Psychological interventions for women with metastatic breast cancer

Mustafa, Mohammed; Carson‐Stevens, Andrew; Gillespie, David; Edwards, Adrian

doi:10.1002/14651858.cd004253.pub4

Cited by 130 publications

(109 citation statements)

References 106 publications

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“…[23] However, there is significant controversy around whether or not BPSI improves survival. [24] This has resulted from factors including lack of consistency in definition of intervention, [25] and inadequate sample sizes. Coyne et al report that trials in which "survival" was the "a priori" endpoint for psycho-therapeutic interventions have not shown to impact median survival.…”

Section: Discussionmentioning

confidence: 99%

“…[26] Given the fact that there are over 3 million long-term breast cancer survivors in United States, focusing on "survival" may be the wrong approach. There is no doubt that cancer survivors in general [27][28][29][30] and breast cancer survivors in particular [24,31,32] face several issues pertaining to "quality" as opposed to "quantity" of life that could be positively impacted by psychosocial interventions. These issues include body-image concerns, difficulties in tolerating treatment side-effects, lack of compliance, social isolation, and lack of emotional support -all of which can directly hamper re-assimilation of survivors in society as productive members.…”

Section: Discussionmentioning

confidence: 99%

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A bio-psychosocial intervention program for improving quality of life in breast cancer survivors: Results of a prospective randomized trial

Pettiford

Felts

Wischkaemper

et al. 2016

JST

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Background: Given the 3.1 million breast cancer survivors in America, quality of life (QoL) is a vital issue. Bio-psychosocial milieu of survivorship is increasingly important. This study assesses the impact of bio-psychosocial intervention (BPSI) on the QoL of breast cancer survivors utilizing Functional Assessment of Cancer Therapy -Breast (FACT-B) instrument. Methods: A prospective randomized trial was designed; intervention arm included a 4-hour BPSI coping skills class; control arm received standard of cancer (SOC) and follow up care. Women diagnosed within 2 years of study initiation were eligible. Sample size was based on 8-point difference in FACT-B score, 90% power, 5% type I error, and 20% attrition. FACT-B questionnaire was administered to all patients at baseline and at 6-month intervals. SAS 9.3 software was used to analyze data using Chi-square test for categorical and Wilcoxon rank sum for ordinal data; linear mixed modeling was used for longitudinal analysis. Results: One hundred and three of 120 (86%) patients were available for analysis. Forty-seven patients were in BSPI arm, and 56 received SOC. For BPSI arm vs. SOC arm, the median (interquartile) age [60 (52, 68) vs. 58 (52, 68)yrs. P = .9135], cancer-stage (0: 1: 2: 3 = 11%: 41%: 35%: 13% vs. 18%: 46%: 22%: 15%, P = .4645), and biology (triple-negative: HER2+ : ER+ = 9%: 74%: 17% vs. 8%: 72%: 20%, P = .8454), respectively, was similar. Mean (SE) FACT-B scores in BPSI vs. SOC arms at 6 months and 1 year were 115.1 (2.2) vs. 114.6 (2.0) (P = .8731) and 124.7(2.8) vs. 101.4 (2.4) (P = .0001). The inter-group difference significantly expanded at 1 year (P = .0001). The 12-month difference persisted when confounding baseline variables were adjusted for in in multivariate modeling. Conclusion: BPSI coping skills class significantly improved the QoL of breast cancer survivors by one year post-intervention time point.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A bio-psychosocial intervention program for improving quality of life in breast cancer survivors: Results of a prospective randomized trial

Pettiford

Felts

Wischkaemper

et al. 2016

JST

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“…Of the eight scientific reviews 40,[60][61][62][73][74][75][76][77] that reported the effects of psychoeducational interventions such as cognitive-behavioural techniques or education for bca patients and survivors, one 61 reported statistically significant benefits for fatigue (p < 0.001), depression (p < 0.001), anxiety (p < 0.001), and body image (p < 0.051). Two reviews found clinically important benefits for anxiety, depression, and stress levels with moderate-intensity activity 60,73 ; one reported benefits for mobility, muscle strength, and general fitness, and clinically important benefits for sexual functioning 62 ; four reported short-term benefits for overall survival with low-intensity activity, and also improvements in mood and pain reduction [74][75][76][77] ; and yet another reported significant reductions in fatigue, nausea, oral mucositis, diarrhea, constipation, pain, and insomnia, and improved qol 60 .…”

