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Erschienen in: Journal of Genetic Counseling 6/2018

03.07.2018 | Original Research

“I Am Uncertain About What My Uncertainty Even Is”: Men’s Uncertainty and Information Management of Their BRCA-Related Cancer Risks

verfasst von: Emily A. Rauscher, Marleah Dean, Gemme M. Campbell-Salome

Erschienen in: Journal of Genetic Counseling | Ausgabe 6/2018

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Abstract

Men with a germline pathogenic BRCA1 or BRCA2 variant have increased risks for developing breast, pancreatic, prostate, and melanoma cancers, but little is known about how they understand and manage their cancer risks. This study examines how men with BRCA-related cancer risks manage uncertainty and information about their risks. Twenty-five men who were either a BRCA carrier or have a BRCA-positive first-degree family member that put the participant at 50% chance of also being a BRCA carrier were interviewed for this study. Using uncertainty management theory as a theoretical framework, this study demonstrates that men manage uncertainty by seeking information from female family members, websites, and healthcare providers, and are under-informed about their cancer risks. Further, in handling their information, men prefer information about cancer risk percentages and screening recommendations in the form of lists presented to them via websites, printed literature, proactive healthcare providers, and an identifiable male spokesperson. Finally, men used BRCA-related cancer risk information to make decisions about whether or not to engage in screening and prevention, manage their BRCA-related cancer risks, and overall family well-being—yet often at the expense of their own individual risks. Implications for genetic counseling and family conversations are discussed.
Literatur
Zurück zum Zitat Brashers, D. E. (2007). A theory of communication and uncertainty management. In B. Whaley & W. Samter (Eds.), Explaining communication theory (pp. 201–218). Mahwah, NJ: Lawrence Erlbaum Associates. Brashers, D. E. (2007). A theory of communication and uncertainty management. In B. Whaley & W. Samter (Eds.), Explaining communication theory (pp. 201–218). Mahwah, NJ: Lawrence Erlbaum Associates.
Zurück zum Zitat Brashers, D. E., Goldsmith, D. J., & Hsieh, E. (2002). Information seeking and avoiding in health contexts. Human Communication Research, 28(2), 258–271.CrossRef Brashers, D. E., Goldsmith, D. J., & Hsieh, E. (2002). Information seeking and avoiding in health contexts. Human Communication Research, 28(2), 258–271.CrossRef
Zurück zum Zitat Brashers, D. E., Neidig, J. L., Haas, S. M., Dobbs, L. K., Cardillo, L. W., & Russell, J. A. (2000). Communication in the management of uncertainty: The case of persons living with HIV or AIDS. Communications Monographs, 67(1), 63–84.CrossRef Brashers, D. E., Neidig, J. L., Haas, S. M., Dobbs, L. K., Cardillo, L. W., & Russell, J. A. (2000). Communication in the management of uncertainty: The case of persons living with HIV or AIDS. Communications Monographs, 67(1), 63–84.CrossRef
Zurück zum Zitat Brashers, D. E., Neidig, J. L., Cardillo, L. W., Dobbs, L. K., Russell, J. A., & Haas, S. M. (1999). “In an important way, I did die”: Uncertainty and revival in persons living with HIV or AIDS. AIDS Care, 11, 201–219.CrossRefPubMed Brashers, D. E., Neidig, J. L., Cardillo, L. W., Dobbs, L. K., Russell, J. A., & Haas, S. M. (1999). “In an important way, I did die”: Uncertainty and revival in persons living with HIV or AIDS. AIDS Care, 11, 201–219.CrossRefPubMed
