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Psychologic intervention improves survival for breast cancer patients
A randomized clinical trial
Version of Record online: 17 NOV 2008
Copyright © 2008 American Cancer Society
Volume 113, Issue 12, pages 3450–3458, 15 December 2008
How to Cite
Andersen, B. L., Yang, H.-C., Farrar, W. B., Golden-Kreutz, D. M., Emery, C. F., Thornton, L. M., Young, D. C. and Carson, W. E. (2008), Psychologic intervention improves survival for breast cancer patients. Cancer, 113: 3450–3458. doi: 10.1002/cncr.23969
- Issue online: 4 DEC 2008
- Version of Record online: 17 NOV 2008
- Manuscript Accepted: 22 JUL 2008
- Manuscript Revised: 18 JUL 2008
- Manuscript Received: 15 MAY 2008
- National Institute of Mental Health. Grant Number: RO1MH51487
- National Cancer Institute. Grant Numbers: R01CA92704, K05 CA098133, KA24 CA93670, P01 CA95426
- American Cancer Society. Grant Number: PBR-89
- LongabergerCompany-American Cancer Society. Grant Number: PBR-89A
- US Army Medical Research Acquisition Activity. Grant Numbers: DAMD17-94-J-4165, DAMD17-96-1-6294, DAMD17-97-1-7062
- Ohio State University Comprehensive Cancer Center. Grant Number: P30 CA16058
- Walther Cancer Institute
The question of whether stress poses a risk for cancer progression has been difficult to answer. A randomized clinical trial tested the hypothesis that cancer patients coping with their recent diagnosis but receiving a psychologic intervention would have improved survival compared with patients who were only assessed.
A total of 227 patients who were surgically treated for regional breast cancer participated. Before beginning adjuvant cancer therapies, patients were assessed with psychologic and behavioral measures and had a health evaluation, and a 60-mL blood sample was drawn. Patients were randomized to Psychologic Intervention plus assessment or Assessment only study arms. The intervention was psychologist led; conducted in small groups; and included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Earlier articles demonstrated that, compared with the Assessment arm, the Intervention arm improved across all of the latter secondary outcomes. Immunity was also enhanced.
After a median of 11 years of follow-up, disease recurrence was reported to occur in 62 of 212 (29%) women and death was reported for 54 of 227 (24%) women. Using Cox proportional hazards analysis, multivariate comparison of survival was conducted. As predicted, patients in the Intervention arm were found to have a reduced risk of breast cancer recurrence (hazards ratio [HR] of 0.55; P = .034) and death from breast cancer (HR of 0.44; P = .016) compared with patients in the Assessment only arm. Follow-up analyses also demonstrated that Intervention patients had a reduced risk of death from all causes (HR of 0.51; P = .028).
Psychologic interventions as delivered and studied here can improve survival. Cancer 2008. © 2008 American Cancer Society.