Sunday, November 23, 2008

Health

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Cancer Patients in Group Therapy Don't Live Longer

By Katherine Hobson
Posted 5/2/07

Group therapy makes life better for patients battling cancer, but it doesn't help them live longer.

That's the conclusion of a team of researchers at the University of Pennsylvania, who examined the literature on group therapy published after one paper in 1989 reported that women with advanced breast cancer who attended group therapy survived nearly twice as long as those who didn't. The Penn researchers say that those findings haven't held up, and that doctors should promote therapy for the sense of well-being it provides and as a source of support rather than as a key to living longer. The study appears in the current issue of the Psychological Bulletin.

"Groups are great for most people," says study author James Coyne, a psychologist and coleader of the Cancer Control and Outcomes Program at Penn's Abramson Cancer Center. But "quality of life is what's important." A full quarter of cancer patients believe therapy can help them live longer, he says.

Backing up the review is another study, published in the April edition of Psycho-Oncology, that tried to replicate the 1989 experiment by taking 227 women with metastatic breast cancer and randomly assigning them to either weekly group therapy sessions for at least a year plus three classes on how to relax or to relaxation classes only. There was no statistically significant difference in survival.

However, says study author David Kissane, a psychiatrist at Memorial Sloan-Kettering Cancer Center, group therapy did alleviate depression and prevent new cases of depression from occurring. "The groups are great," he says. "It's not a morbid process, nor is it disheartening; it's a marvelous source of support and becomes empowering."

David Spiegel, author of the original 1989 study and associate chair of the department of psychiatry and behavioral sciences at Stanford University School of Medicine, thinks that the topic merits further study. There's still a lot to learn about how stress hormones affect cancer, he says. For now, "therapy helps people cope with illness," but not everyone will want it–and they needn't feel guilty that they're somehow giving in to the disease if they have sad or angry thoughts. "We die because we're mortal, not because we don't have a positive attitude," he says.

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