Support groups in advanced breast cancer

Abstract

Considerable research has been conducted into the potential benefits of support groups for patients with metastatic breast cancer. An early report by Spiegel et al. suggested that participation in these groups not only had psychologic benefits but also resulted in prolongation of survival. A review of the published literature was women with metastatic breast cancer who had participated in a randomized trial of group psychosocial support group a decade earlier. These results, which were published in The Lancet, 1 attracted worldwide attention. They proved to be a turning point in psychosocial oncology, opening the door to the possibility of a beneficial survival effect of psychologic interventions in a difficult to treat, and uniformly fatal, oncology setting: metastatic breast cancer. Because the result was unexpected and the study involved only 86 women, members of the scientific community recognized that replication was necessary. However, the results of Spiegel et al. were embraced as conclusive evidence of benefit by many women with breast cancer who were seeking to do everything they could to prolong their survival; by the breast cancer advocacy movement, which was just gaining momentum; and, at times, by members of the clinical and research communities.Survival benefits also have been reported for a brief, individual intervention in a randomized trial in gastrointestinal cancer 2 and a brief group psychosocial intervention in a randomized trial in earlystage melanoma. 3 The latter recently was updated after 10 years of follow-up. 4 The effect of the intervention on recurrence and death was weakened and was not significant in univariate analyses. In 2596

Affective Forecasting: An Unrecognized Challenge in Making Serious Health Decisions

“…30 Support groups for cancer survivors have been shown to engender optimism and active coping. 54,55 Knowing people who have adapted to a similar disability or health condition seems to help patients envision better quality of life if living with a disability. 30 And even the stories of virtual others appear to be quite valuable, as evidenced by patients, avid use of Internet sites for sharing their experiences.…”

“…Empathic listening, cognitive reframing, 49,51 gathering social supports, and encouraging peer support groups 54,67 are all effective ways to help alleviate patients' distress. However, when patients are upset, physicians sometimes respond in problematic ways, ranging from avoidance, to anger, to using stereotypes as a form of distancing.…”

Social support among women who died of ovarian cancer

“…Recognizing the benefits of such support, health care professionals and health systems should be encouraged to take the time to assess the cancer patient's social situation and identify areas where help may be needed. In addition to assistance and support provided by family, friends, health care professionals, religious groups, and private organizations, interventions that may improve social support and quality of life among women with ovarian cancer include patient support groups [4,7,13,14,32,33] and comprehensive models of care such as palliative care and hospice care for dying patients [26]. Clinicians could consider these resources as an option for their ovarian cancer patients who appear to lack social support.…”

What is the state of the evidence on the mind–cancer survival question, and where do we go from here? A point of view

“…In 2001, the results from the first of the more definitive trials (the Breast Expressive-Supportive Therapy trial) were published [29]. In this study, the researchers set out to replicate the Spiegel trial with greater methodological rigor.…”