Vol. 38, No. 18

11-19-2008
By: Jeff Grabmeier

Intervention program boosts survival in breast cancer patients

A new study provides the best evidence to date that a psychological intervention program designed for breast cancer patients not only improves their health — it actually increases their chance of survival.

Researchers at Ohio State’s Comprehensive Cancer Center found that patients participating in an intervention program reduced their risk of dying of breast cancer by 56 percent after an average of 11 years.

Participants in the program, which taught strategies to reduce stress, improve mood and alter health behaviors, also reduced the risk of breast cancer recurrence by 45 percent.

“The results suggest that we can help breast cancer patients take positive steps that may help them live longer and make recurrence less likely,” said Barbara Andersen, lead author of the study and a member of Ohio State’s Comprehensive Cancer Center and professor of psychology.

“We already knew a psychological intervention program could help breast cancer patients to handle their stress, function more effectively and improve their health. Now we know it does even more.”

The study will be published in the Dec. 15 issue of the journal Cancer and is currently available to subscribers online.

The study is part of the long-running Stress and Immunity Breast Cancer Project at Ohio State. Participants included 227 patients who were surgically treated for Stage II or Stage III breast cancer.

Half of the patients were enrolled in the intervention program, while the other half were simply assessed on a regular basis. All received their regular medical treatments as well.

Those in the intervention group met weekly in groups of eight to 12 with a clinical psychologist. During these sessions, which continued for four months, participants learned progressive muscle relaxation for stress reduction, problem solving for common difficulties (such as fatigue), how to find support from family and friends, exercise and diet tips, and how to deal with treatment side effects and keep up with medical treatment and follow-up.

After four months of weekly sessions, participants met monthly for eight months.

Researchers have followed up regularly with all participants. By October 2007, patients had been followed from 7-13 years.

In addition to improving survival and reducing recurrence, the intervention program had other positive effects, said Andersen.

Among patients who died of breast cancer, those who participated in the intervention program lived longer — an average of 6.1 years for program participants versus 4.8 years for those who were simply assessed.

Intervention participants were also less likely to die from causes other than breast cancer, such as heart disease or other cancers. For those who died of any cause, participants lived an average of six years compared to five years for non-participants.

“Many of the strategies patients learned in the intervention program, such as stress reduction, may have protected them from heart disease and other causes of death,” Andersen said.

In a follow-up analysis, researchers excluded people who were put in the intervention group but who attended fewer than 20 percent of the sessions (16 of the 114 participants fit this requirement).

When the infrequent attendees were excluded, the remainder had a 68 percent reduced risk of breast cancer death, compared to the 56 percent risk reduction for the whole participant group.

How did the intervention program help cancer patients?

Overall, the results show a promising new way to help treat cancer patients, she said.

“If psychological interventions to reduce stress are delivered early, they can improve mental health, health and possibly even their odds of survival.”

Co-authors on the study were William Farrar, professor of surgery; William Carson III, professor of surgery and associate director for clinical research at the OSU Comprehensive Cancer Center; Hae-Chung Yang, research associate in psychology; Deanna Golden-Kreutz, clinical research manager in medicine; Lisa Thornton, post-doctoral fellow in psychology; Charles Emery, professor of psychology; and Donn Young, a biostatistician and research scientist in the OSU Comprehensive Cancer Center.

The study was supported by the National Institute of Mental Health and the National Cancer Institute, with additional help from American Cancer Society; Longaberger Company-American Cancer Society Grant for Breast Cancer Research; US Army Medical Research Institute; the OSU Comprehensive Cancer Center; and the Walther Cancer Institute.

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