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.
