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Pain Narratives in Breast Cancer Survivors

Identifieur interne : 004542 ( Pmc/Curation ); précédent : 004541; suivant : 004543

Pain Narratives in Breast Cancer Survivors

Auteurs : Patrick Peretti-Watel [France] ; Marc-Karim Bendiane [France] ; Laura Spica [France] ; Dominique Rey [France]

Source :

RBID : PMC:3488421

Abstract

In-depth interviews were conducted with French breast cancer survivors 24 month after cancer diagnosis (N = 21 women). We documented their experience of chronic pain, compared their pain narratives with their answers to the WHOQOL-BREF questionnaire, and studied both the meaning they gave to their pain and how they dealt with it in their daily lives. Half of participants reported are suffering from iatrogenic chronic pain. Most of the time, this pain was not captured by the WHOQOL questionnaire and was not medically treated. Patients “normalized” their pain in various ways: they considered it either as a necessary step on the road to recovery, as the proof of treatment efficacy, or as a permanent condition one must learn to live with. They learned to deal with pain by taking precautions, giving up certain activities, and changing the way they performed others. Participants were also prone to compare themselves with other patients suffering worse pain. Breast cancer survivors should be better informed about chronic pain and how to alleviate it. Physicians should contribute to fighting pain-related beliefs which lead patients to conceal their pain. Techniques used by patients to cope with chronic pain in their daily lives should also be promoted.


