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PMC Articles

Men's Lived Experiences of Breast Cancer and Changes in Occupation

PMCID: PMC9940971

PMID:

Abstract

Introduction Male breast cancer is rare and frequently diagnosed at later stages of disease with low survival rates. There is a lack of knowledge of how breast cancer impacts men's occupations. Objectives This study is aimed at understanding the lived experiences of men with breast cancer and their changes in occupation. Methodology . Twenty-four men with breast cancer participated in semistructured phone interviews. Data was open-coded and analyzed for themes. Findings . The six major themes are as follows: (1) death as a reality, (2) unique personal insights, (3) social environment, (4) interactions with the healthcare system, (5) decreased engagement in occupations, and (6) finding meaning in new occupations. Conclusion The healthcare team can improve the patient experience by discussing and responding to the client's experience throughout the diagnosis, intervention, and survival continuum. The scope of occupational therapy is well suited to address the needs of men with breast cancer to maintain optimal levels of functioning.

Full Text

Men diagnosed with breast cancer (MBC) face many challenges from diagnosis through the treatment process. This rare disease in men has an approximately 1.2 per 100,000 incidences and 2710 new diagnoses expected in the United States [1, 2]. The median age at diagnosis for MBC is 68 years compared to 62 for women [2]. Despite presenting with similar signs and symptoms as women, male breast cancer often goes unrecognized due to a lack of awareness and male-specific screening protocols [3, 4]. Males tend to be diagnosed at a later age with a more clinically advanced presentation, including larger tumor size, grade, and increased lymph involvement [5–7]. These factors affect the prognosis for males with breast cancer, ultimately creating a lower survival rate when compared to females with the same classification of the disease [3].
A small bank of literature indicates there are a host of emotional and psychosocial challenges faced by men diagnosed with breast cancer [8, 9]. Many men diagnosed with breast cancer reported little knowledge of the disease prior to diagnosis and report a sense of shock when they receive their diagnosis [10–12]. Limited support systems with a high reliance on wives, limited involvement in support groups as they are typically oriented to females, and barriers to accessing health professionals with specialized knowledge of male breast cancer are typical issues reported by MBC [7, 8, 11]. Men are less likely to talk about their diagnosis due to fear of embarrassment related to social acceptability or a perceived threat to their masculinity which may impact coping [9, 10, 13–15]. Stigmatization and marginalization of men with breast cancer has been cited; however recent qualitative studies are not finding this to bare out in the reports of MBC about their experiences with the diagnosis [9, 10, 12]. While the focus of most of the existing literature is on lived experience and coping, Hiltrop et al. [16] examined return to work for MBC. Their qualitative study of fourteen men indicates that men returned to work for a variety of reasons including maintaining normalcy, distraction, socialization, finances, and passion for work.
Occupational therapists have delved into understanding the female experience of breast cancer and its impact on everyday occupations, occupational engagement, and interaction with the environment [17–19]. These studies highlight the interplay of sequelae related to breast cancer and the effects on the physical abilities to perform activities of daily living and instrumental activities of daily living, role performance, and participation in work and leisure activities. The impact of breast cancer on men's occupations has not been explored. The aim of this research study was to better understand how men experience changes in occupation when diagnosed with breast cancer.
Semistructured telephone interviews were conducted between January and March 2018. A semistructured phone interview format (Table 1) was developed by the research team based on existing literature and theoretical constructs of occupation from the person-environment-occupation model [20]. This approach allowed the researchers to receive relevant and meaningful answers geared to understanding the experience of change in roles and occupation. Before initiating the study's interviews, each team member participated in a pilot interview with a male diagnosed with pancreatic cancer, known to the team. This pilot interview helped researchers understand unforeseen circumstances, such as timing or poor wording of questions, from the perspective of an individual with cancer and helped ensure each interviewer utilized similar styles and probing [21]. The interviews ranged from 10 to 100 minutes.
Research team members, all females, were randomly assigned participants for interviews. Participants in the USA called into a Google Voice number created for this study. International calls used Skype voice. Each interview was recorded, downloaded into a password-protected file, and transcribed using VoiceBase. A research team member checked the transcripts word-for-word with the audio recording and added notes to reflect participants' expressions of emotion. Researchers followed up with participants on multiple occasions to clarify interview responses. Data saturation occurs in collection through a deductive process and inductively during analysis [22]. Data collection saturation occurred when the research team no longer perceived new perspectives shared by participants during the interviews.
