The Behavioral Medicine Report

In a long term follow up (median = 11 years) study, researchers* report that women with breast cancer who received group therapy (i.e., psychological treatment in a group format) versus those in an assessment only group (n = 227) experienced statistically significant improvements life expectancy 11 years after diagnosis. Group therapy consisted of 8-12 participants and 2 psychologists with an overall focus on stress reduction, quality of life improvements, improved health behaviors, and adherence to medical treatment. A multi-modal approach to intervention was used, including progressive muscle relaxation, problem solving, identification of available social support, and physical exercise and dietary regimens. Group therapy was, of course, administered concurrently with the participants’ medical therapies. The researchers did an excellent job in their statistical control of extraneous factors, such as lymph node status, tumor size, and type of medical treatment.

A total of 26 group therapy sessions were conducted over the course of 1 year. Participants attended weekly group therapy sessions during months 1-4 and then moved to once per month sessions for remaining 8 months. The current study tracked participants for an average of 11 years (range of 7-13 years) after the completion of group therapy, and follow-ups were frequent and extensive and included clinical interviews, blood work to assess immune system functioning, mammograms, etc..

Overall, researchers reported that compared to the assessment only group, participants in the group therapy condition realized statistically significant reductions in the risk of breast cancer, breast cancer related death, and overall disease recurrence. In fact, these women had a reduced risk of death from all causes of mortality found in this study (i.e., other types of cancer, diseases, and illnesses).

More specifically, group therapy participants had:

1. Reduced likelihood of cancer recurrence, and an extra 6 months of cancer free living in those that went on to have cancer recurrence [45% reduced risk].
2. Reduced likelihood dying from cancer, and an extra 1 year or more of survival in those who died [56% reduced risk].

The authors discussed the body’s probable physical systems that react to stress and contribute to declining health, which included, for example, excessive activation of the autonomic nervous system and hypothalamic-pituitary-adrenal axis, suppression of the immune system, and increased release of hormones, such as adrenalin and cortisol.

These results are impressive and encouraging for women with breast cancer and provides further evidence that biopsychosocial based treatments may represent an important approach to health and wellness. The authors also discuss the urgent need to disseminate information about the role of stress in cancer treatment outcome to cancer patients and their doctors.

I plan to hunt down several articles cited in this research that discuss psychological interventions for cancer and may report on these in future posts in this Blog.

CFisher

Reference:

* Andersen, B., Yang, H.C., Farrar, W., Golden-Kreutz, D., Emery, C., Thornton, L., Young, D., & Carson, W. (2008). Psychologic intervention improves survival in breast cancer patients: A randomized clinical trial. Cancer, 113(12), 3450-3458.