Url:
DOI: 10.1155/2012/153060
PubMed: 23150819
PubMed Central: 3488421

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PMC:3488421

Le document en format XML

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<article-id pub-id-type="pmc">3488421</article-id>
<article-id pub-id-type="doi">10.1155/2012/153060</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Pain Narratives in Breast Cancer Survivors</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Peretti-Watel</surname>
<given-names>Patrick</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bendiane</surname>
<given-names>Marc-Karim</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Spica</surname>
<given-names>Laura</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rey</surname>
<given-names>Dominique</given-names>
</name>
<xref ref-type="aff" rid="I1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="I2">
<sup>2</sup>
</xref>
<xref ref-type="aff" rid="I3">
<sup>3</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1">
<sup>1</sup>
INSERM, UMR912 (SESSTIM), 13006 Marseille, France</aff>
<aff id="I2">
<sup>2</sup>
Aix Marseille Université, UMR_S912, IRD, 13006 Marseille, France</aff>
<aff id="I3">
<sup>3</sup>
ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13006 Marseille, France</aff>
<author-notes>
<corresp id="cor1">*Patrick Peretti-Watel:
<email>patrick.peretti-watel@inserm.fr</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Alok Madan</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2012</year>
</pub-date>
<pub-date pub-type="epub">
<day>24</day>
<month>10</month>
<year>2012</year>
</pub-date>
<volume>2012</volume>
<elocation-id>153060</elocation-id>
<history>
<date date-type="received">
<day>17</day>
<month>6</month>
<year>2012</year>
</date>
<date date-type="accepted">
<day>30</day>
<month>7</month>
<year>2012</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2012 Patrick Peretti-Watel et al.</copyright-statement>
<copyright-year>2012</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>In-depth interviews were conducted with French breast cancer survivors 24 month after cancer diagnosis (
<italic>N</italic>
= 21 women). We documented their experience of chronic pain, compared their pain narratives with their answers to the WHOQOL-BREF questionnaire, and studied both the meaning they gave to their pain and how they dealt with it in their daily lives. Half of participants reported are suffering from iatrogenic chronic pain. Most of the time, this pain was not captured by the WHOQOL questionnaire and was not medically treated. Patients “normalized” their pain in various ways: they considered it either as a necessary step on the road to recovery, as the proof of treatment efficacy, or as a permanent condition one must learn to live with. They learned to deal with pain by taking precautions, giving up certain activities, and changing the way they performed others. Participants were also prone to compare themselves with other patients suffering worse pain. Breast cancer survivors should be better informed about chronic pain and how to alleviate it. Physicians should contribute to fighting pain-related beliefs which lead patients to conceal their pain. Techniques used by patients to cope with chronic pain in their daily lives should also be promoted.</p>
</abstract>
</article-meta>
</front>
<floats-group>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Sociodemographic and medical characteristics of the 21 breast cancer survivors interviewed.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">Age</th>
<th align="center" rowspan="1" colspan="1">PHY</th>
<th align="center" rowspan="1" colspan="1">PSY</th>
<th align="center" rowspan="1" colspan="1">Marital status</th>
<th align="center" rowspan="1" colspan="1">Employment situation</th>
<th align="center" rowspan="1" colspan="1">Mastectomy</th>
<th align="center" rowspan="1" colspan="1">Reconstruction</th>
<th align="center" rowspan="1" colspan="1">Axillary surgery</th>
<th align="center" rowspan="1" colspan="1">On hormonotherapy at the time of the study</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Stella</td>
<td align="center" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">28</td>
<td align="center" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">Single</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Cindy</td>
<td align="center" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">16</td>
<td align="center" rowspan="1" colspan="1">Single</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hannah</td>
<td align="center" rowspan="1" colspan="1">30</td>
<td align="center" rowspan="1" colspan="1">29</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Emmy</td>
<td align="center" rowspan="1" colspan="1">31</td>
<td align="center" rowspan="1" colspan="1">31</td>
<td align="center" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Sick leave</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Megan</td>
<td align="center" rowspan="1" colspan="1">32</td>
<td align="center" rowspan="1" colspan="1">32</td>
<td align="center" rowspan="1" colspan="1">20</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Helen</td>
<td align="center" rowspan="1" colspan="1">32</td>
<td align="center" rowspan="1" colspan="1">30</td>
<td align="center" rowspan="1" colspan="1">25</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Nancy</td>
<td align="center" rowspan="1" colspan="1">33</td>
<td align="center" rowspan="1" colspan="1">21</td>
<td align="center" rowspan="1" colspan="1">8</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Sue</td>
<td align="center" rowspan="1" colspan="1">40</td>
<td align="center" rowspan="1" colspan="1">34</td>
<td align="center" rowspan="1" colspan="1">29</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Silvia</td>
<td align="center" rowspan="1" colspan="1">41</td>
<td align="center" rowspan="1" colspan="1">27</td>
<td align="center" rowspan="1" colspan="1">22</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Kate</td>
<td align="center" rowspan="1" colspan="1">42</td>
<td align="center" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Housewife</td>
<td align="center" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hillary</td>
<td align="center" rowspan="1" colspan="1">42</td>
<td align="center" rowspan="1" colspan="1">35</td>
<td align="center" rowspan="1" colspan="1">29</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Laura</td>
<td align="center" rowspan="1" colspan="1">42</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">20</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Working</td>
<td align="center" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Rachel</td>
<td align="center" rowspan="1" colspan="1">43</td>
<td align="center" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">12</td>
<td align="center" rowspan="1" colspan="1">Single</td>
<td align="center" rowspan="1" colspan="1">Sick leave</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
</tr>
<tr>
<td align="left" colspan="10" rowspan="1">
<hr></hr>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Bree</td>
<td align="center" rowspan="1" colspan="1">66</td>
<td align="center" rowspan="1" colspan="1">29</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">Widow</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Eva</td>
