Managing the illness experience of women with advanced breast cancer: hopes and fears of cancer-related insecurity.

The cultural significance of a diagnosis of advanced breast cancer is important in Pakistan particularly due to the high incidence in women, limited breast cancer screening, healthcare resources and cancer educational programmes in Pakistan. The psychological impact of breast cancer is therefore an important concern for women. This qualitative study explored the psychological impact of advanced breast cancer in Pakistani women. Twenty-one women with advanced breast cancer were interviewed. Women acknowledged feelings related to the insecurity of health, resistance to cancer, the impact of their illness on their physical and emotional well-being and marital relationships and emotions related to cultural discrimination. The majority of women had metastatic spread to bone, liver or lungs. More effort is needed to educate women on the aetiology of cancer, breast self-examination and mammographic screening to ensure that all Pakistanis are educated that cancer is not a communicable disease or one that is transmitted by personal contact.