Zurück zum Zitat Carey, M., Lambert, S., Smits, R., Paul, C., Sanson-Fisher, R., & Clinton-McHarg, T. (2012). The unfulfilled promise: A systematic review of interventions to reduce the unmet supportive care needs of cancer patients. Supportive Care in Cancer, 20(2), 207–219.CrossRefPubMed Carey, M., Lambert, S., Smits, R., Paul, C., Sanson-Fisher, R., & Clinton-McHarg, T. (2012). The unfulfilled promise: A systematic review of interventions to reduce the unmet supportive care needs of cancer patients. Supportive Care in Cancer, 20(2), 207–219.CrossRefPubMed
Zurück zum Zitat Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Thousand Oaks, CA: Sage Publications. Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Thousand Oaks, CA: Sage Publications.
Zurück zum Zitat Creswell, J. W. (2007). Qualitative inquiry & research design: Choosing among five approaches (2nd ed.). Thousand Oaks, CA: Sage Publications. Creswell, J. W. (2007). Qualitative inquiry & research design: Choosing among five approaches (2nd ed.). Thousand Oaks, CA: Sage Publications.
Zurück zum Zitat Dean, M. (2016). “It’s not if I get cancer, it’s when I get cancer”: BRCA-positive patients’(un)certain health experiences regarding hereditary breast and ovarian cancer risk. Social Science & Medicine, 163, 21–27.CrossRef Dean, M. (2016). “It’s not if I get cancer, it’s when I get cancer”: BRCA-positive patients’(un)certain health experiences regarding hereditary breast and ovarian cancer risk. Social Science & Medicine, 163, 21–27.CrossRef
Zurück zum Zitat Dean, M., Scherr, C. L., Clements, M., Koruo, R., Martinez, J., & Ross, A. (2017). “What information is not enough”: A model for understanding BRCA-positive previvors’ information needs regarding hereditary breast and ovarian cancer risk. Patient Education and Counseling, 100, 1738–1743.CrossRefPubMed Dean, M., Scherr, C. L., Clements, M., Koruo, R., Martinez, J., & Ross, A. (2017). “What information is not enough”: A model for understanding BRCA-positive previvors’ information needs regarding hereditary breast and ovarian cancer risk. Patient Education and Counseling, 100, 1738–1743.CrossRefPubMed
Zurück zum Zitat Galarce, E. M., Vishwanath, K., & Ramanadhan, S. (2011). Health information seeking. In T. L. Thompson, R. Parrott, & J. F. Nussbaum, The Routledge handbook of health communication. New York, NY: Routledge. Galarce, E. M., Vishwanath, K., & Ramanadhan, S. (2011). Health information seeking. In T. L. Thompson, R. Parrott, & J. F. Nussbaum, The Routledge handbook of health communication. New York, NY: Routledge.
Zurück zum Zitat Gumaste, P. V., Penn, L. A., Cymerman, R. M., Kirchhoff, T., Polsky, D., & McLellan, B. (2015). Skin cancer risk in BRCA1/2 mutation carriers. British Journal of Dermatology, 172, 1498–1506.CrossRefPubMed Gumaste, P. V., Penn, L. A., Cymerman, R. M., Kirchhoff, T., Polsky, D., & McLellan, B. (2015). Skin cancer risk in BRCA1/2 mutation carriers. British Journal of Dermatology, 172, 1498–1506.CrossRefPubMed
Zurück zum Zitat Hallowell, N., Ardern-Jones, A., Eeles, R., Foster, C., Lucassen, A., Moynihan, C., et al. (2005). Communication about genetic testing in families of male BRCA1/2 carriers and non-carriers: Patterns, priorities and problems. Clinical Genetics, 67(6), 492–502.CrossRefPubMed Hallowell, N., Ardern-Jones, A., Eeles, R., Foster, C., Lucassen, A., Moynihan, C., et al. (2005). Communication about genetic testing in families of male BRCA1/2 carriers and non-carriers: Patterns, priorities and problems. Clinical Genetics, 67(6), 492–502.CrossRefPubMed
