Effect of Group Therapy on Survival in Early-Stage Breast Cancer
Without a doubt, a cancer diagnosis and subsequent treatment has a profound emotional impact on the patient. Feelings of hopelessness, helplessness, and depression are common and understandable in patients diagnosed with cancer. Past research has linked these negative feelings to slowed recovery and even shortened survival time. In an effort to address the impact of emotional distress on breast cancer patients, researchers have attempted to evaluate the effect of psychosocial interventions, like group therapy, on the survival time of patients.
Thus far, these studies have yielded mixed results. Initial research found that group therapy can extend the survival of cancer patients, but subsequent trials have not found that to be true. Previous research on the effect of therapy on survival time has evaluated patients at advanced stages of cancer. However, therapy early in the disease process might have a better chance of influencing the overall progression of cancer and increasing survival time.
A study in the September 27, 2004 issue of the Journal of Clinical Oncology found no effect of group therapy on survival time in patients with early stage ]]>breast cancer]]> . However, other benefits were found.
About the Study
The researchers randomly assigned 303 women diagnosed with early-stage breast cancer into one of two groups: 20 sessions of weekly group therapy plus three relaxation classes or a control group of only three relaxation classes.
All patients received adjuvant chemotherapy as well. The weekly group sessions consisted of Cognitive-Existential Group Therapy (CEGT), a therapy developed by the authors of the study. During each 90-minute session, participants shared various aspects of their illness experience. The therapists who conducted the sessions encouraged the women to meet informally outside the sessions for further support.
The results of the study revealed that the group therapy did not extend survival time in early-stage breast cancer patients. Those patients who received therapy had a survival time of 81.9 months, whereas those who did not receive therapy had a survival time of 85.5 months, a statistically insignificant difference. While therapy had no effect on survival time, certain biological features of the tumor, such as spread to local lymph nodes, did.
There were other benefits associated with group therapy. The patients receiving therapy had several other important results. They displayed reduced anxiety, improved family functioning, and significantly greater satisfaction with their therapy. The group that received the therapy reported feeling significantly more supported than the control group. In fact, the authors reported that the women continued to meet regularly several years after the end of the study.
The authors concluded that while group therapy did not have an effect on survival time, it was a useful adjuvant therapy for women with early-stage breast cancer.
How Does This Affect You?
A number of studies have evaluated the benefits of therapy for breast cancer patients, with varied results. Although the benefits of therapy do not appear to translate to increased survival time, it clearly does provide important psychosocial advantages for the patient. In fact, in 2004, both the National Cancer Policy Board and the Central European Cooperative Group recommended that psychosocial management be part of any treatment plan for women with breast cancer.
Emotional support during cancer treatment has many critical benefits including:
- Better mood
- Enhanced coping skills
- Improved health-related quality of life
- Reduced uncertainty
- Improved self-esteem
Many different forms of therapy have been proven to be effective as well, from relaxation and hypnosis to cognitive-behavioral therapy, to cognitive-existential therapy like the type used in this study.
Clearly, there are many benefits of therapy for patients with breast cancer, perhaps the most important is that it gives patients the tools they need to cope with the stress of their disease, and improve their quality of life.
Kissane DW, Love A, Hatton A, et al. Effect of cognitive-existential group therapy on survival in early-stage breast cancer. J Clin Oncol. 2004; 22 (21): 1-6.
Goodwin PJ. Support groups in breast cancer: When a negative result is positive. J Clin Oncol. 2004; 22 (21): 1-6.
The emotional impact of a cancer diagnosis. 2004. Available at www.cancer.org/ docroot/MBC/content/MBC_4_1X_The_Emotional_Impact_of_A_Cancer_Diagnosis.asp?sitearea=MBC. Accessed September 14, 2004.
Last reviewed Oct 1, 2004 by ]]>Richard Glickman-Simon, MD]]>
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