Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy

Walker, Leslie G.; Walker, Mary B.; Ogston, Keith N.; Heys, Steven Darryll; Ah‐See, A. K.; Miller, I.D.; Hutcheon, A. W.; Sarkar, T. K.; Eremin, O.

doi:10.1038/sj.bjc.6690349

Cited by 183 publications

(119 citation statements)

References 46 publications

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“…Despite the commonality of its use for physical disorders, there have been relatively few tests of relaxation usage and outcomes (Walker et al, 1999). Antoni et al (2006) reported effects not with relaxation frequency but with patients' reported confidence in their ability to use relaxation.…”

Section: Treatment Utilization and Outcomementioning

confidence: 99%

RCT of a psychological intervention for patients with cancer: I. Mechanisms of change.

Andersen¹,

Shelby²,

Golden-Kreutz³

2007

Journal of Consulting and Clinical Psychology

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Little is known about the therapeutic processes contributing to efficacy of psychological interventions for patients with cancer. Data from a randomized clinical trial yielding robust biobehavioral and health effects (B. L. Andersen et al., 2004Andersen et al., , 2007 were used to examine associations between process variables, treatment utilization, and outcomes. Novel findings emerged. Patients were highly satisfied with the treatment, but their higher levels of felt support (group cohesion) covaried with lower distress and fewer symptoms. Also, specific. treatment strategies were associated with specific outcomes, including lower distress, improved dietary habits, reduced symptomatology, and higher chemotherapy dose intensity. These data provide a comprehensive test of multiple therapeutic processes and mechanisms for biobehavioral change with an intervention including both intensive and maintenance phases. Keywordsprocess; therapy; cancer; compliance; dose intensity Psychological interventions for patients with cancer are largely effective in reducing the many burdens and sequelae of the disease and treatment. Interventions can improve emotional adjustment and quality of life, with selected demonstrations of positive health and immune outcomes (Andersen, 2002;Meyer & Mark, 1995). Despite this, little is known about the therapeutic events or processes that lead to or are responsible for therapeutic change and the durability of such change. Kazdin (2006) noted that evaluating mechanisms is important for many reasons. Data on mechanisms can bring order to the variety of treatments available, provide explanations of the broad effects of therapy, enhance translation of treatments to clinical practice, assist in the identification of treatment moderators, and facilitate understanding of therapeutic change. We discuss the influence of process variablessatisfaction with the treatment and feelings of cohesion-and the relationship between utilization of intervention techniques and treatment outcomes. Necessarily, we also draw on the psychotherapy outcome research literature.Patient satisfaction with treatment is a singularly important goal, but it may also be important because it is influential to patients' involvement intreatment (Dearing, Barrick, Dermen, & Walitzer, 2005) and, in turn, treatment efficacy. For group psychotherapy patients, treatment satisfaction has been associated with willingness to participate (Perrone & Sedlacek, 2000). It is important to note that studies with both psychotherapy and primary care outpatients have identified associations between satisfaction and adherence, including appointment keeping (Dearing et al., 2005), compliance with treatment recommendations (Hirsh et al., 2005), and medication use (Barfod et al., 2005). When asked, patients with cancer are typically satisfied with what psychological interventions have to offer (Petersson, Berglund, Brodin, Glimelius, & Sjoden, 2000;Manne et al., 2007). More specific questions have found that, among interventions that includ...

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Section: Treatment Utilization and Outcomementioning

confidence: 99%

RCT of a psychological intervention for patients with cancer: I. Mechanisms of change.

Andersen¹,

Shelby²,

Golden-Kreutz³

2007

Journal of Consulting and Clinical Psychology

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“…there is potential, therefore, for stress-reducing CAM interventions to influence the immune system via this neuroendocrine pathway. a number of previous randomised trials evaluating the effects of various behavioural, psychosocial and complementary therapies in cancer patients have demonstrated both improvements in quality of life as well as changes in biological parameters (38)(39)(40)(41)(42)(43). however, diagnostic and therapeutic heterogeneity, as well as the use of different tumour types and outcome measures, limit the conclusions that can be drawn.…”

Section: Introductionmentioning

confidence: 94%

“…however, diagnostic and therapeutic heterogeneity, as well as the use of different tumour types and outcome measures, limit the conclusions that can be drawn. previous research on breast cancer patients has shown that patients do not always comply with relaxation and guided imagery (38,42); therefore, the present study was designed to evaluate an alternative well-received intervention to promote relaxation. Hence, the current randomised controlled trial evaluated the effects of reflexology and scalp massage on host defences and neuroendocrine function.…”

