Paper

Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial

  1. David W. Kissane1,2,*,
  2. Brenda Grabsch2,
  3. David M. Clarke3,
  4. Graeme C. Smith3,
  5. Anthony W. Love2,4,
  6. Sidney Bloch2,5,
  7. Raymond D. Snyder6,
  8. Yuelin Li1

Article first published online: 23 MAR 2007

DOI: 10.1002/pon.1185

Issue

Psycho‐Oncology

Psycho-Oncology

Volume 16, Issue 4, pages 277–286, April 2007

Additional Information

How to Cite

Kissane, D. W., Grabsch, B., Clarke, D. M., Smith, G. C., Love, A. W., Bloch, S., Snyder, R. D. and Li, Y. (2007), Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psycho-Oncology, 16: 277–286. doi: 10.1002/pon.1185

Author Information

  1. 1

    Department of Psychiatry and Behavioural Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

  2. 2

    Centre for Palliative Care, University of Melbourne, Melbourne, Australia

  3. 3

    Department of Psychological Medicine, Monash Medical Centre, Melbourne, Australia

  4. 4

    School of Psychological Science, La Trobe University, Melbourne, Australia

  5. 5

    Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia

  6. 6

    Department of Medical Oncology, St Vincent's Hospital, Melbourne, Australia

*Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA

Publication History

  1. Issue published online: 23 MAR 2007
  2. Article first published online: 23 MAR 2007
  3. Manuscript Accepted: 27 JAN 2007
  4. Manuscript Revised: 26 JAN 2007
  5. Manuscript Received: 26 OCT 2006

Funded by

  • National Health and Medical Research Council of Australia
  • Cancer Council of Victoria
  • Kathleen Cuningham Foundation
  • National Breast Cancer Foundation of Australia

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Keywords:

  • breast cancer;
  • group therapy;
  • survival;
  • depression;
  • psychosocial outcome

Abstract

Background: Mixed reports exist about the impact of supportive-expressive group therapy (SEGT) on survival.

Methods: From 485 women with advanced breast cancer recruited between 1996–2002, 227 (47%) consented and were randomized within an average 10 months of cancer recurrence in a 2:1 ratio to intervention with 1 year or more of weekly SEGT plus three classes of relaxation therapy (147 women) or to control receiving three classes of relaxation therapy (80 women). The primary outcome was survival; psychosocial well-being was appraised secondarily. Analysis was by intention-to-treat.

Results: SEGT did not prolong survival (median survival 24.0 months in SEGT and 18.3 in controls; univariate hazard ratio for death 0.92 [95% CI, 0.69–1.26]; multivariate hazard ratio, 1.06 [95% CI, 0.74–1.51]). Significant predictors of survival were treatment with chemotherapy and hormone therapy (p<0.001), visceral metastases (p<0.001) and advanced disease at first diagnosis (p<0.05). SEGT ameliorated and prevented new DSM-IV depressive disorders (p = 0.002), reduced hopeless–helplessness (p = 0.004), trauma symptoms (p = 0.04) and improved social functioning (p = 0.03).

Conclusions: SEGT did not prolong survival. It improved quality of life, including treatment of and protection against depression. Copyright © 2007 John Wiley & Sons, Ltd.

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