Psychological interventions associated with breast cancer survival

November 17, 2008

A new study finds that 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. Published in the December 15, 2008 issue of Cancer, a peer-reviewed journal of the American Cancer Society, the study indicates 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. But studies linking psychotherapy to improved survival have had inconsistent results. To test the hypothesis, Dr. Barbara L. Andersen and colleagues at The Ohio State University conducted a randomized clinical trial with newly diagnosed breast cancer patients that tested whether receiving a psychological intervention could reduce the negative effects of stress and ultimately change the course of a patient's disease. Previous papers have shown that the intervention significantly improved psychological, behavioral, and health outcomes and enhanced immunity.

The investigators followed the 227 patients who had been treated for regional breast cancer for an average of 11 years, noting any cancer recurrences. Overall, they found that cancer recurred in 62 of 212 (29 percent) women for whom recurrence data was available; 54 of the total group of 227 (24 percent) died. Patients who were randomized to the intervention groups had about half (55 percent) the risk of recurrence compared to the control patients. The patients who did suffer a recurrence had been cancer-free an average of six months longer than the patients in the control group, a 45 percent reduced risk. The study also found patients receiving the intervention had less than half the risk (44 percent) 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.

The authors hypothesize that psychological interventions may impact immune changes that are secondary to stress hormones and that may promote cancer growth or metastasis, and that in addition to treating cancer patients with powerful antitumor medications, it is also important to treat psychological distress as well.

"If efficacious psychological interventions to reduce stress are delivered early, they will improve mental health, health and treatment-relevant behaviors, and potentially, biologic outcomes," the authors wrote. "If so, there is the possibility for improved survivorship and survival for cancer patients," they added.

Source: American Cancer Society

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