Online social support among breast cancer patients: longitudinal changes to Facebook use following breast cancer diagnosis and transition off therapy

Purpose: Active social engagement, both on and offline, is widely recognized as an important buffer against the negative effects of cancer-related stress. Nevertheless, studies show that social stigma can lead to a decrease in available social support following cancer diagnosis. This study examines whether Facebook friends provide continuous, health-promoting social support to breast cancer patients following transitions in care. Methods: To examine support provided to breast cancer patients, we hand-coded 21,291 status updates and wall posts with respect to both post content and support exchange. We then use descriptive statistics, pairwise t tests, and temporal maps to show whether posts received more likes, comments, or unique commenters following breast cancer diagnosis and the post content that was most likely to garner positive responses from Facebook friends. Results: Results showed an initial increase across all three support metrics (likes, comments, and unique commenters) after cancer diagnosis but that all three metrics decrease steadily over time. Results also revealed significant decreases in the average number of comments and number of commenters following transition off cancer treatment. Conclusions: Taken together, our results reveal that while support is available through Facebook, support may be sporadic, characterized by limited engagement and low cost. There is also limited support available through Facebook to weather the stress of transition off cancer treatment. Implications for Cancer Survivors: Facebook is an important feature in people’s lives, particularly among the demographic most impacted by breast cancer. Our results suggest that social media can be useful in accessing support but should be used with caution.