Each transcript was read, open-coded by hand, and themed independently by two members of the primary research team. The primary research team jointly confirmed the themes and conclusions. A second research team of occupational therapy graduate students, 2 female and 1 male, uploaded the cleaned transcripts to Dedoose and performed an additional two rounds of open coding and theming. These results were compared to the first round of coding results and finalized. Inductive thematic saturation [22] was achieved at the point the second research team no longer identified new codes or themes in the data.
The method of researcher triangulation is a validation strategy to view the research data from multiple different points [23]. Multiple researchers conducted interviews to balance the subjective influences of each interviewer throughout the data collection process. Researcher triangulation was also used during data analysis by ensuring that each transcription was individually coded by at least two of the researchers to avoid bias and confirm the consistency of emerging themes and conclusions.
Twenty-four men completed interviews describing their experience with breast cancer. Five individuals did not follow up with attempted email and telephone communication regarding scheduling and participation. Table 2 provides an overview of the sample's demographics. Twenty-one participants resided in the United States; the other participants lived in South Africa, Australia, and the Netherlands. The average age of the participants was 57.75 years, the median age was 59 years, and the mode was 70 years of age.
The men in this study revealed the various impacts breast cancer had on their occupations throughout everyday life. They shared what it was like living with a widely female diagnosed disease, the personal implications, and the resulting changes in their occupations. Similarities in cultural norms across the world consisted of different gender norms, including the idea of hegemonic masculinity [24]. This concept divides men and women through stereotypical notions of what it means to be a man, and according to society, breast cancer does not fit into that box. Some men revealed embarrassment and fear of social stigma because they thought they would be perceived as less of a man. This perception is consistent with findings of role strain and stigmatization associated with the “perception of breast cancer as one of being exotic” [8]. Consistent with the work of Rayne et al. [12] and Thompson and Haydock [9] not all participants felt stigma and marginalization and accepted the disease as a diagnosis. Like other recent studies, living with a female's disease left the participants with many unmet health information needs and frequently poorly informed health care providers [5]. These unmet needs prompted participants to assume new roles and occupations in self-advocacy.
Changes in activities of daily living (ADL), instrumental activities of daily living (IADL), social participation, and work were connected to the diagnosis of cancer and side effects including fatigue, pain, physical limitations, support systems, and social perceptions. Declines in functional status, ADLs, and IADLs for all types of cancer survivors, male and female, are well documented [25–28]. ADLs, IADLs, and social participation are domains commonly addressed in oncologic occupational therapy [27, 29]. Current practice trends and evidence support occupational therapy interventions across the cancer continuum to address disease self-management, physical impairments, fatigue, cognition, emotions, energy conservation, work-related issues, and social participation [28–33].
Every participant related a story of their involvement in and the importance of advocacy without a direct question or prompt. This highlights the importance and weight of advocacy in the lives of these men. Self-advocacy is defined as “a means for patients to exert control over complex treatment decisions and uncertain health outcomes, address their unmet needs, and improve their healthcare experience” [34]. In a qualitative study of the self-advocacy experiences of men with cancer, the three major themes managing information, finding the best medical team, and strategic social connections were identified [34]. These themes are consistent with our findings. We viewed concepts of managing information and medical team as separate constructs from advocacy. We interpreted advocacy in the sense of representing a cause and raising awareness. The men in this study viewed the rarity of their diagnosis and the overwhelming focus on female breast cancer the impetus to becoming involved in advocacy with the goal of helping other men to have a better experience and receive better health care. The sense of isolation as a man with cancer, confronting stigma, and seeking others were themes in a study of prostate cancer survivors in Australia [35] and are consistent with the drivers to advocacy expressed in this sample.