Section: Psychoeducational Interventionsmentioning

confidence: 99%

“…Two reviews found clinically important benefits for anxiety, depression, and stress levels with moderate-intensity activity 60,73 ; one reported benefits for mobility, muscle strength, and general fitness, and clinically important benefits for sexual functioning 62 ; four reported short-term benefits for overall survival with low-intensity activity, and also improvements in mood and pain reduction [74][75][76][77] ; and yet another reported significant reductions in fatigue, nausea, oral mucositis, diarrhea, constipation, pain, and insomnia, and improved qol 60 .…”

Section: Psychoeducational Interventionsmentioning

confidence: 99%

Survivorship Care Plans for Breast Cancer Patients: Understanding the Quality of the Available Evidence

2017

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AimThe overall goal of the present study was to contribute to consistency in the provincial approach to survivorship care planning through knowledge synthesis and exchange. Our review focused on the research concerning the physical and emotional challenges of breast cancer (bca) patients and survivors and the effects of the interventions that have been used for lessening those challenges. MethodsThe psychosocial topics identified in bca survivorship care plans created by two different initiatives in our province provided the platform for our search criteria: quality of life (qol), sexual function, fatigue, and lifestyle behaviours. We conducted an umbrella review to retrieve the best possible evidence, and only reviews investigating the intended outcomes in bca survivors and having moderate-to-high methodologic quality scores were included. ResultsOf 486 reports retrieved, 51 reviews met the inclusion criteria and form part of the synthesis. Our results indicate that bca patients and survivors experience numerous physical and emotional challenges and that interventions such as physical activity, psychoeducation, yoga, and mindfulness-based stress reduction are beneficial in alleviating those challenges. ConclusionsOur study findings support the existing survivorship care plans in our province with respect to the physical and emotional challenges that bca survivors often face. However, the literature concerning cancer risks specific to bca survivors is scant. Although systematic reviews are considered to be the "gold standard" in knowledge synthesis, our findings suggest that much remains to be done in the area of synthesis research to better guide practice in cancer survivorship.

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“…Women with metastatic breast cancer often are not included or included in such small numbers in those trials that reliable subgroup analyses are not possible. A recent review and meta-analysis of ten psychological RCTs with 1,378 women diagnosed with metastatic breast cancer included three trials of distinct individual approaches and seven group psychotherapy trials (four supportive-expressive therapy trials and three cognitive-behavioral trials) (Mustafa et al 2013 ). Although some trials produced psychological benefi t, the meta-analysis did not yield a clear pattern of psychological effects, given that a wide variety of outcome measures and follow-up durations were used.…”

Section: Care Of Women With Metastatic Diseasementioning

confidence: 99%

Living with Metastatic Breast Cancer

Ganz

Stanton

2015

Advances in Experimental Medicine and Biology

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Although prevalence estimates are imprecise, growing numbers of women in the United States are living longer with metastatic breast cancer, attributable at least in part to the availability of effective targeted therapies. Women living with metastatic disease are understudied, however, and substantial heterogeneity exists in both the clinical characteristics of metastatic tumors and the physical and psychological experience of patients living with the disease. Survivorship issues are complex for patients who are living with metastatic disease over extended periods of time, from years to decades. Newly diagnosed patients with stage IV disease are confronting cancer for the first time, while others have metastatic disease as a result of breast cancer recurrence. Many patients are able to live for years on stable medical regimens, and yet others live with a moving target of aggressive disease with arduous treatments and uneven response. The psychological common denominator is the experience of profound life threat and the accompanying uncertainty, for both the affected woman and her loved ones. Maintaining life balance in the face of metastatic disease, as well as managing pain, fatigue, and other physical and psychological symptoms are major challenges. Increasingly, the clinical approach to metastatic disease reflects the consensus that palliative and supportive care are essential from the point of diagnosis. To remedy the paucity of systematic research on women living with metastatic breast cancer for extended periods, we offer directions for research to understand the experience of metastatic breast cancer and to provide evidence-based inter-professional care.

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Psychological interventions for women with metastatic breast cancer

Cited by 130 publications

References 106 publications

A bio-psychosocial intervention program for improving quality of life in breast cancer survivors: Results of a prospective randomized trial

A bio-psychosocial intervention program for improving quality of life in breast cancer survivors: Results of a prospective randomized trial

Survivorship Care Plans for Breast Cancer Patients: Understanding the Quality of the Available Evidence

Living with Metastatic Breast Cancer

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