As a full-time student and single mother of five, Theclia Holloway had little time to spare for a mammogram. So she put it off for two years, and when the doctor called her in for more extensive tests after the mammogram, she was in the midst of midterms, so she put that off as well.
“What happens with single moms is that you’re so busy taking care of everyone else that you don’t take care of yourself,” Holloway said.
When a biopsy in June 2012 confirmed that she had early-stage breast cancer, Holloway felt like she’d “been sucker punched by life,” unable to comprehend how her hard-fought path had suddenly veered out of control. Her diagnosis led to a double mastectomy.
“To be the person receiving help was devastating to me,” said Holloway, 45, who is divorced and lives with her five kids, ages 9 to 23, in Gilbert, Ariz. “I had to keep my pride in check.”
Scant research has examined how breast cancer affects single moms and their families, but women in that position and people who work with them say the financial and emotional burdens of cancer can be compounded when there’s no partner to share the load.
Of the estimated 1.58 million U.S. parents with cancers of all types living with their minor children, about 24.5 percent — 387,000 — are single parents, according to a 2010 study published in the journal Cancer. It is a challenge particularly germane to African-American women, who are most likely to be single parents (68 percent of black women who gave birth in 2011 were unmarried, compared with 36 percent overall, according to the U.S. Census Bureau) and most likely to get breast cancer at a young age, when the disease can be more aggressive.
A 1996 study published in the journal Cancer Practice found that, compared with married mothers with breast cancer, single moms had significantly higher rates of depression, reported higher numbers of illness-related pressures on their families and had more children scoring in the abnormal range on measures of self-worth and acceptance.
A more recent federally funded clinical trial examining the effectiveness of counseling on single moms with breast cancer found that they “struggle with a huge sense of personal vulnerability which is beyond what we have seen among women who are married or unhappily married,” said University of Washington School of Nursing professor Frances Marcus Lewis, lead author on the 1996 study and the recent research, which has yet to be published.
“These were women who had come to rely on their own strength, and now they had become vulnerable in their own minds, so they’re going to drill down and get through the treatment, but they had no time to deal with their fears,” Lewis said.
Lewis said it is crucial for single moms to express their feelings, reach out to their networks, make a list of what they need and accept that they may not be able to do it all alone.
“We want to control everything,” said Nicole Dove, 41, who was diagnosed with Stage 3 triple-negative breast cancer eight years ago. “That was hard for me to let go.”
Dove became a single mom to her daughters, at the time 10 and 8, after she and her husband split a few months after her diagnosis. When her employer put her on long-term leave, which halved her salary, she moved in with her mother in Jacksonville, Fla.
After a double mastectomy, hysterectomy and hair loss from chemotherapy, Dove felt that “everything that made me a woman was gone,” and she fell into a deep depression. Having a partner would have helped “because the kids would have felt like they had a parent,” Dove said. “And it would have been one less thing for me to worry about.”
Looking at her kids’ faces gave her the push to keep fighting.
“I wanted to see them get into high school; I would think, if I can just make it to that,” said Dove, who is now six years cancer-free, living in Houston and working at Sisters Network, an African-American breast cancer support group with chapters in 22 states.
For the first few weeks after Angela Harris was diagnosed with Stage 2B triple-negative breast cancer in September 2012, she would cry every time she looked at her kids.
It had been a rough ride: Shortly after her diagnosis, which came while she was pregnant, the company she was working for opted not to renew her contract; the van she had recently bought was repossessed; and her relationship with her boyfriend, the father of her three children, ended.
Coupled with the pain she suffered during treatment, it often felt like too much to bear.
“I couldn’t give my kids baths, I couldn’t change (my newborn’s) diaper; some days I couldn’t hold him,” said Harris, 39, who had to move in with her parents in Phoenix. “That was so hard.”
She found overwhelming support from her parents, her children, fellow survivors and the kindness of strangers.