There were high expectations of the men in this study to maintain their employment, causing some men to carry a heavy burden when they had to stop or limit working due to treatment, with participants noting the need to maintain routine and normalcy as well as their professional identity. These themes match those identified in a systematic review of returning to work after breast cancer and other studies including multiple types of cancer [16, 28, 36, 37]. Our results are consistent with the findings of Hiltrop et al. [16], in which male breast cancer survivors in Germany indicated the need to continue with their activities and maintain a sense of normalcy. A study of Italian cancer survivors determined that fatigue, memory issues, and coordinating treatment appointments with work schedule impacted the ability to maintain participation in work activities and are prognostic factors in return to work [36]. Occupational therapists address factors related to return to work with cancer survivors and can fulfill a vital role in promoting and facilitating participation in work [28, 31, 32, 36, 38, 39].
The experience of a decrease in occupational performance led to changes in role fulfillment in these men, such as being a husband, partner, or father. Although the desire to fulfill the expectations of these roles was still present, the demands exceeded their ability to perform these tasks physically. Societal stigmas in the environment pushed the men to challenge concepts of their identity and body image. This effect impacted occupations, as some men reported embarrassment in social occupations with people who were not aware of their diagnosis to avoid further questioning. Social participation is another area frequently addressed by oncology occupational therapists [27, 29, 31, 40].
The diagnosis of cancer provoked mortal salience, the recognition of the inevitability of death, for these participants. The men reported an abundance of conflicting feelings. The sense of death's imminence prompted many of the participants to reevaluate their lives and make changes in their routines, habits, values, and beliefs. Although cancer is associated with alterations in future expectations, cancer survivors demonstrate resilience and continue to demonstrate positive social well-being and social growth [41].
Trust, communication, and respect are foundations of client- or patient-centered care [42] leading to better health care outcomes. Participants in this study had varied experiences with the healthcare team and environment. Many felt marginalized in environments catering to females, with treatment protocols extrapolated from clinical research and guidelines created for females, and a lack of recognition from their medical providers. Men with breast cancer are frequently viewed as unusual or exotic and report lack of awareness of medical providers which results in limited participation in their own care [8, 10, 11, 14, 24]. Positive support and open communication with medical providers resulted in greater comfort, trust, and comfort in the provider and the treatment process in this study.
Our results concerning the ability to fulfill required and desired roles were consistent with findings from a previous qualitative study of women with breast cancer and men with bowel cancer highlighting the importance of social, emotional, and physical support in maintaining a sense of self-worth [17–19, 30]. Finding meaning in engagement in new occupations was a common theme in both genders dealing with breast cancer. New occupations allow those living with breast cancer to replace occupations that were once meaningful but can no longer be performed nor desired. The experience of a life-threatening condition can compromise an individual's identity, engagement in social relationships, and ability to fulfill roles of everyday life. Engagement in modified or new occupations may be a coping response to the psychological challenges presented by cancer [43].
The aim of this research study was to better understand how men experience changes in occupation when diagnosed with breast cancer. The lived experiences shared by the men in this study provide insight into the physical, emotional, and social challenges they faced from diagnosis through treatment and into the survival phase. Participation in meaningful occupations were altered for all participants by the experience of male breast cancer. Participants discussed ways of adapting, such as seeking out needed support in their environment or engaging in new occupations such as becoming involved in advocacy groups. Evidence from this study supports that a sense of self, identity, and ability to interact with the social environment strengthened engagement in meaningful occupations. The lived experiences of the men in our study were like the lived experiences of women with breast cancer, men with prostate cancer, and bowel cancer survivors [17, 18, 30, 35]. Stigma related to having a diagnosis of a disease associated with women created challenges in diagnosis, medical treatment, and in social environments.
All health care providers must maintain a client-centered approach that provides space for the unique experiences of each client and not fall into stereotyping which may stigmatize or marginalize the client. Occupational therapy has the ability promote engagement in meaningful occupations and therefore promote overall health and well-being [27, 29, 33, 39] in the lives of men affected by breast cancer through understanding the unique barriers and successes men in this study described. The men in this study expressed instances where they did not feel welcome in the healthcare environment and their health care providers were not well versed in treatment of male breast cancer. Only through a client-centered and occupation-based approach will occupational therapy benefit clients to achieve optimal occupational engagement [20].

