Category: Cancer

It’s not always beneficial to feel in control of your illness

Feeling in control of your illness is normally considered a good thing – research shows it means you’re more likely to take constructive, pro-active steps to cope and more likely to engage in health-promoting behaviours.

But now Carolyn Fang and colleagues have looked at the specific case of women who are at dramatically increased risk of developing ovarian cancer because they have one or more close relatives with the disease. Fang’s team found those women who felt more in control of the possibility of developing cancer, and who actively engaged in problem-focused coping strategies, actually suffered more distress over time and were less likely to attend ovarian cancer screening.

Why might this be? Possibly because feeling in control is only beneficial if it matches reality. Unfortunately, there is currently little that a woman at risk of hereditary ovarian cancer can do to protect herself against developing the disease (but see here). “The subgroup of women who perceived high control and reported high levels of problem-focused coping may have become increasingly more distressed if their efforts to reduce or manage their cancer risk did not lead to actual changes in risk”, the researchers said.

Consistent with this, the women in this study who felt in control, but who didn’t pursue problem-focused coping strategies, did not experience increased distress over time – perhaps because they were “not faced with their subsequent failure to control or alter the health threat”.

But why would the women with high-perceived control and active coping strategies be less likely to attend cancer screening? Perhaps because of the increased distress they were experiencing – this would fit with past research. The researchers said “Health professionals should be aware that, although some women may appear to be actively coping with and managing their cancer risk well, [they] may be less likely to adhere to recommended ovarian cancer-screening regimens”.

The findings come from a three month follow-up of 80 women enrolled on a family risk assessment programme at a cancer centre, all of whom had one or more immediate relatives with ovarian cancer.
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Fang, C.Y., Daly, M.B., Miller, S.M., Zerr, T., Malick, J. & Engstrom, P. (2006). Coping with ovarian cancer risk: The moderating effects of perceived control on coping an adjustment. British Journal of Health Psychology, 11, 561-580.

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Link to UK-based ovarian cancer support network.

Keeping check

One in twelve women will develop breast cancer in their lifetime. If it’s detected early, for example by self-examination for abnormal lumps, then the chances of preventing the cancer spreading can be increased. Paul Norman and Kate Brain (University of Wales College of Medicine) investigated which health beliefs held by women predict how often they check their breasts.

Five hundred and sixty-seven women with a family history of breast cancer completed health belief and breast self-examination questionnaires at ‘Time 1’ and nine months later. Based on their answers, the women were categorised as either infrequent checkers (3-4 times a year or less), appropriate checkers (monthly or fortnightly) or excessive checkers (weekly or daily).

The strongest predictor of infrequent checking at nine months was past behaviour – infrequent checkers at Time 1 were also likely to be infrequent checkers nine months later. However, women lacking confidence in their ability to perform breast self-examination, and those who perceived there to be few benefits, were also more likely to be infrequent checkers nine months later, regardless of their past behaviour. This suggests “health professionals should highlight the positive benefits of performing a monthly self-examination and should seek to enhance women’s confidence in their ability to self-check”, the authors said.

Excessive checkers tended to be women who were confident in their ability to self-check, and who were more worried about breast cancer. Excessive breast self-examination can be counter-productive, being more frequent but less thorough, and diagnosis of benign lumps may be increased, impeding the detection of malignant lumps. The authors recommended practical demonstrations of self-checking, and said there was a need to address the high levels of cancer-related anxiety experienced by some women with a family history of breast cancer.
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Norman, P. & Brain, K. (2005). An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer. British Journal of Health Psychology, 10, 1-17.

Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.