Studies of Group Support and Survival Rates in Patients with Metastatic Breast Cancer
The Spiegel study's goal was to find if group therapy, for inpatients with metastatic breast cancer, had an impact on survival time. 86 patients with metastatic breast cancer were either assigned to group 1 or group 2 and evaluated in a randomized, controlled, 10-year follow up study.(1) Group 1 met weekly for 90 minutes for one year. Group 2, the control group did not meet at all.
Group 1 was led by a psychiatrist and a social worker. The participants in the group were told at no time, that involvement in the support group would affect the course of their disease. Group members shared physical problems, vented their feelings, discussed side effects and learned a self hypnosis regimen for pain management. It must be noted that chemotherapy and radiation treatments between group 1 and group 2 and the severity of the disease did not differ exceptionally.
Group 1 survival time doubled, as compared to group 2, with an average survival time of 37 months. The survival mean for group 2, the control group, was 19 months. The difference in survival started to show 8 months after treatment. Psychological assessments did not greatly foretell survival. It was established that the only variable a influencing survival time was the very involved psychosocial intervention itself.
The above study, conducted at Stanford University, was considered to be very riveting. Social support may have played a major role in participant's survival time. The interaction of neuroendocrine system, immune systems, and the emotional process might have affected the course of the cancer also. The patients in group 1 also were taught about hypnosis for pain control, which could have led to increased maintenance of exercises and routine activities, both very conductive to health.
Next we take a look at studies, trying to replicate Spiegel's favorable outcomes with metastatic breast cancer, unfortunately with much less success. We will try to establish why Spiegel's study was so successful and what treatment it included which other studies did not.
1. Spiegel D., et al. Effect of Psychosocial Treatment on Survival of Patients with Metastatic Breast Cancer. Lancet 2(8668) (1989):888