<td align="center" rowspan="1" colspan="1">68</td>
<td align="center" rowspan="1" colspan="1">21</td>
<td align="center" rowspan="1" colspan="1">11</td>
<td align="center" rowspan="1" colspan="1">Widow</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Linda</td>
<td align="center" rowspan="1" colspan="1">68</td>
<td align="center" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Mary</td>
<td align="center" rowspan="1" colspan="1">72</td>
<td align="center" rowspan="1" colspan="1">35</td>
<td align="center" rowspan="1" colspan="1">27</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Clara</td>
<td align="center" rowspan="1" colspan="1">75</td>
<td align="center" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">17</td>
<td align="center" rowspan="1" colspan="1">Divorced</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ella</td>
<td align="center" rowspan="1" colspan="1">75</td>
<td align="center" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Sharon</td>
<td align="center" rowspan="1" colspan="1">78</td>
<td align="center" rowspan="1" colspan="1">24</td>
<td align="center" rowspan="1" colspan="1">20</td>
<td align="center" rowspan="1" colspan="1">Single</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Partial</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Susan</td>
<td align="center" rowspan="1" colspan="1">83</td>
<td align="center" rowspan="1" colspan="1">27</td>
<td align="center" rowspan="1" colspan="1">22</td>
<td align="center" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">No</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
<td align="center" rowspan="1" colspan="1">Yes</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float">
<label>Table 2</label>
<caption>
<p>WHOQOL-BREF items, pain management, and pain narratives.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1"></th>
<th align="center" rowspan="1" colspan="1">QoL self-rating</th>
<th align="center" rowspan="1" colspan="1">Feeling activity limitation due to pain</th>
<th align="center" rowspan="1" colspan="1">Satisfaction in everyday activities</th>
<th align="center" rowspan="1" colspan="1">Pain management</th>
<th align="left" rowspan="1" colspan="1">Pain-related quotations from in-depth interviews</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Clara</td>
<td align="center" rowspan="1" colspan="1">Neither…
<sup>1</sup>
</td>
<td align="center" rowspan="1" colspan="1">Very much</td>
<td align="center" rowspan="1" colspan="1">Neither…
<sup>2</sup>
</td>
<td align="center" rowspan="1" colspan="1">Paracetamol</td>
<td align="left" rowspan="1" colspan="1">My scar hurts … I have also shooting pains in the arm, I can't lift it.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ella</td>
<td align="center" rowspan="1" colspan="1">Good</td>
<td align="center" rowspan="1" colspan="1">A little</td>
<td align="center" rowspan="1" colspan="1">Neither…
<sup>2</sup>
</td>
<td align="center" rowspan="1" colspan="1">Diclofenac</td>
<td align="left" rowspan="1" colspan="1">I'm dripping with sweat … I've lost my appetite … and the pain starts every morning at 7 A.M.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Nancy</td>
<td align="center" rowspan="1" colspan="1">Very poor</td>
<td align="center" rowspan="1" colspan="1">A little</td>
<td align="center" rowspan="1" colspan="1">Neither…
<sup>2</sup>
</td>
<td align="center" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">My scar hurts all the time, especially when the weather is hot … The scar was done too tight and it hurts a lot because I put on weight due to my pills.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Eva</td>
<td align="center" rowspan="1" colspan="1">Poor</td>
<td align="center" rowspan="1" colspan="1">Not at all</td>
<td align="center" rowspan="1" colspan="1">Satisfied</td>
<td align="center" rowspan="1" colspan="1">Diclofenac, paracetamol</td>
<td align="left" rowspan="1" colspan="1">I have a hematoma since breast reconstruction … it has been hurting for six months now … I'm tired as soon as I wake up and I feel aching in my entire body, especially the bones.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Linda</td>
<td align="center" rowspan="1" colspan="1">Good</td>
<td align="center" rowspan="1" colspan="1">Not at all</td>
<td align="center" rowspan="1" colspan="1">Neither…
<sup>2</sup>
</td>
<td align="center" rowspan="1" colspan="1">Trinitrin</td>
<td align="left" rowspan="1" colspan="1">My breastbone hurts a lot … sometimes my chest feels like it has a huge weight on it and I suffocate … I can't sleep.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Emmy</td>
<td align="center" rowspan="1" colspan="1">Very good</td>
<td align="center" rowspan="1" colspan="1">A little</td>
<td align="center" rowspan="1" colspan="1">Satisfied</td>
<td align="center" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">I'm always out of breath because of the chemotherapy, it's weakened my heart … I'm 31 and I can't ride a scooter, I can't raise my arms … I can't lift a pack of milk, it's too painful.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Stella</td>
<td align="center" rowspan="1" colspan="1">Good</td>
<td align="center" rowspan="1" colspan="1">Moderate</td>
<td align="center" rowspan="1" colspan="1">Satisfied</td>
<td align="center" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">My arm has been hurting since the surgery … especially in the morning … and sometimes my breast also hurts.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Cindy</td>
<td align="center" rowspan="1" colspan="1">Poor</td>
<td align="center" rowspan="1" colspan="1">Moderate</td>
<td align="center" rowspan="1" colspan="1">Satisfied</td>
<td align="center" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Before my cancer I used to blow dry 20 clients' hair every day, but now after 4 or 5 I must stop because my arm hurts too much … today I can't even hold my handbag … sometimes I've got shooting pains in my breast, like a stab from a knife.
<break></break>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Rachel</td>
<td align="center" rowspan="1" colspan="1">Neither…
<sup>1</sup>
</td>
<td align="center" rowspan="1" colspan="1">Very much</td>
<td align="center" rowspan="1" colspan="1">Not satisfied at all</td>
<td align="center" rowspan="1" colspan="1">Paracetamol</td>
<td align="left" rowspan="1" colspan="1">I can't go upstairs, my ankles swell … If I lift something my arm starts hurting and swelling the day after.</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Silvia</td>
<td align="center" rowspan="1" colspan="1">Good</td>
<td align="center" rowspan="1" colspan="1">Moderate</td>
<td align="center" rowspan="1" colspan="1">Satisfied</td>
<td align="center" rowspan="1" colspan="1">None</td>
<td align="left" rowspan="1" colspan="1">Because of the pills I take I have muscular pain, like cramps, especially in the back and the arm.</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>1: Neither poor nor good.</p>
</fn>
<fn>
<p>2: Neither satisfied nor dissatisfied.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
</record>

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