A breast cancer survivor sobbed after testing positive for a harmful genetic variant related to breast cancer. The doctor explained that knowledge can be empowering, helping the patient feel comforted in just one appointment.
In a new study, Summer Martin, associate professor of human communication studies at Cal State Fullerton, examines how women use metaphors to frame their experience and communicate their mental states during breast cancer genetic testing. The testing can detect whether the patients’ carry a harmful variant that significantly increases their risk of breast and ovarian cancer.
“Women’s Metaphors About BRCA Gene Testing and How They Can Inform Health Communication Theory and Practice” was published in the journal of Health Communication by Martin, Allison Scott of the University of Kentucky and Anne Stone of Rollins College.
From the researchers’ interviews with 42 women, eight themes emerged: knowledge is power; gambling; a journey; a rollercoaster; battle, disaster, or wreckage; Pandora’s box or a can of worms; doom and gloom; and the release or placing of a weight.
“For instance, some women who tested BRCA-positive used metaphors like ‘a death sentence’ or ‘a bomb being dropped’ to describe their experiences, indicating the profound negative emotions they felt soon after getting the results,” explained Martin.
“These metaphors illuminate women’s emotions surrounding the gene testing process, which can yield important information about their psychological health.”
Uplifting patients through psychosocial consultation reduces uncertainty and encourages women who test BRCA-positive to consider options including preventative surgeries to protect their well-being, said Martin.
“Instead of perceiving BRCA-positive test results as solely threatening, participants who are able to shift their view of this information and see it as a source of empowerment can potentially take proactive control over their health to reduce the risk of breast and ovarian cancer,” Martin said.
According to her research, about 70% of women with a harmful BRCA mutation develop breast cancer by the age of 80. Although the news of testing positive for BRCA can be highly distressing, it can also serve as an impetus for potentially life-saving action, such as increased medical surveillance or preventative surgeries, said Martin.
“My co-authors and I are excited about the potential use of metaphors as therapeutic tools in health care appointments, interventions and educational materials within the BRCA gene testing experience,” said Martin.
Martin said that even for patients who test BRCA-negative, they can still experience an “emotional rollercoaster” and fear that their loved ones may be at risk due to a family history of cancer.
To minimize patients’ distress, Martin added that practical implications, including follow-up care, should be easily accessible for women who test positive or negative for the breast cancer gene.
“Screening for metaphors indicating distress in the language of patients during the BRCA gene testing process could be one way of identifying women who might particularly benefit from psychosocial intervention,” Martin noted. “In addition, health care providers can help shape patients’ experiences through their own use of metaphors, such as a medical provider describing ‘knowledge as power’ or the BRCA gene testing experience as a ‘journey’.”
In Martin’s “Health Communication” and “Interpersonal Health Communication” courses, she teaches students how families mitigate health conditions and illness in their everyday lives. She emphasized the importance of psychosocial care in future BRCA gene testing.
“BRCA gene testing can be an emotionally laden and highly uncertainty-inducing experience,” said Martin. “It’s valuable for health care professionals to communicate in ways that acknowledge patients’ varying emotions and empower individuals going through this process.”