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Psychosocial Distress


Hypnosis and relaxation prior to excisional breast biopsy

In one study, a group of women scheduled for excisional breast biopsy (N = 90) were randomly assigned either to a brief session (15 minutes) of hypnosis and guided relaxation delivered by trained clinical psychologists on the day of surgery or to an attention-control empathic listening session of equal length. Presurgery distress was measured by the visual analogue scale and the short version of the Profile of Mood States. The hypnosis session markedly decreased anticipatory anxiety and increased relaxation measured just prior to the biopsy.[47][Level of evidence: II]

Use of online information

The Comprehensive Health Enhancement Support System (CHESS) [48] is an online resource for cancer patients that has been available for more than 5 years. It has two components:

  1. Didactic material.
  2. Narrative information about medical, practical, and psychosocial issues.

This study addressed the relative appeal and value of these two components separately for Caucasian and African American women who had been diagnosed with breast cancer (three-fourths of participants had early-stage disease). The average time spent online with either type of resource was slightly longer for African American women (didactic: 19.7 minutes, standard deviation [SD] = 31.10; narrative: 17.16 minutes, SD = 38.19) than for Caucasian women (didactic: 18.30 minutes, SD = 28.62; narrative: 15.78 minutes, SD = 36.60) but had substantially more effect.

Before using the resource, African American women were markedly lower in health care participation; after use, African American women increased health care participation markedly, regardless of type of resource, surpassing the level of health care participation by Caucasian women, particularly in regard to the effect of the didactic services. This result suggests that while the use of both the didactic and narrative CHESS resources is valuable for both groups, it is particularly useful for African American women; the narrative resource version appears to differentially have more impact for Caucasian women.

Can psychosocial interventions increase survival?

The intriguing question of whether participation in a psychosocial group intervention can result in increased survival has been investigated since 1989. The original study [49] tested a supportive-expressive group therapy format for women with metastatic breast cancer, while another study [50] tested a psychoeducational group intervention for patients with malignant melanoma. In both of these studies, a survival advantage was found in the intervention group. However, a critique of the first study [51] found that members of the control group had significantly shorter survival times than would have been expected, when compared with data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program, suggesting that the survival advantages may have resulted from inadvertent sampling errors.

Attempts to replicate the supportive-expressive group therapy findings were made in Canada,[52] the United States,[53] and Australia.[54] Although all three studies found significant psychological benefits, no study could replicate the survival benefit.


WebMD Public Information from the National Cancer Institute

Last Updated: May 16, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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