Zurück zum Zitat Hallowell, N., Arden-Jones, A., Eeles, R., Foster, C., Lucassen, A., Moynihan, C., et al. (2006). Guilt, blame and responsibility: Men’s understanding of their role in the transmission of BRCA1/2 mutations within their family. Sociology of Health & Illness, 28(7), 969–988.CrossRef Hallowell, N., Arden-Jones, A., Eeles, R., Foster, C., Lucassen, A., Moynihan, C., et al. (2006). Guilt, blame and responsibility: Men’s understanding of their role in the transmission of BRCA1/2 mutations within their family. Sociology of Health & Illness, 28(7), 969–988.CrossRef
Zurück zum Zitat Hogan, T. P., & Brashers, D. E. (2009). The theory of communication and uncertainty management: Implications from the wider realm of information behavior. In T. D. Afifi & W. A. Afifi (Eds.), Uncertainty, information management, and disclosure decisions: Theories and applications, (pp. 45–66). New York: Routledge. Hogan, T. P., & Brashers, D. E. (2009). The theory of communication and uncertainty management: Implications from the wider realm of information behavior. In T. D. Afifi & W. A. Afifi (Eds.), Uncertainty, information management, and disclosure decisions: Theories and applications, (pp. 45–66). New York: Routledge.
Zurück zum Zitat Honda, K. (2000). Who gets the information about genetic testing for cancer risk? The role of race/ethnicity, immigration status, and primary care clinicians. Clinical Genetics, 64, 131–136.CrossRef Honda, K. (2000). Who gets the information about genetic testing for cancer risk? The role of race/ethnicity, immigration status, and primary care clinicians. Clinical Genetics, 64, 131–136.CrossRef
Zurück zum Zitat Kent, E. E., Arora, N. K., Rowland, J. H., Bellizzi, K. M., Forsythe, L. P., Hamilton, A. S., et al. (2012). Health information needs and health-related quality of life in a diverse population of long-term cancer survivors. Patient Education and Counseling, 89(2), 345–352.CrossRefPubMedPubMedCentral Kent, E. E., Arora, N. K., Rowland, J. H., Bellizzi, K. M., Forsythe, L. P., Hamilton, A. S., et al. (2012). Health information needs and health-related quality of life in a diverse population of long-term cancer survivors. Patient Education and Counseling, 89(2), 345–352.CrossRefPubMedPubMedCentral
Zurück zum Zitat Leongamornlert, D., Mahmud, N., Tymrakiewicz, M., Saunders, E., Dadaev, T., Castro, E., et al. (2012). Germline BRCA1 mutations increase prostate cancer risk. British Journal of Cancer, 106, 1697–1701.CrossRefPubMedPubMedCentral Leongamornlert, D., Mahmud, N., Tymrakiewicz, M., Saunders, E., Dadaev, T., Castro, E., et al. (2012). Germline BRCA1 mutations increase prostate cancer risk. British Journal of Cancer, 106, 1697–1701.CrossRefPubMedPubMedCentral
Zurück zum Zitat Mahon, S. M. (2014). Cancer risks for men with BRCA1/2 mutations. Oncology Nursing Forum, 41, 99–101.CrossRefPubMed Mahon, S. M. (2014). Cancer risks for men with BRCA1/2 mutations. Oncology Nursing Forum, 41, 99–101.CrossRefPubMed
Zurück zum Zitat Mai, P. L., Vadaparampil, S. T., Breen, N., McNeel, T. S., Wideroff, L., & Graubard, B. I. (2014). Awareness of cancer susceptibility genetic testing. American Journal of Preventive Medicine, 46, 440–448.CrossRefPubMedPubMedCentral Mai, P. L., Vadaparampil, S. T., Breen, N., McNeel, T. S., Wideroff, L., & Graubard, B. I. (2014). Awareness of cancer susceptibility genetic testing. American Journal of Preventive Medicine, 46, 440–448.CrossRefPubMedPubMedCentral
Zurück zum Zitat Malone, K. E., Daling, J. R., Doody, D. R., Hsu, L., Bernstein, L., Coates, R. J., et al. (2006). Prevalence and predictors of BRCA1 and BRCA2 mutations in a population-based study of breast cancer in white and black American women ages 35 to 64 years. Cancer Research, 66, 8297–8308.CrossRefPubMed Malone, K. E., Daling, J. R., Doody, D. R., Hsu, L., Bernstein, L., Coates, R. J., et al. (2006). Prevalence and predictors of BRCA1 and BRCA2 mutations in a population-based study of breast cancer in white and black American women ages 35 to 64 years. Cancer Research, 66, 8297–8308.CrossRefPubMed