Sections

"[{\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B1\", \"B2\", \"B2\", \"B3\", \"B4\", \"B5\", \"B7\", \"B3\"], \"section\": \"1. Introduction\", \"text\": \"Men diagnosed with breast cancer (MBC) face many challenges from diagnosis through the treatment process. This rare disease in men has an approximately 1.2 per 100,000 incidences and 2710 new diagnoses expected in the United States [1, 2]. The median age at diagnosis for MBC is 68 years compared to 62 for women [2]. Despite presenting with similar signs and symptoms as women, male breast cancer often goes unrecognized due to a lack of awareness and male-specific screening protocols [3, 4]. Males tend to be diagnosed at a later age with a more clinically advanced presentation, including larger tumor size, grade, and increased lymph involvement [5\\u20137]. These factors affect the prognosis for males with breast cancer, ultimately creating a lower survival rate when compared to females with the same classification of the disease [3].\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B8\", \"B9\", \"B10\", \"B12\", \"B7\", \"B8\", \"B11\", \"B9\", \"B10\", \"B13\", \"B15\", \"B9\", \"B10\", \"B12\", \"B16\"], \"section\": \"1. Introduction\", \"text\": \"A small bank of literature indicates there are a host of emotional and psychosocial challenges faced by men diagnosed with breast cancer [8, 9]. Many men diagnosed with breast cancer reported little knowledge of the disease prior to diagnosis and report a sense of shock when they receive their diagnosis [10\\u201312]. Limited support systems with a high reliance on wives, limited involvement in support groups as they are typically oriented to females, and barriers to accessing health professionals with specialized knowledge of male breast cancer are typical issues reported by MBC [7, 8, 11]. Men are less likely to talk about their diagnosis due to fear of embarrassment related to social acceptability or a perceived threat to their masculinity which may impact coping [9, 10, 13\\u201315]. Stigmatization and marginalization of men with breast cancer has been cited; however recent qualitative studies are not finding this to bare out in the reports of MBC about their experiences with the diagnosis [9, 10, 12]. While the focus of most of the existing literature is on lived experience and coping, Hiltrop et al. [16] examined return to work for MBC. Their qualitative study of fourteen men indicates that men returned to work for a variety of reasons including maintaining normalcy, distraction, socialization, finances, and passion for work.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B17\", \"B19\"], \"section\": \"1. Introduction\", \"text\": \"Occupational therapists have delved into understanding the female experience of breast cancer and its impact on everyday occupations, occupational engagement, and interaction with the environment [17\\u201319]. These studies highlight the interplay of sequelae related to breast cancer and the effects on the physical abilities to perform activities of daily living and instrumental activities of daily living, role performance, and participation in work and leisure activities. The impact of breast cancer on men's occupations has not been explored. The aim of this research study was to better understand how men experience changes in occupation when diagnosed with breast cancer.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"tab1\", \"B20\", \"B21\"], \"section\": \"2.4. Data Collection\", \"text\": \"Semistructured telephone interviews were conducted between January and March 2018. A semistructured phone interview format (Table 1) was developed by the research team based on existing literature and theoretical constructs of occupation from the person-environment-occupation model [20]. This approach allowed the researchers to receive relevant and meaningful answers geared to understanding the experience of change in roles and occupation. Before initiating the study's interviews, each team member participated in a pilot interview with a male diagnosed with pancreatic cancer, known to the team. This pilot interview helped researchers understand unforeseen circumstances, such as timing or poor wording of questions, from the perspective of an individual with cancer and helped ensure each interviewer utilized similar styles and probing [21]. The interviews ranged from 10 to 100 minutes.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B22\"], \"section\": \"2.4. Data Collection\", \"text\": \"Research team members, all females, were randomly assigned participants for interviews. Participants in the USA called into a Google Voice number created for this study. International calls used Skype voice. Each interview was recorded, downloaded into a password-protected file, and transcribed using VoiceBase. A research team member checked the transcripts word-for-word with the audio recording and added notes to reflect participants' expressions of emotion. Researchers followed up with participants on multiple occasions to clarify interview responses. Data saturation occurs in collection through a deductive process and inductively during analysis [22]. Data collection saturation occurred when the research team no longer perceived new perspectives shared by participants during the interviews.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B22\"], \"section\": \"2.5. Data Analysis\", \"text\": \"Each transcript was read, open-coded by hand, and themed independently by two members of the primary research team. The primary research team jointly confirmed the themes and conclusions. A second research team of occupational therapy graduate students, 2 female and 1 male, uploaded the cleaned transcripts to Dedoose and performed an additional two rounds of open coding and theming. These results were compared to the first round of coding results and finalized. Inductive thematic saturation [22] was achieved at the point the second research team no longer identified new codes or themes in the data.