A behavioural intervention can reduce stress in cancer patients

Washington: According to a new study, a behavioural program to reduce harmful stress in cancer patients can be taught to therapists from around the country and implemented at their sites, which effectively improves the moods of their patients.

Researchers designed this program at The Ohio State University. "It's challenging to take a treatment and scale it up to where it will work with a diverse group of therapists and patients under a wide variety of circumstances," said study author Barbara L. Andersen.

The program, now called Cancer to Health, was developed by Andersen and colleagues in the early 2000s. It teaches patients how to think about stress, communicate with doctors and others about their treatment, seek social support, become physically active and take other actions to reduce their stress, improve their mood and enhance quality of life. It consists of 18 weekly sessions and eight monthly maintenance sessions, as well as homework assignments for patients.

Dealing with stress is important because research has found that high levels of stress can lead to not just depression, lower quality of life and negative health behaviors, but also lower immunity and faster disease progression. "We need to help cancer patients deal with their stress, because it has effects on their physical as well as their mental health," Andersen said.

In several studies published between 2004 and 2010, Andersen and her colleagues tested the Cancer to Health program and found it effective with breast cancer patients at the Arthur G. James Cancer Hospital at Ohio State. Results showed that patients who went through the program felt better and also had significantly improved immune responses and a lower risk of breast cancer recurrence.

This new study aimed to see if some of the results could be duplicated around the country. It involved therapists who work with cancer patients at 15 sites, from California to Maine. Most were associated with local hospitals or cancer support communities. All of the therapists came to Ohio State to learn how to implement the Cancer to Health program.

They then took the program to their sites, where it was tested with 158 patients with a variety of different types of cancer. Participating therapists were allowed to modify the program for local needs and shorten it if necessary.

Results showed that 60 to 70 per cent of patients received the core components of the main program. It also showed that patients showed significant improvement on a measure of mood after completing the program.

In addition, patients became more physically active, with the average participant going from "moderately active" before the treatment to "active" afterwards.
"That's significant because 71 per cent of the patients were still receiving cancer treatment when they began our study, and maintaining, resuming or beginning physical activity during this period is difficult," said Andersen.

Moreover, most patients thought the program was helpful and reported that their therapists were very supportive. When asked to rate the program on a scale of 0 to 4, the average overall score was 3.48.

The study appeared in the Journal of American Psychologist.