Effects of a psychosocial intervention on survival among patients with stage I breast and prostate cancer: A matched case-control study

Context Psychosocial factors have been linked to the development and progre ssion of cancer and shown to be relevant in cancer care However, the eviden ce that psychosocial interventions affect cancer survival is less conclusiv e Fete methodologically, sound studies have addressed this issue Objective To investigate the effects of a 6-week psychosocial intervention oil survival among patients with stage 1 breast and prostate cancer Design Matched case-control. Setting 3 rural hospitals or cancer centers in central Pennsylvania. Patients 21 breast and 29 prostate stage I cancer patients (treatment group ) matched with 74 breast and 65 prostate stage I cancer patients from the s ame hospitals who did not receive the intervention (control group). Intervention Six 2-hour health psychology classes conducted by a licensed s taff psychologist. Main Outcome Measures Survival time was compared between the 2 groups and w ith national norms. Results The intervention group lived significantly longer than did matched controls. At 4- to 7-year follow-up (median = 4.2 years), none of the breas t cancer patients in the intervention group died whereas 12% of those in th e control group died. Twice as many matched-control prostate cancer patient s died compared with those in the intervention group (28% vs 14%). Control group survival was similar to national norms. Conclusions These results are consistent with prior clinical trials and sug gest that short-term psychosocial interventions that encourage the expressi on of emotions, provide social support, and teach coping skills can influen ce survival among cancer patients. However, self-selection bins cannot be r uled out as an alternative explanation for the results. These interventions merit further consideration and research.