Group therapy
fails to improve breast cancer survival
A follow up to a previous study on group therapy
in breast cancer patients finds group therapy
does not prolong the lives of women with
metastatic breast cancer.
Published in the September 1, 2007 issue of
CANCER, a peer-reviewed journal of the American
Cancer Society, the new case-control trial finds
patients with metastatic breast cancer who took
part in weekly group psychotherapy had similar
survival rates as those given literature-based
patient education.
Earlier results from the same researcher had
suggested a survival benefit of group therapy
for women with metastatic breast cancer.
However, the new study did find that women with
estrogen receptor (ER) negative tumors did show
survival benefit, and that group therapy
improved quality of life (QOL).
Early reports in the 1980s and 1990s, including
published studies by Dr. David Spiegel from
Stanford University, found that group
psychotherapy for women with metastatic breast
cancer improved survival.
Dr. Spiegel's
1989 study found that women who received group
therapy for one year were more likely to be
alive 18-months after diagnosis compared to a
group of patients who received no therapy. Four
subsequent studies had similar results, but six
other studies failed to confirm the finding. Dr.
Spiegel and co-investigators sought to replicate
their original finding in a new randomized
prospective study.
For the new study, half (64 of 125) of a group
of 125 women with metastatic breast cancer
received one year of weekly group support and
psychotherapy, in addition to one year of
educational literature offered to all subjects.
All also received standard oncological treatment
for their metastatic breast cancer.
Dr. Spiegel and colleagues found no difference
in overall survival between the two groups.
Women who received supportive group therapy
survived a median of 31 months, while group that
received educational literature survived a
median of 33 months.
Further analysis did show a clear benefit for
women with ER-negative tumors. Median survival
in women with ER-negative tumors who received
group therapy was 21 months longer than those
who received educational literature (30 months
versus 9 months). There was no survival benefit
from psychotherapy treatment among women with
ER-positive tumors. These women have benefited
from improved hormonal treatments, such as
aromatase inhibitors.
While there was no overall survival difference
due to group therapy, Dr. Spiegel and colleagues
point to the clear psychological benefit of
group psychotherapy for women with metastatic
breast cancer, writing that
being confronted with their worst fears
as they see others die of the same illness, with
help in managing the strong emotions that
understandably arise, is emotionally helpful for
patients and not physically harmful.
