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Dr Jonathan Koffman
Although the black Caribbean community comprises nearly a fifth of all ethnic groups living in the UK no previous research has taken place among this community that tells us anything of their experience of cancer when cure is no longer a possibility. We are now writing up a study that has provided a deeper understanding of advanced cancer among the black Caribbean and native-born white community living in south London. We interviewed 26 Caribbean and 19 white patients in their homes and in hospital settings.
This study has helped us better understand what cancer, and particularly cancer that is incurable, means to Caribbean and white patients, what aspects of the illness they were most troubled by, for example physical symptoms and their thoughts and feelings, and how these affected their everyday lives. We also have a greater understanding of how patients coped with their experience of advanced cancer. Patients explained how family, friends and the local community helped them. They also spoke about the care offered by health care professionals in hospitals and the community. More Caribbean than white patients discussed the importance of God, their religious faith and the role of the church in helping them understand their illness and cope with its uncertainties.
Cancer also affected the lives of family members from both communities. Carers discussed how their lives had changed as the cancer had progressed and how this caused great distress. They also shared how they had coped, sometimes relying on the support of other close family members and the community, and sometimes on health care professionals. As with the Caribbean patients, more carers from this community mentioned their religious faith as being invaluable during this crisis. Whist it is clear from our findings that are distinct differences between black Caribbean and white patients and their relatives with advanced we also observed important variations within the two cultures, suggesting taking these two communities at face value may reduce them to cultural stereo-types. This may affect well-intentioned multi-cultural practice and care. Further research is being carried out with health and social care professionals to explore how they deliver care to different communities at the end of life.