According to new research, psychological interventions for cancer patients can directly improve health.
In a study of 227 breast cancer patients, lead author and professor of psychology at Ohio State University, Barbara Andersen found that those who participated in a psychological intervention program showed a significant improvement in health a full year after the program started.
Especially welcoming was the observation that patients who exercised could tolerate a higher dose of their chemotherapy drug, in the process bettering their treatment.
"Patients who participated in the program showed fewer and less severe symptoms, and functioned better than those who didn't take part," says Andersen.
"These were independent health evaluations by nurses who didn't know which patients were participating in the psychological intervention, so we know the effects were real and significant", she adds.
The results were chronicled in recent issues of the Journal of Consulting and Clinical Psychology and Brain, Behavior, and Immunity.
The study subjects were breast cancer patients at the Ohio State University Medical Center. All had been diagnosed with Stage II or Stage III breast cancer. They had all received mastectomies and underwent chemotherapy during the course of the study.
Half the patients received the intervention. Here, they met weekly in groups of 8 to 12 with a clinical psychologist. These sessions, which spanned four months, included training on relaxation and coping with stress, strategies to improve health behaviors, information on the value of exercise, communication skills for dealing with physicians, and other related issues. After four months of these weekly meetings, the participants met once a month, for another eight months.
At the beginning of the study, and then at 4 and 12 months, trained research nurses evaluated the participants' health and physical functioning using a standard 100-point scale used in cancer patients.
Results showed that after 12 months, those who participated in the intervention increased their functioning score by 7 percent. This was against 1 percent in the group that did not participate.
It was also seen that disease symptoms and signs and treatment side effects increased by 29 percent in those who did not participate in the intervention, but only by 14 percent in those who did take part.
"These changes were big enough to be clinically important," says Andersen. "When patients have better health, they have less emotional distress, better quality of life, and are more likely to follow through on their treatment."
In the Journal of Consulting and Clinical Psychology paper, the researchers studied in detail which parts of the intervention were most helpful in improving the health and functioning of patients.
According to results, the use of relaxation techniques was most effective in controlling stress. Learning relaxation, as well as techniques to communicate with doctors, strategies for increasing physical activity and how to deal with stress were all related with fewer symptoms and signs associated with disease, the researchers found.
This is not all. Participants who exercised as part of the intervention received a significantly higher dose of taxol - the chemotherapy drug - than did women who exercised less or not at all.
"The actual dosage differences were substantial," Andersen says. Those who exercised regularly received 99 percent dose intensity, compared to 88 percent for those patients who were less active.
"Women who exercised regularly tolerated the taxol treatment better, had less severe symptoms and received an increased dose intensity compared to others," Andersen explains.
The researchers also tested blood samples from the participants to determine if the intervention had any effect on measures of immune function. It was seen that women in the intervention did indeed show signs of improved immune function compared to those who did not participate. Yet, these improvements were not linked to better health.
"We still don't know the clinical relevance of the improvements in immune function," says Andersen. "We will continue to look at the participants to see whether these immune changes have any impact on the progression of the disease."