Zurück zum Zitat Merriam, S. B. (2014). Qualitative research: A guide to design and implementation. John Wiley & Sons. Merriam, S. B. (2014). Qualitative research: A guide to design and implementation. John Wiley & Sons.
Zurück zum Zitat Mersch, J., Jackson, M. A., Park, M., Nebgen, D., Peterson, S. K., Singletary, C., et al. (2015). Cancers associated with BRCA1 and BRCA2 mutations other than breast and ovarian. Cancer, 121, 2474–2475.CrossRef Mersch, J., Jackson, M. A., Park, M., Nebgen, D., Peterson, S. K., Singletary, C., et al. (2015). Cancers associated with BRCA1 and BRCA2 mutations other than breast and ovarian. Cancer, 121, 2474–2475.CrossRef
Zurück zum Zitat Morgan, M. G., Fischhoff, B., Bostrom, A., & Atman, C. J. (2002). Risk communication: A mental models approach. Cambridge University Press. Morgan, M. G., Fischhoff, B., Bostrom, A., & Atman, C. J. (2002). Risk communication: A mental models approach. Cambridge University Press.
Zurück zum Zitat Moynihan, C., Bancroft, E. K., Mitra, A., Arden-Jones, A., Castro, E., Page, E. C., et al. (2017). Ambiguity in a masculine world: Being a BRCA1/2 mutation carrier and a man with prostate cancer. Psycho-Oncology, 26, 1987–1993.CrossRefPubMedPubMedCentral Moynihan, C., Bancroft, E. K., Mitra, A., Arden-Jones, A., Castro, E., Page, E. C., et al. (2017). Ambiguity in a masculine world: Being a BRCA1/2 mutation carrier and a man with prostate cancer. Psycho-Oncology, 26, 1987–1993.CrossRefPubMedPubMedCentral
Zurück zum Zitat Rauscher, E. A., & Dean, M. (2017). “I’ve just never gotten around to doing it”: Men’s approaches to managing BRCA-related cancer risks. Patient Education and Counseling, 101, 340–345.CrossRefPubMed Rauscher, E. A., & Dean, M. (2017). “I’ve just never gotten around to doing it”: Men’s approaches to managing BRCA-related cancer risks. Patient Education and Counseling, 101, 340–345.CrossRefPubMed
Zurück zum Zitat Strømsvik, N., Råheim, M., Øyen, N., Engebretsen, L. F., & Gjengedal, E. (2010). Stigmatization and male identity: Norwegian males’ experience after identification as BRCA1/2 mutation carriers. Journal of Genetic Counseling, 19, 360–370.CrossRefPubMed Strømsvik, N., Råheim, M., Øyen, N., Engebretsen, L. F., & Gjengedal, E. (2010). Stigmatization and male identity: Norwegian males’ experience after identification as BRCA1/2 mutation carriers. Journal of Genetic Counseling, 19, 360–370.CrossRefPubMed
Zurück zum Zitat Strømsvik, N., Råheim, M., Øyen, N., & Gjengedal, E. (2009). Men in the women’s world of hereditary breast and ovarian cancer—A systematic review. Familial Cancer, 8(3), 221–229.CrossRefPubMed Strømsvik, N., Råheim, M., Øyen, N., & Gjengedal, E. (2009). Men in the women’s world of hereditary breast and ovarian cancer—A systematic review. Familial Cancer, 8(3), 221–229.CrossRefPubMed
Zurück zum Zitat Tracy, S.J. (2013). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. Malden, MA: Wiley-Blackwell. Tracy, S.J. (2013). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. Malden, MA: Wiley-Blackwell.
Metadaten
Titel
“I Am Uncertain About What My Uncertainty Even Is”: Men’s Uncertainty and Information Management of Their BRCA-Related Cancer Risks
verfasst von
Emily A. Rauscher
Marleah Dean
Gemme M. Campbell-Salome
Publikationsdatum
03.07.2018
Verlag
Springer US
Erschienen in
Journal of Genetic Counseling / Ausgabe 6/2018
Print ISSN: 1059-7700
Elektronische ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-018-0276-y

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