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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Psychosomatic Medicine, Vol 54, Issue 4 489-517, Copyright © 1992 by American Psychosomatic Society

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 cancer patients are reviewed. Only studies that compared one or more experimental conditions with at least one control group have been considered. The studies were evaluated with respect to a) research methods, b) psychological interventions, and c) results. Tailored counseling has been shown 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. Behavioral interventions and hypnosis were effective with respect to specific symptoms such 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 psychological intervention can reduce emotional distress, improve health behaviors and dose-intensity, and enhance immune responses.

PATIENTS AND METHODS: We studied 227 women who were surgically treated for regional breast cancer. Before adjuvant therapy, women completed interviews and questionnaires assessing emotional distress, social adjustment, and health behaviors. A 60-mL blood sample was drawn for immune assays. Patients were randomly assigned to either the intervention group or assessment only group. The intervention was conducted in 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 treatment and care. Reassessment occurred after completion of the intervention.

RESULTS: As predicted, patients receiving the intervention showed significant lowering of anxiety, improvements in perceived social support, improved dietary habits, and reduction in smoking (all P < .05). Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability (ie, more dispersion in the dose-intensity values) for the assessment arm (P < .05). Immune responses for the intervention patients paralleled their psychological and behavioral improvements. T-cell proliferation in response to 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 psychological intervention for cancer patients.

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