psychological treatment on cancer patients

CANCER RELATED PSYCHOLOGICAL TREATMENT

Relaxation techniques ease side effects for cancer patients in treatment
Teaching cancer patients how to relax while they undergo a variety of
hard-to-tolerate cancer treatments helps them cope with symptoms such
as nausea and pain, according to a new analysis of 15 studies.
Relaxation techniques investigated included techniques such as
progressive muscle relaxation, hypnosis and mental imagery.

Relaxation techniques can also reduce tension, depression and
anxiety, yet few cancer treatment programs use these techniques on a
regular basis.

Relaxation techniques learned prior to undergoing cancer treatment
proved more effective at reducing anxiety than techniques taught
while the patient was undergoing aggressive treatment to eradicate or
slow the cancer, says lead study author Karin Luebbert of the
University Hospital Hamburg.

Teaching relaxation techniques involves very little of a
professional's time -- usually less than two hours -- making the
intervention inexpensive, according to the study published in the
February issue of Psycho-Oncology.

Relaxation techniques may help patients achieve a physical
restfulness that reduces their anxiety and reactivity to unpleasant
stimuli. The muscular relaxation that results from these techniques
may also ease the physiological cascade that leads to nausea and
vomiting, the authors say.

Besides some of the documented emotional benefits of relaxation
training, these techniques may also help patients feel more in
control of their treatment, especially if they are encouraged to
practice on their own, they say. Cancer patients can often feel
helpless and hopeless "Relaxation affords an active coping strategy
for them."

Twelve types of side effects commonly associated with cancer
treatment were addressed in the review. These included four
treatment-related symptoms, namely nausea, pain, blood pressure, and
pulse rate; and eight emotional adjustment issues: anxiety,
depression hostility, tension, fatigue, confusion, vigor and overall
mood. Investigators also evaluated a broad variety of interventions,
including type of relaxation training, the time professionals spent
teaching the technique and how often relaxation was done.

Relaxation therapy eased symptoms of anxiety more than it did any
other side effect, regardless of the type of cancer treatment given
the patient.

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Effects of psychological treatment on cancer patients: a critical review

RW Trijsburg, FC van Knippenberg and SE Rijpma
Department of Medical Psychology and Psychotherapy, Erasmus University, Rotterdam, The Netherlands.

Twenty-two studies on the effects of psychological treatment on cancerpatients are reviewed. Only studies that compared one or more experimentalconditions with at least one control group have been considered. Thestudies were evaluated with respect to a) research methods, b)psychological interventions, and c) results. Tailored counseling has beenshown to be effective with respect to distress, self-concept, (health)locus of control, fatigue, and sexual problems. Structured counseling showed positive effects with respect to depression and distress. Behavioralinterventions and hypnosis were effective with respect to specific symptomssuch as anxiety, pain, nausea, and vomiting.

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Journal of Clinical Oncology, Vol 22, No 17 (September 1), 2004: pp. 3570-3580
© 2004 American Society of Clinical Oncology
DOI: 10.1200/JCO.2004.06.030

Psychological, Behavioral, and Immune Changes After a Psychological Intervention: A Clinical Trial

Barbara L. Andersen, William B. Farrar, Deanna M. Golden-Kreutz, Ronald Glaser, Charles F. Emery, Timothy R. Crespin, Charles L. Shapiro, William E. Carson, III

From the Department of Psychology, Department of Surgery, Department of Molecular Virology, Immunology, and Medical Genetics, and Division of Medical Oncology, Department of Internal Medicine, College of Medicine, and Comprehensive Cancer Center, The Ohio State University; and Primetrics, Inc, Columbus, OH

PURPOSE: This randomized clinical trial tests the hypothesis that a psychologicalintervention can reduce emotional distress, improve health behaviorsand dose-intensity, and enhance immune responses.

PATIENTS AND METHODS: We studied 227 women who were surgically treated for regionalbreast cancer. Before adjuvant therapy, women completed interviewsand questionnaires assessing emotional distress, social adjustment,and health behaviors. A 60-mL blood sample was drawn for immuneassays. Patients were randomly assigned to either the interventiongroup or assessment only group. The intervention was conductedin small patient groups, with one session per week for 4 months.The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatmentand care. Reassessment occurred after completion of the intervention.

RESULTS: As predicted, patients receiving the intervention showed significantlowering of anxiety, improvements in perceived social support,improved dietary habits, and reduction in smoking (all P <.05). Analyses of adjuvant chemotherapy dose-intensity revealedsignificantly more variability (ie, more dispersion in the dose-intensityvalues) for the assessment arm (P < .05). Immune responsesfor the intervention patients paralleled their psychologicaland behavioral improvements. T-cell proliferation in responseto phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients, whereas both responses declined for Assessment patients; this effect was replicated across three concentrations for each assay (all P < .01).

CONCLUSION: These data show a convergence of significant psychological,health behavior, and biologic effects after a psychologicalintervention for cancer patients.