Psychological Intervention May Improve Survival in Breast Cancer
Breast cancer patients who receive psychological intervention during treatment experience improved overall survival, as well as a reduced risk of cancer recurrence, according to the results of a study published in an early online issue of Cancer.
Breast cancer is diagnosed in about 180,000 women annually in the United States alone. Fortunately, cure rates remain high for women whose cancer is detected and treated early. Because more women are surviving breast cancer, long-term quality of life during and after treatment has become an important issue.
The stress that results from a cancer diagnosis can be debilitating. Patients not only must cope with the fear that results from facing their own mortality but also with stressors such as the financial issues that arise with treatment, the challenges of coping with side effects, balancing work and family alongside treatment, and much more. One study even noted that 47% of women diagnosed with breast cancer met the criteria for significant distress or a psychiatric disorder.
Chronic stress is known to suppress the immune system, and some researchers have speculated that prolonged stress could have an impact on cancer progression and outcomes. However, to date there has been no definitive data to make such an association. Researchers from Ohio State University conducted a study to determine whether breast cancer patients who received psychological intervention to help them cope with stress have improved survival over patients who did not receive such support.
The study included 227 women who had been surgically treated for regional breast cancer. Prior to beginning adjuvant therapy, all patients underwent a psychological and behavioral assessment. Then approximately half the patients were assigned to receive psychological intervention while the remaining half underwent no further assessment. The psychological intervention consisted of an intensive phase, which involved four months of weekly small-group sessions led by two psychologists, followed by a maintenance phase of eight monthly sessions. In total, the patients participated in 26 sessions (39 therapy hours) over the course of 12 months. The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care.
After 11 years of follow-up, 62 women experienced recurrence of their cancer (29 in the intervention group and 33 in the assessment-only group) and 54 women had died (24 in the intervention group and 30 in the assessment-only group). Patients in the intervention group experienced a longer average period of time before disease recurrence (approximately three years versus approximately two years in the assessment-only group) and also a longer average survival time (approximately six years versus approximately five years in the assessment-only group). The results indicated that women who received the psychological intervention had a significantly lower risk of recurrence and breast cancer death. The researchers concluded that with appropriate psychological intervention, women with breast cancer have a chance of improved survival.
Based on the results of this study, it appears that breast cancer patients who receive psychological support and intervention fare better than those who go it alone. Research is ongoing to examine the psychological aspects of the disease and treatment.
 Andersen BL, Yan HC, Farrar WB, et al. Psychologic intervention improves survival for breast cancer patients. Cancer [early online publication]. November 17, 2008.
 Hegel MT, Moore CP, Collins ED et al. Distress, Psychiatric Syndroms, and Impairment of Function in Women with Newly Diagnosed Breast Cancer. Cancer [early online publication]. November 13, 2006.
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