Group therapy may improve breast cancer survival.Istockphoto/HealthA breast cancer diagnosis and stress—you can pretty much count on the two going hand in hand. Now, a new study is raising hopes about the effects of group therapy and relaxation techniques on the well-being and survival rates of women with breast cancer. Learning how to handle the stress of a diagnosis and treatment in the first year may help such women live better and longer, researchers said today.

The Ohio State University randomized clinical trial looked at 227 women with stage II or stage III breast cancer over 11 years. About half took part in what researchers call intervention—26 small therapy groups led by psychologists in the first year—and half did not.

The result: That one year of therapy and stress reduction (weekly sessions for four months and monthly sessions for eight months) was linked to improved survival 11 years later in the intervention group, the researchers write in the December 15 issue of Cancer, an American Cancer Society journal. In fact, breast cancer patients who had the group therapy were 45% less likely to have a recurrence of breast cancer and 56% less likely to die of breast cancer than those who did not.

Interestingly, breast cancer patients in the intervention group who were open to the idea that stress reduction could make a difference and who practiced progressive muscle relaxation techniques daily had the greatest reductions in distress and physical symptoms.

Progressive muscle relaxation involves slowly tensing and relaxing each muscle group (you can watch a video here). The technique, along with guided imagery, has been studied as a way to reduce anxiety in patients being treated for breast cancer. But this was the first study to link the technique to increased immunity and breast cancer survival.

Next Page: The results [ pagebreak ]
The pro-intervention results of this study are a boost for those who believe that psychological therapy, such as talking with a psychologist, improving diet and exercise habits, and learning new coping skills and relaxation techniques, can provide big benefits—from increased immunity to better survival rates—in cancer patients. Past studies on the role of group therapy have been controversial and sometimes have yielded conflicting results.

That's why Michael Stefanek, PhD, vice president of behavioral research and director of the Behavioral Research Center at the American Cancer Society, is only cautiously optimistic. "Psychological interventions have been found in the majority of well-controlled studies to enhance quality of life and reduce distress," he said in a statement. Patients may learn healthy lifestyle habits and strategies that enhance their quality of life and communication skills, he said, but "it would not be reasonable for patients to participate in psychological interventions with the goal of extending survival."

It's understandable that experts don't want to falsely raise hopes of survival. But the authors of the new study do link stress-reduction techniques with improved immunity: "Added immune control of disease processes, particularly early—when patients were recovering from surgery and receiving adjuvant cancer therapies—may have occurred with the declining stress."

And they hypothesize that psychological interventions that reduce stress may also interrupt the inflammatory process, which has been linked to tumor growth and disease progression.

The fact is, the patients who received therapy had a reduced risk of death from all causes, not just breast cancer. Wrap this research up with 30 years of hundreds of psychological intervention trials, the study authors say, and you have a good case for promoting group therapy and stress reduction as a survival technique.

Indeed, policy makers and oncology professionals in the United States and around the world recommend treating those diagnosed with breast cancer for their psychological distress. The researchers hope their study results are a step toward making that goal a reality.