Research Article| Volume 62, 102253, February 2023

Lived experiences of young adult Chinese American breast cancer survivors: A qualitative analysis of their strengths and challenges using expressive writing

  • Eunju Choi
    Corresponding author. Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
    Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States

    Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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  • Lilian J. Shin
    Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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  • Lingjun Chen
    School of Education, Shanghai Jiao Tong University, Shanghai, China
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  • Qian Lu
    Corresponding author. Dept. of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, United States.
    Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Published:December 04, 2022DOI:


      • YA CABCSs experienced culture- and age-specific challenges and strengths.
      • YA CABCSs described the importance of interpersonal relationships.
      • YA CABCSs need financial, career, psychological, and peer support.
      • Nurses should respond with culturally-appropriate support and resources for YA CABCSs.



      Immigrant young adults of cancer survivors face unique challenges but their unmet needs are not well understood. The purpose of this study was to identify the challenges and strengths of immigrant young adult Chinese American breast cancer survivors.


      Descriptive phenomenology using a qualitative research approach was employed in this study. Expressive writing was used to explore the experiences of 15 young adult Chinese American immigrant breast cancer survivors. Thematic analysis was conducted to gain an understanding of the lived experiences of young adult Chinese American breast cancer survivors.


      On average, participants had been diagnosed at 37 years (ranging from 32 to 39) and living in the USA for 12 years. Participants' writings revealed their challenges during and after treatment (major theme), including difficulty accepting having cancer at a young age, financial difficulties, self-blame, inadequate family support, uncertainty about their futures, and worries about their children and infertility (sub-themes). Participants’ strengths and coping strategies (major theme) included physical recovery and positive self-perception, family as motivation for survival, and support from family and friends (sub-themes). Post-traumatic growth (major theme) included shifting life priorities and enjoying life and self-transcendence (i.e., forgiving and helping others) (sub-themes).


      The overarching topic found across the major themes in the young adult Chinese American breast cancer survivors’ essays was the importance of interpersonal relationships, especially with family and children. Healthcare providers should respond with culturally appropriate support, referrals, and resources based on these findings.


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