Transitions in breast cancer care are associated with significant increases in stress and anxiety, and this stress can negatively impact the mental and physical health of patients. Increasingly, patients are seeking support from friends and family through social media, including Facebook. A new study from the School of Public Health examined the posting behavior of breast cancer patients on Facebook and offers details on how — and possibly why — it changed over time.

The study was led by researcher Jude Mikal and appears in the journal Health Communication. The article is the third in a series of studies conducted by Mikal examining overall trends in posting by breast cancer patients and how Facebook friends respond. 

The researchers used a novel approach of analyzing 21,291 Facebook posts made by 30 breast cancer patients participating in the study. The posts occurred from a period between three months before breast cancer diagnosis to three months following completion of treatment for the disease. 

Results revealed that:

• following diagnosis, patients significantly increased their volume of posts and information offered on Facebook; however, this increase in posts did not correspond to a proportional increase in support requests;
• requests for support were primarily for resources, such as physical items, yet were frequently answered with discordant comments and offers of encouragement;
• over time, patients reduced their interaction on Facebook either through posts or in their responses to comments.

“The results are interesting because we saw that women were initially very active and engaging more in online communication, but with zero uptick in requests for help,” says Mikal. “The percentage of requests made by patients stayed 3% across the board as reported in our first study.”

As to why the posting activity of patients declined over time, Mikal said it could be due to two factors. One, Facebook might be where patients initially seek support because it’s often as close as their phone and a familiar service they regularly use to communicate with others. However, over time patients may begin to connect with cancer groups online or in the communities that provide more specific and empathetic support. 

Second, Mikal explained that declines in posting following the end of cancer treatment could be due to a sense of guilt patients feel about asking for help now that they no longer have cancer. This may occur despite research showing that completing therapy is another major point of emotional upheaval for patients because of rapid shifts back to a more “normal” lifestyle and the new realities of being a breast cancer survivor.

Mikal suggests that scientists continue the research by looking deeper into the mindset of patients when posting on Facebook. Particularly, he recommends that future studies delve into examining what patients were thinking when making posts and their thoughts on what they chose to say or omit.