Reduction of Cancer-Specific Thought Intrusions and Anxiety Symptoms With a Stress Management Intervention Among Women Undergoing Treatment for Breast Cancer

Abstract

Objective-After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention.Method-A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment.Results-The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy.Conclusions-Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer.Approximately 216,000 new cases of breast cancer were diagnosed in the United States in 2004 (1). Diagnosis and treatment of breast cancer are clearly stressful events (2) involving invasive medical procedures with aversive side effects of treatment such as pain, nausea, vomiting, and fatigue (3). Recurring thoughts about the diagnosis and treatment are common (4). Although diagnostic levels of posttraumatic stress disorder (PTSD) are relatively rare (5), PTSD-like symptoms and subthreshold levels of PTSD are more frequent (6, 7). After Address correspondence and reprint requests to Dr. Antoni, Department of Psychology, 5665 Ponce DeLeon Blvd., University of Miami, Coral Gables, FL 33124-0751; MAntoni@miami.edu. Dr. Antoni reports that he is the author of a book that details the intervention discussed in the article which is published by the American Psychological Association. The other authors report no competing interests. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript treatment, many survivors experience residual psychological strain from the diagnosis, shifts in social support, fear of recurrence, and fear of death (8).Factors that influence distress after breast cancer treatment include coping style and social support (6,9,10). Prospective studies reveal that optimism (11), coping strategies such as positive reframing and acceptance (11,12), and social support (13) yield less distress in the months after treatment. Similarly, psychosocial interventions that foster optimistic appraisals, build coping strategies, and bolster social support should benefit women treated for breast cancer (14).Psychosocial interventions for persons with cancer and other chronic illnesses typically use cognitive behavior techniques, often incorporating skills training an...

Effect of Group Therapy on Psychological Symptoms and Quality of Life in Turkish Patients with Breast Cancer

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Diffuse large b-cell lymphoma with hemophagocytic syndrome in an HIV+ patient treated with CCR5- bone marrow transplant

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