Psychological intervention benefits women with recurrent breast cancer
MedWire News: A stress-reducing psychological intervention improves survival rates in women with recurrent breast cancer, US researchers report.
In a previous study, The Stress and Immunity Breast Cancer Project, Barbara Andersen (The Ohio State University, Columbus) and colleagues reported that after an average of 11 years of follow-up, women who received a psychological intervention had a 45% reduced risk for breast cancer recurrence compared with women who received psychological assessment only.
In that study, 227 women with newly diagnosed stage II or III breast cancer were randomly assigned to receive a psychological intervention or assessment only. Intervention included relaxation training, positive ways to cope with stress and cancer-related difficulties (eg., fatigue), methods to maximize social support, and strategies for improving health behaviors (diet, exercise) and adherence to cancer treatments.
In the present follow-up study, Andersen and team investigated whether patients who received the psychological intervention had longer survival after recurrence. During follow-up, 62 women were diagnosed with recurrent breast cancer.
The researchers found that, after recurrence, women who had received psychological intervention had a 59% reduced risk for breast cancer death, compared with those who received assessment only.
Follow-up analyses with biobehavioral data revealed that all patients responded to the recurrence diagnosis with significant psychological distress. Thereafter, emotional distress declined significantly for the intervention arm, but remained high for the assessment arm.
“A plausible hypothesis for this pattern is that after the shock of diagnosis, the intervention arm patients may have drawn upon strategies they had learned for reducing stress and coping positively,” remark Andersen and co-authors in the journal Clinical Cancer Research.
In addition, at 12 months after recurrence, immune indices were significantly higher for the intervention arm compared with the assessment arm.
According to Andersen, these results "show enduring benefits from the psychological intervention that were never previously considered or observed," and suggest that the intervention's mechanisms affected patients' risks for recurrence and for breast cancer death.
“If psychological interventions are offered early, they may provide enduring, late benefits and possibly longer survival,” say the researchers.
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By Laura Dean