Communication, Wake Forest University, P.O. Box 7347, Winston-Salem, NC, 27109, USA

    Mollie Rose Canzona

  2. Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, P.O. Box 7347, Winston-Salem, NC, 27109, USA

    Mollie Rose Canzona

  3. Department of Advertising, UF Health Cancer Center, STEM Translational Communication Center, Center for Arts in Medicine, University of Florida, Gainesville, FL, USA

    Carla L. Fisher

  4. Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Christy J. W. Ledford

Authors
  1. Mollie Rose Canzona
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  3. Christy J. W. Ledford
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Corresponding author

Correspondence to Mollie Rose Canzona.

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We have full control of all primary data and we agree to allow the journal to review our data if requested.

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The authors declare that they have no conflict of interests.

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Disclaimer: The opinions and assertions contained herein are the private views of the authors and are not to be considered as official or as reflecting the views of the Uniformed Services University of the Health Sciences or the Department of Defense at large.

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Canzona, M.R., Fisher, C.L. & Ledford, C.J.W. Perpetuating the cycle of silence: the intersection of uncertainty and sexual health communication among couples after breast cancer treatment. Support Care Cancer 27, 659–668 (2019). https://doi.org/10.1007/s00520-018-4369-9

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  • DOI: https://doi.org/10.1007/s00520-018-4369-9

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