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B23\"], \"section\": \"2.6. Trustworthiness\", \"text\": \"The method of researcher triangulation is a validation strategy to view the research data from multiple different points [23]. Multiple researchers conducted interviews to balance the subjective influences of each interviewer throughout the data collection process. Researcher triangulation was also used during data analysis by ensuring that each transcription was individually coded by at least two of the researchers to avoid bias and confirm the consistency of emerging themes and conclusions.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"tab2\"], \"section\": \"3. Results\", \"text\": \"Twenty-four men completed interviews describing their experience with breast cancer. Five individuals did not follow up with attempted email and telephone communication regarding scheduling and participation.  Table 2 provides an overview of the sample's demographics. Twenty-one participants resided in the United States; the other participants lived in South Africa, Australia, and the Netherlands. The average age of the participants was 57.75 years, the median age was 59 years, and the mode was 70 years of age.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B24\", \"B8\", \"B12\", \"B9\", \"B5\"], \"section\": \"4. Discussion\", \"text\": \"The men in this study revealed the various impacts breast cancer had on their occupations throughout everyday life. They shared what it was like living with a widely female diagnosed disease, the personal implications, and the resulting changes in their occupations. Similarities in cultural norms across the world consisted of different gender norms, including the idea of hegemonic masculinity [24]. This concept divides men and women through stereotypical notions of what it means to be a man, and according to society, breast cancer does not fit into that box. Some men revealed embarrassment and fear of social stigma because they thought they would be perceived as less of a man. This perception is consistent with findings of role strain and stigmatization associated with the \\u201cperception of breast cancer as one of being exotic\\u201d [8]. Consistent with the work of Rayne et al. [12] and Thompson and Haydock [9] not all participants felt stigma and marginalization and accepted the disease as a diagnosis. Like other recent studies, living with a female's disease left the participants with many unmet health information needs and frequently poorly informed health care providers [5]. These unmet needs prompted participants to assume new roles and occupations in self-advocacy.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B25\", \"B28\", \"B27\", \"B29\", \"B28\", \"B33\"], \"section\": \"4. Discussion\", \"text\": \"Changes in activities of daily living (ADL), instrumental activities of daily living (IADL), social participation, and work were connected to the diagnosis of cancer and side effects including fatigue, pain, physical limitations, support systems, and social perceptions. Declines in functional status, ADLs, and IADLs for all types of cancer survivors, male and female, are well documented [25\\u201328]. ADLs, IADLs, and social participation are domains commonly addressed in oncologic occupational therapy [27, 29]. Current practice trends and evidence support occupational therapy interventions across the cancer continuum to address disease self-management, physical impairments, fatigue, cognition, emotions, energy conservation, work-related issues, and social participation [28\\u201333].\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B34\", \"B34\", \"B35\"], \"section\": \"4. Discussion\", \"text\": \"Every participant related a story of their involvement in and the importance of advocacy without a direct question or prompt. This highlights the importance and weight of advocacy in the lives of these men. Self-advocacy is defined as \\u201ca means for patients to exert control over complex treatment decisions and uncertain health outcomes, address their unmet needs, and improve their healthcare experience\\u201d [34]. In a qualitative study of the self-advocacy experiences of men with cancer, the three major themes managing information, finding the best medical team, and strategic social connections were identified [34]. These themes are consistent with our findings. We viewed concepts of managing information and medical team as separate constructs from advocacy. We interpreted advocacy in the sense of representing a cause and raising awareness. The men in this study viewed the rarity of their diagnosis and the overwhelming focus on female breast cancer the impetus to becoming involved in advocacy with the goal of helping other men to have a better experience and receive better health care. The sense of isolation as a man with cancer, confronting stigma, and seeking others were themes in a study of prostate cancer survivors in Australia [35] and are consistent with the drivers to advocacy expressed in this sample.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B16\", \"B28\", \"B36\", \"B37\", \"B16\", \"B36\", \"B28\", \"B31\", \"B32\", \"B36\", \"B38\", \"B39\"], \"section\": \"4. Discussion\", \"text\": \"There were high expectations of the men in this study to maintain their employment, causing some men to carry a heavy burden when they had to stop or limit working due to treatment, with participants noting the need to maintain routine and normalcy as well as their professional identity. These themes match those identified in a systematic review of returning to work after breast cancer and other studies including multiple types of cancer [16, 28, 36, 37]. Our results are consistent with the findings of Hiltrop et al. [16], in which male breast cancer survivors in Germany indicated the need to continue with their activities and maintain a sense of normalcy. A study of Italian cancer survivors determined that fatigue, memory issues, and coordinating treatment appointments with work schedule impacted the ability to maintain participation in work activities and are prognostic factors in return to work [36]. Occupational therapists address factors related to return to work with cancer survivors and can fulfill a vital role in promoting and facilitating participation in work [28, 31, 32, 36, 38, 39].