Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial

Jamie M. Stagl, Laura C. Bouchard, Suzanne C Lechner, Bonnie B. Blomberg, Lisa M. Gudenkauf, Devika R. Jutagir, Stefan Gluck, Robert P. Derhagopian, Charles S Carver, Michael H. Antoni

Research output: Contribution to journalArticlepeer-review

99 Scopus citations

Abstract

BACKGROUND Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.

Original languageEnglish (US)
Pages (from-to)1873-1881
Number of pages9
JournalCancer
Volume121
Issue number11
DOIs
StatePublished - Jun 1 2015

Keywords

  • breast neoplasms
  • cognitive therapy
  • depression
  • follow-up studies
  • psychological stress
  • quality of life
  • relaxation therapy
  • survivors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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