Section: Introductionmentioning

confidence: 99%

Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage

Green¹,

Alexandropoulou²,

Walker³

et al. 2010

Experimental and Therapeutic Medicine

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Abstract. the diagnosis and treatment of breast cancer can adversely affect quality of life. here the aim was to determine the effects of reflexology on host defences and endocrine function in women with early breast cancer. Six weeks after surgery for early breast cancer, 183 women were randomly assigned to self-initiated support (SIS), SIS plus foot reflexology, or SIS plus scalp massage. peripheral blood mononuclear cells and serum were isolated at T1 (6 weeks post surgery; baseline), T2 and T3 (4 and 10 weeks post completion of intervention, respectively). lymphocyte phenotyping found that cd25 + cells were significantly higher in the massage group compared with the SiS group at t3. the percentage of t cells, and more specifically the T helper subset expressing IL4, decreased significantly in the massage group compared with the SIS group at t3. this change was accompanied by an increase in the percentage of cd8 + T cytotoxic cells expressing IFNγ in the massage group. Natural killer and lymphokine activated killer cell cytotoxicity measurements, serum levels of cortisol, prolactin and growth hormone, and flow cytometric assessment of their corresponding receptors all revealed no significant differences between the three groups of patients. this study provides evidence that the immunological balance of patients can be altered in a potentially beneficial manner by massage. the original trial was registered with the international Standard randomised controlled trial registry (iSrctn87652313).

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“…The six subscales can be summated to obtain a single total score. Reliability and validity have been found to be good (Anderson et al, 2000), and the scale has been shown to be responsive to the effects of cancer therapies (Walker et al, 1997(Walker et al, , 1999a, psychological interventions (Walker et al, 1999b) and work-induced stress. It takes approximately one minute to complete (Anderson et al, 2000).…”

Section: Tolerance Assessmentmentioning

confidence: 99%

Switching to letrozole or exemestane improves hot flushes, mood and quality of life in tamoxifen intolerant women

et al. 2008

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We report an open-label, prospective, crossover study involving 184 post-menopausal women experiencing hot flushes on adjuvant tamoxifen (T). Six weeks after switching to an AI, the primary end point, hot flush score, improved by 47.3% (Po0.001) compared to those reported on T. The mean mood rating scale (MRS) score improved by 9.7% (P ¼ 0.01). The total mean combined FACT (b þ es) score improved from 134.2 (95% CI ± 2.96) to 143.5 (95% CI ± 2.96 o0.001), and the endocrine subscale improved by 9.8% from 51.73 (95% CI ±1.38) to 57.34 (CI ±1.38, Po0.001). At 6 weeks, significantly more women chose to remain on an AI: 133 (72%), vs 40 (22%) (Po0.001) preferring T. At 3 months, 107 (58%) preferred to remain on an AI, 55(30%) on T, and 22 (12%) withdrew. The overall arthralgia rate at 3 months was 47% on AI and 30% on T (P ¼ 0.001). In all 182 (99%) women reported appreciating the opportunity to experience both drugs. These data suggest that if patients suffering significant adverse effects on T are given the opportunity to try an AI, this empowers them to prioritise relative side-effects, improving wellbeing in a significant proportion. These data also highlight the need for hospital follow-up in this intolerant cohort. British Journal of Cancer (2008) The routine adjuvant endocrine standard of care for post menopausal women with oestrogen receptor positive breast cancer has shifted towards including an aromatase inhibitors (AI), following the evidence presented in five international trials demonstrating improved disease-free survival with AI containing regimens, compared to tamoxifen alone (Baum, 2001;Mouridsen et al, 2001; Coombes et al, 2004;Boccardo et al, 2005;Jakesz et al, 2005).It is, however, unlikely that all post menopausal women, particularly those with a good prognosis, where the relapse rate is low on either drug, have a clinically relevant advantage (Baum, 2001). Subgroups of patients have been identified who would benefit the most from AIs over tamoxifen, and particularly benefit from initial selection rather than sequencing a switch at 2 years. These include pathological prognostic factors which predict a higher and earlier relapse rate, such as histological grade, presence of vascular invasion, tumour size and number of positive axillary nodes (Mauriac et al, 2007); Biological molecular markers such a Cerb2, Ki67, CYP-2D6, level of oestrogen receptor positivity, progesterone receptor negativity (Ellis et al, 2001;Mauriac et al, 2007); Patient-related factors such as a history of thromboembolic disease, risk of uterine carcinoma or osteoporosis (Ellis et al, 2001;Lonning et al, 2005;Mauriac et al, 2007). The roles played by quality of life, tolerance and patient preference in the choice for either AI or tamoxifen; however, has not been formally established previously.Menopausal symptoms and overall quality of life have been extensively investigated within adjuvant breast cancer studies (Baum, 2001; Coombes et al, 2004; BIG 1-98 Collaborative Group, 2005;Boccardo et al, 2005;Jakesz et al, 2005), wi...

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Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy

Cited by 183 publications

References 46 publications

RCT of a psychological intervention for patients with cancer: I. Mechanisms of change.

RCT of a psychological intervention for patients with cancer: I. Mechanisms of change.

Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage

Switching to letrozole or exemestane improves hot flushes, mood and quality of life in tamoxifen intolerant women

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