Cancer treatment has come a long way in recent decades—with enormous gains in new chemotherapy and supportive care agents, evolving radiation therapy techniques, enhanced diagnostic imaging, as well as an emerging array of complementary therapies to improve quality of life.
Support groups of various kinds are among the most widely recognized complementary therapies that can enrich cancer care. Connection with others, especially sharing with others who are going through the cancer journey—either personally or as a loved one or caregiver—has been shown to be beneficial in numerous ways. A large and growing number of scientific studies have documented improvements in quality of life, sense of well-being, and purposeful living among participants in many different kinds of support groups and other psychosocial interventions.
The extent to which support and connection with others might impact survival in people with cancer has been a subject of great debate for many years. This debate was accelerated by a well-known 1989 study by Dr. David Spiegel at Stanford University, in which patients with metastatic breast cancer who participated in a weekly support group along with conventional treatment had both improved quality of life and significantly longer survival times than those who received conventional treatment alone. Since then, a number of additional studies have shown improvements in a variety of quality of life parameters among patients who participate in a variety of support programs, but with no conclusive evidence of longer survival.
Two recent studies shed further interesting light on this subject. The first, published in the Journal of Clinical Oncology in July 2007, reported on the impact of an in-hospital, psychotherapeutic support program for patients with a variety of gastrointestinal cancers who were undergoing surgery. Patients were randomly selected to receive standard treatment with or without psychotherapeutic support during their hospital stay. Results of a 10-year follow-up study showed that patients with localized or regional disease at the time of their surgery who were part of the psychotherapeutic support program had both improved quality of life and longer survival than similar patients who received standard care alone. This finding is intriguing and raises important questions about the potential benefits of support programs for patients with other types of cancer.
The second study, published in the online edition of the journal Cancer (also in July 2007) was led by Dr. Speigel himself in an effort to replicate the findings of his original study published in 1989. In this new study, patients with metastatic breast cancer were again randomly selected to receive conventional treatment with or without psychosocial therapies. After more that 10 years of follow-up study, Dr. Speigel found decreased levels of distress, anxiety, and pain among those who attended therapy, but no improvement in survival. However—quite remarkably—a significant survival advantage was found among a subgroup comprised of those patients who had estrogen-receptor negative breast cancers who also participated in the support program. These women had a median survival of almost 30 months, compared with just 9 months for those who did not participate in the support program.
There are at least two “take-home messages” from these recent studies. First, there may yet prove to be meaningful survival benefits from support groups and therapy programs for some patients. If so, further research will help clarify which patients might benefit the most. Second, evidence nonetheless continues to grow confirming clear improvements in quality of life for people with cancer from support groups and other psychosocial interventions, and all patients should explore them if interested. These programs are not only about adding “years to your life,” but adding “life to your years,” which is a worthy and valuable goal.
Posted
Sep 06 2007, 10:20 AM
by
DrJeremyGeffen