Psychotherapy may improve breast cancer survival
Reported November 17, 2007
COLUMBUS, OH Nov. 17, 2008 Breast cancer patients who participate in intervention sessions focusing on improving mood, coping effectively, and altering health behaviors live longer than patients who do not receive such psychological support, a new study shows.
Led by Dr. Barbara L. Andersen, a member of Ohio State’s Comprehensive Cancer Center and professor of psychology, researchers found that women who participated in psychological intervention during their treatment had about half the risk of recurrence compared to women who did not take part in such programs. The study appears today online in the journal CANCER, ahead of Dec. 15, 2008 print addition.
“The results suggest that we can help breast cancer patients make positive steps that may help them live longer and make recurrence less likely,” Andersen said in a prepared statement. “We already knew a psychological intervention program could help breast cancer patients to handle their stress, function more effectively, and improve their health. Now we know it does even more.”
The study is part of the long-running Stress and Immunity Breast Cancer Project at Ohio State. Participants included 227 patients who were surgically treated for Stage II or Stage III breast cancer. Half of the patients were enrolled in the intervention program, while the other half were simply assessed on a regular basis. All received their regular medical treatments as well.
Those in the intervention group met weekly in groups of 8 to 12 with a clinical psychologist. During these weekly sessions, which continued for four months, participants learned progressive muscle relaxation for stress reduction, problem solving for common difficulties (such as fatigue), how to find support from family and friends, exercise and diet tips, and how to deal with treatment side effects and keep up with medical treatment and follow-up. After four months of weekly sessions, participants met monthly for eight months.
The study is based on the theory that reducing the stress that can accompany cancer diagnosis and treatment can have a significant impact on patients’ survival. Cancer patients undergo a significant amount of stress before, during, and after treatment. Many researchers have theorized that providing mental health services in addition to cancer care may improve patients’ health and even prolong their survival.
Studies linking psychotherapy to improved survival, however, have had inconsistent results. While some papers have shown that the intervention significantly improved psychological, behavioral, and health outcomes and enhanced immunity, others have shown inconclusive results.
Andersen and colleagues followed the study participants for an average of 11 years, noting any cancer recurrences. Overall, they found that cancer recurred in 62 of 212 women (29 percent) for whom recurrence data was available; 54 of the total group of 227 died (24 percent). Patients who had been assigned to the intervention groups had a 55 percent lower risk of recurrence compared to the non-intervention patients.
The patients in the intervention group who did suffer a recurrence remained cancer-free an average of six months longer than the patients in the non-intervention group. The study also found patients receiving the intervention had a 44 percent lower risk of death from breast cancer compared to those who did not receive the intervention, and had a reduced risk of death from all causes, not just cancer.
While the biological basis for this difference in the two groups is not known, the authors theorize that psychological interventions may impact immune changes that are secondary to stress hormones that may promote cancer growth or spread (metastasis), and that in addition to treating cancer patients with powerful antitumor medications, it is also important to treat psychological distress as well.
SOURCE: “Psychological intervention improves survival for breast cancer patients: A randomized clinical trial. CANCER; Published Online: Nov. 17, 2008; Print Issue Dec. 15, 2008.