\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B27\", \"B29\", \"B31\", \"B40\"], \"section\": \"4. Discussion\", \"text\": \"The experience of a decrease in occupational performance led to changes in role fulfillment in these men, such as being a husband, partner, or father. Although the desire to fulfill the expectations of these roles was still present, the demands exceeded their ability to perform these tasks physically. Societal stigmas in the environment pushed the men to challenge concepts of their identity and body image. This effect impacted occupations, as some men reported embarrassment in social occupations with people who were not aware of their diagnosis to avoid further questioning. Social participation is another area frequently addressed by oncology occupational therapists [27, 29, 31, 40].\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B41\"], \"section\": \"4. Discussion\", \"text\": \"The diagnosis of cancer provoked mortal salience, the recognition of the inevitability of death, for these participants. The men reported an abundance of conflicting feelings. The sense of death's imminence prompted many of the participants to reevaluate their lives and make changes in their routines, habits, values, and beliefs. Although cancer is associated with alterations in future expectations, cancer survivors demonstrate resilience and continue to demonstrate positive social well-being and social growth [41].\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B42\", \"B8\", \"B10\", \"B11\", \"B14\", \"B24\"], \"section\": \"4. Discussion\", \"text\": \"Trust, communication, and respect are foundations of client- or patient-centered care [42] leading to better health care outcomes. Participants in this study had varied experiences with the healthcare team and environment. Many felt marginalized in environments catering to females, with treatment protocols extrapolated from clinical research and guidelines created for females, and a lack of recognition from their medical providers. Men with breast cancer are frequently viewed as unusual or exotic and report lack of awareness of medical providers which results in limited participation in their own care [8, 10, 11, 14, 24]. Positive support and open communication with medical providers resulted in greater comfort, trust, and comfort in the provider and the treatment process in this study.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B17\", \"B19\", \"B30\", \"B43\"], \"section\": \"4. Discussion\", \"text\": \"Our results concerning the ability to fulfill required and desired roles were consistent with findings from a previous qualitative study of women with breast cancer and men with bowel cancer highlighting the importance of social, emotional, and physical support in maintaining a sense of self-worth [17\\u201319, 30]. Finding meaning in engagement in new occupations was a common theme in both genders dealing with breast cancer. New occupations allow those living with breast cancer to replace occupations that were once meaningful but can no longer be performed nor desired. The experience of a life-threatening condition can compromise an individual's identity, engagement in social relationships, and ability to fulfill roles of everyday life. Engagement in modified or new occupations may be a coping response to the psychological challenges presented by cancer [43].\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B17\", \"B18\", \"B30\", \"B35\"], \"section\": \"5. Conclusion\", \"text\": \"The aim of this research study was to better understand how men experience changes in occupation when diagnosed with breast cancer. The lived experiences shared by the men in this study provide insight into the physical, emotional, and social challenges they faced from diagnosis through treatment and into the survival phase. Participation in meaningful occupations were altered for all participants by the experience of male breast cancer. Participants discussed ways of adapting, such as seeking out needed support in their environment or engaging in new occupations such as becoming involved in advocacy groups. Evidence from this study supports that a sense of self, identity, and ability to interact with the social environment strengthened engagement in meaningful occupations. The lived experiences of the men in our study were like the lived experiences of women with breast cancer, men with prostate cancer, and bowel cancer survivors [17, 18, 30, 35]. Stigma related to having a diagnosis of a disease associated with women created challenges in diagnosis, medical treatment, and in social environments.\"}, {\"pmc\": \"PMC9940971\", \"pmid\": \"\", \"reference_ids\": [\"B27\", \"B29\", \"B33\", \"B39\", \"B20\"], \"section\": \"5. Conclusion\", \"text\": \"All health care providers must maintain a client-centered approach that provides space for the unique experiences of each client and not fall into stereotyping which may stigmatize or marginalize the client. Occupational therapy has the ability promote engagement in meaningful occupations and therefore promote overall health and well-being [27, 29, 33, 39] in the lives of men affected by breast cancer through understanding the unique barriers and successes men in this study described. The men in this study expressed instances where they did not feel welcome in the healthcare environment and their health care providers were not well versed in treatment of male breast cancer. Only through a client-centered and occupation-based approach will occupational therapy benefit clients to achieve optimal occupational engagement [20].\"}]"

Metadata

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