Psychological Intervention Improves Breast Cancer Survival
Women who participate in psychological measures that provide stress reduction and lifestyle changes have a significant reduction in death and breast cancer recurrence. The surprising study showed a 45% decline in breast cancer recurrence in women who were randomized to receive psychological intervention after being diagnosed with the disease. Death rates from breast cancer were reduced by 56%.
Barbara L. Andersen, PhD, professor of psychology at Ohio State University, in Columbus said, "Nobody was more surprised with the results than we were," in an interview with Medscape oncology. We've long known that our mind affects our health. Stress releases harmful chemicals that promote inflammation in the body, leading to chronic disease, and fueling existing illness.
Whether or not stress accelerates cancer progression has been the subject of speculation. Poorer outcomes have been noted, but not proven.
The current study definitively shows that mortality and breast cancer recurrence can be thwarted through psychological interventions, and may be useful for survival of patients with all types of cancer.
The study results published online on November 17 in Cancer, clearly show that breast cancer recurrence could be thwarted by interventions not reimbursed by insurance companies. According to Dr. Anderson, "active lobbying" is needed to allow women to obtain the tools needed to cope with breast cancer.
The researchers chose 227 women with stage 2 breast cancer to participate in 26-week sessions of psychological therapy. The women began the interventions following surgery, for a period of one year, prior to other adjunctive treatments. The women were followed for eleven years.
Dr. Anderson says, "We purposely chose stage II patients - and not stage I or metastatic patients - because variability would allow us to see an effect." The result clearly showed that survival and recurrence from breast cancer increased when women received psychological interventions targeted toward daily stress reduction through muscle relaxation and mindfulness. Other goals included dietary changes, smoking cessation and compliance with medical follow-up. The intervention groups were encouraged to exercise, find solutions for side effects of breast cancer treatment, such as nausea, advocate toward having their needs met, and seek social support from family and friends.
Daily progressive muscle relaxation seemed to have the most significant impact on breast cancer survival and recurrence. "With progressive muscle relaxation, you tense and release muscles throughout the body. It takes 40 minutes to perform the exercise at first, but then you can eventually accomplish it in as little as 2 minutes," explains Dr. Anderson.
The authors concluded, "A psychologic intervention that reduces stress could conceivably interrupt the inflammatory process, thereby mediating the intervention effect to limit [breast cancer] disease progression,"
The effects of psychological intervention for successful breast cancer treatment were measured by blood tests. Increased immunity, lower white blood cell counts and decreased cortisol levels (a marker of inflammation) was found in the women who free from breast cancer. The researcher feels the study is significant proof that psychological interventions should be readily available to women to improve breast cancer survival and recurrence.
Source: Cancer. 2008;113:3450-3458