Elen Levine, Ph.D.
California Pacific Medical Center Research Institute

Dalia Drucker, Ph.D.
California Pacific Medical Center Research Institute

Award Type: Scientific Perspectives Exploratory Award Pilot
Duration: 1.5 yrs., 2001-2002

Although the psychological effects of breast cancer on women have been well documented, little is known about the impact of the disease on their children. This information is important because how children react to a mothher's breast cancer can affect the mother's quality of life. Adolescence is an especially difficult time because these children are often aware of the potential seriousness of a parent's illness. Furthermore, the period of treatment is an especially stressful time for a woman with newly diagnosed breast cancer and her family. However, there are studies that suggest that although parents are concerned about their children's reactions, they often underestimate their distress. In addition, previous research on children of parents with cancer has limitations that make it difficult to apply their findings to adolescent boys and girls in general, and especially to diverse racial-ethnic groups.

The goal of the proposed research is to investigate the reactions of an ethnically diverse sample of male and female adolescent children of mothers undergoing treatment for breast cancer. It will also look at factors that might influence their reactions, including the severity of the mother's illness, the intensity of the mother's treatment side effects, increased household responsibilities the adolescent must assume, and the adolescent's coping strategies, including social support. The relation of the adolescent's reactions to the mother's quality of life will also be examined. Because this is an exploratory study, the first phase will involve gathering together a multi-disciplinary team of social science researchers to share their expertise and refine the study design and methods. The second phase will involve implementing the pilot study.

Eighty adolescent boys and girls whose mothers are undergoing treatment for breast cancer will be recruited. Because racial-ethnic and gender differences are foci of this study, the aim is to recruit 10 boys and 10 girls from each of the major ethnic groups in the San Francisco Bay Area: African-American, Latino, Asian-American, and Caucasian. The mother will also be asked to provide demographic and medical information and a medical release form so that information can be acquired from her oncologist and to fill out a brief measure on their own quality of life. The adolescents will be asked to fill out standard questionnaires about their emotional and behavioral reactions, their household responsibilities, and their coping, including social support. The adolescents will also participate in an interview in order to gather further information about their experiences, especially stresses related to their mothers illness and treatment.

This study is innovative in several ways:

1. It brings together a multidisciplinary team of researchers with expertise in psycho-oncology, and in areas not traditionally associated with oncology: psychology of women, adolescence, ethnic studies, and clinical psychology so that all can contribute their knowledge and skills to the research effort;
2. It focuses on adolescent children of women with breast cancer;
3. It focuses on both male and female adolescents;
4. It focuses on adolescents from diverse racial and ethnic backgrounds;
5. Participants will be recruited from underserved groups;
6. It involves breast cancer survivors and advocates in all phases. One of the PIs is a breast cancer survivor and an active participant in breast cancer support groups. Breast cancer advocates have had input in the development of this proposal and have been invited to be part of the team that further refines and develops the study.

Progress Report Year 1 (2002)

Little is known about the impact of a mother's breast cancer on her children. Adolescence is a difficult time because these children are often aware of the seriousness of a parent's illness. The period of treatment is an especially stressful time for women and their families. There are studies that suggest that parents often underestimate their children's distress. Previous research on children of parents with cancer has limitations that make it difficult to apply their findings to adolescent boys and girls in general, and to diverse racial-ethnic groups in particular.

The goal of this study is to investigate the reactions of an ethnically diverse sample of adolescent children of mothers undergoing treatment for breast cancer. It also looks at factors that might influence their reactions, including severity of mother's illness, intensity of mother's side effects, increased household responsibilities, and coping strategies. The relation of the adolescent's reactions to the mother's quality of life is also examined.

The first phase of this project involved gathering together a multi-disciplinary team of social science researchers who shared their expertise on adolescents and diverse samples. They advised us on recruiting and on the content of the interview for the adolescents. The second phase is still in progress. Due to difficulty going through two IRB's and recruiting we have had to broaden our methods of recruiting as well as our target populations. So far we have collected data from only one mother and her two children.

We have expanded our protocol to include recruitment on the internet to in order to increase the potential subject base.