Group therapy doesn’t extend breast cancer survival

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Women who seek support in coping with early-stage breast cancer through group counseling sessions don’t appear to improve their odds of surviving the disease, new research indicates.

Two years ago, a study reported that group therapy extended survival of women with advanced breast cancer, but other results have been mixed.

In the current report, researchers found that among 303 women with stage I or II breast cancer, those who attended weekly sessions of cognitive-existential group therapy showed no survival benefit compared with the other study patients.

Nonetheless, the study’s lead author told Reuters Health, that finding does not detract from the benefits of group therapy.

“It does appear to reduce anxiety and fear of cancer recurrence, and to improve family relationships,” said Dr. David W. Kissane, chairman of the department of psychiatry and behavioral sciences at Memorial Sloan-Kettering Cancer Center in New York City.

Whether or not group therapy affects breast cancer survival, the “important finding,” Kissane said, is that quality of life can be improved.

Indeed, experts have recommended that more attention be given to the psychological and social needs of women with breast cancer, who suffer a high rate of distress. According to Kissane, this should include greater availability of support groups that are led by mental health professionals.

The study by Kissane and his colleagues, published in the Journal of Clinical Oncology, included 303 women younger than 65 who were undergoing post-surgery chemotherapy for earlier-stage breast tumors. Half attended 20 weekly sessions of cognitive-existential group therapy, plus three classes where they were taught relaxation techniques. The rest of the women served as a “control” group and attended only the relaxation classes.

Part of the goal of the group therapy was to improve the women’s coping skills and to allow them to grieve while encouraging them to be hopeful. Patients discussed issues such as anxiety over facing death, problems with family and friends, and body- and self-image.

Women in group therapy did show less anxiety and better family relationships than those in the control group. They also reported greater satisfaction with their treatment, and appeared to have better coping skills and more knowledge of their disease.

However, the therapy did not improve the women’s survival over the following years.

This is the first study to look at the impact of group therapy on survival among women with early-stage breast cancer. Research on those with advanced cancer has yielded mixed results, and Kissane said it’s still an “open question” as to whether group therapy might prolong the lives of these women.

It’s possible, he said, that the support they receive could encourage women with late-stage cancer to persevere with treatment.

Also, group therapy might improve survival through the general health benefits that have been attributed to social support. Studies in the general population have linked social isolation to poorer health and higher mortality.

But regardless of whether group therapy affects breast cancer survival, it may still make living with the disease easier, according to Kissane.

An editorial published with the report echoes that idea. The study, writes Dr. Pamela J. Goodwin of the University of Toronto in Ontario, Canada, “reinforces the growing evidence” that psychological counseling benefits women with breast cancer.

SOURCE: Journal of Clinical Oncology, November 1, 2004.

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