Assessing the Benefits of Support Groups

A new study published in the New England Journal of Medicine (NEJM) has confirmed that breast cancer survivors can gain significant emotional benefits from participating in support groups. However, contrary to the findings of earlier studies, it did not discern any measurable benefit in actual survival.

Dr. Pamela Goodwin of the University of Toronto and colleagues assigned 235 women with metastatic breast cancer to either participate in weekly "supportive-expressive group therapy" sessions, or to not participate in any support group activities (the control group).

The researchers found that the 158 women who participated in the support group experienced marked improvement in a number of psychological symptoms, including mood and coping, compared to the women in the control group. Furthermore, the women in the emotional support group reported significantly less pain perception than the other women.

However, while the emotional benefits from supportive-expressive therapy were dramatic, Goodwin's team did not find any statistical difference in actual survival between the support and control groups.

"It [supportive-expressive group therapy] improves mood and the perception of pain, particularly in women who are initially more distressed," Goodwin's team wrote. "[But] it does not prolong survival in women with metastatic breast cancer."

Nonetheless, their conclusion on survival contradicts the seminal findings of Dr. David Spiegel of the Stanford University School of Medicine, who first concluded in a 1989 study that supportive-expressive group therapy could significantly prolong survival in women with metastatic disease.

In an accompanying editorial in the same issue of the NEJM, Spiegel countered that the question of a survival benefit from supportive group therapy remains open. "In the meantime, group therapy for patients with cancer can be prescribed for its psychological benefit, if not necessarily for any prolongation of survival," he suggested.

SOURCE:
New England Journal of Medicine, December 13, 2001; 345:1719-1726, 1767-1768

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