Study Contradicts Belief that Psychotherapy Extends Cancer Patients" Lives

By Michelle Rizzo

NEW YORK MAY 15, 2007 (Reuters Health) - Psychotherapy and support groups do not prolong the survival of cancer patients, according to a report in the May issue of the Psychological Bulletin.

"Many cancer patients find considerable emotional and social benefits to participating in group therapy or support groups," Dr. James C. Coyne said in an interview with Reuters Health. "If they are satisfied with those experiences, they should continue them," he said, "but they should not be there if it is only because they believe that they are prolonging their lives or slowing the progression of their cancer."

Previous research, and two studies in particular (Spiegel et al., 1989 and Fawzy et al., 1993), have been interpreted as providing support for the idea that psychotherapy extends the lives of people with cancer, Dr. Coyne, of the University of Pennsylvania School of Medicine, Philadelphia, and colleagues explain in their report.

To investigate further, the researchers conducted a systematic critical review of the relevant literature to examine the link between psychotherapy and survival in cancer. A total of 11 studies were included in the review.

The authors found "endemic problems" with the literature. A positive effect was not observed in any randomized clinical trial that had survival as the primary end point and in which psychotherapy was not confounded with medical care.

The team found numerous methodological and analytical flaws in the Spiegel et al. and Fawzy et al. trials. Specifically, the studies were not designed to test the hypothesis that psychotherapy extends the lives of cancer patients. In fact, after looking at their data, the authors of those studies redefined the purpose of their studies, according to the investigators.

Dr. Coyne and colleagues conclude that the strength of the available evidence does not justify the resources that would be necessary to conduct an adequately powered study to examine the effects of psychotherapy on survival after a cancer diagnosis.

"For some persons with cancer, psychotherapy and support groups can be a way of improving their quality of life," Dr. Coyne commented. "We need to understand who benefits most from such experiences and how we can improve the effectiveness of individual and group interventions focusing on quality of life, not quantity," he noted. "And we need to understand for whom and under what circumstances therapy and support groups have negative effects."

Dr. Coyne noted that the belief that psychotherapy could prolong their lives restores patients" sense of control. "We need to find ways to give cancer patients more of a sense of control over their experience that is not based on an illusion," he concluded.

SOURCE:

• Psychol Bull 2007.