"Mind Matters--Group Therapy and Survival in Breast Cancer" by David Spiegel Editorial in the New England J. Med., December 13, 2001; Vol 345, No. 24, P. 1767

"Now, with the addition of the study by Goodwin et al., five published trials have not found any survival benefit from various forms of psychotherapy. Three of these studies reported only transient [11] or no [12,13] psychological benefit of any kind. Only one of the other negative studies [14] showed a positive effect on the psyche but none on the body... .In the study by Goodwin et al., the... .greatest benefit was among those who were the most anxious and depressed initially, which is not surprising. This finding suggests... .identifying the populations that are most likely to need and respond to emotional support."

"[I]n group therapy a direct confrontation with the possibility of dying from metastatic breast cancer is emotionally helpful and not physically harmful. It is now well documented that the secrecy that surrounded cancer in the medical practice of yesteryear undermined rather than enhanced the patient's well-being. Facing the realities of metastatic breast cancer does not cause physical deterioration or hasten death. Indeed, the study by Goodwin et al. confirms that bearing and sharing all the emotions associated with advancing cancer in a supportive setting reduces distress and pain. The literature is divided on the question of a survival benefit, and more trials are being conducted, both in the United States [15] and overseas.[16] In the meantime, group therapy for patients with cancer can be prescribed for its psychological benefit, if not necessarily for any prolongation of survival. Curing cancer may not be a question of mind over matter, but mind does matter. "
David Spiegel, M.D.

11. Edelman S, Lemon J, Bell DR, Kidman AD. Effects of group CBT on the survival time of patients with metastatic breast cancer. Psychooncology 1999;8:474-481.[Medline]
12. Ilnyckyj A, Farber J, Cheang MC, Weinerman BH. A randomized controlled trial of psychotherapeutic intervention in cancer patients. Ann R Coll Physicians Surg Can 1994;27:93-6.
13. Cunningham AJ, Edmonds CVI, Jenkins GP, Pollack H, Lockwood GA, Warr D. A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology 1998;7:508-517.[Medline]
14. Linn MW, Linn BS, Harris R. Effects of counseling for late stage cancer patients. Cancer 1982;49:1048-1055.[Medline]
15. Classen C, Butler LD, Koopman C, et al. Supportive-expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial. Arch Gen Psychiatry 2001;58:494-501.[Medline]
16. Kissane DW, Bloch S, Clarke DM, Smith GC. Australian RCT of group therapy for breast cancer. Presented at the American Psychiatric Association Annual Meeting, New Orleans, 2001.