Reply to Effects of Supportive-Expressive Group Therapy on Survival of Patients with Metastatic Breast Cancer: A Randomized Prospective Trial

Drs. Kissane and Li's data clearly do not support the hypothesis emerging from our exploratory finding of a moderating effect of estrogen receptor status on group psychotherapeutic treatment effectiveness in promoting survival.1 While one null finding does not prove the hypothesis wrong, it clearly tends in that direction. We call upon other investigators who have conducted psychosocial intervention trials with breast cancer patients to conduct a similar analysis to that presented here. In the meantime, we concur with Drs. Kissane and Li that group therapy provides considerable emotional benefit regardless of any effect on survival time.

David Spiegel MD*, Lisa D. Butler PhD*, Janine Giese-Davis PhD*, Cheryl Koopman PhD*, Elaine Miller RN, MPH*, Sue DiMiceli BA*, Catherine Classen PHD*, Patricia Fobair LCSW, MPH*, Robert W. Carlson MD*, * Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University Medical Center, Stanford, California.