List of Titles

Supportive-expressive group therapy for women with metastatic breast cancer : Survival and psychosocial outcome from a randomized controlled trial

- Kissane, David, Grabsch, Brenda, Clarke, David, Smith, Graeme, Love, Anthony, Bloch, Sidney, Snyder, Raymond, Li, Yuellin

Authors: Kissane, David , Grabsch, Brenda , Clarke, David , Smith, Graeme , Love, Anthony , Bloch, Sidney , Snyder, Raymond , Li, Yuellin
Date: 2007
Type: Text , Journal article
Relation: Psycho-Oncology Vol. 16, no. 4 (2007), p. 277-286
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Reviewed:
Description: Background: Mixed reports exist about the impact of supportive-expressive group therapy (SEGT) on survival. Methods: From 485 women with advanced breast cancer recruited between 1996-2002, 227 (47%) consented and were randomized within an average 10 months of cancer recurrence in a 2:1 ratio to intervention with 1 year or more of weekly SEGT plus three classes of relaxation therapy (147 women) or to control receiving three classes of relaxation therapy (80 women). The primary outcome was survival; psychosocial well-being was appraised secondarily. Analysis was by intention-to-treat. Results: SEGT did not prolong survival (median survival 24.0 months in SEGT and 18.3 in controls; univariate hazard ratio for death 0.92 [95% CI, 0.69-1.26]; multivariate hazard ratio, 1.06 [95% CI, 0.74-1.51]). Significant predictors of survival were treatment with chemotherapy and hormone therapy (p<0.001), visceral metastases (p<0.001) and advanced disease at first diagnosis (p<0.05). SEGT ameliorated and prevented new DSM-IV depressive disorders (p = 0.002), reduced hopeless-helplessness (p = 0.004), trauma symptoms (p = 0.04) and improved social functioning (p = 0.03). Conclusions: SEGT did not prolong survival. It improved quality of life, including treatment of and protection against depression. Copyright © 2007 John Wiley & Sons, Ltd.
Description: C1
Description: 2003007261

Psychological morbidity and quality of life in women with advanced breast cancer : A cross-sectional survey

- Grabsch, Brenda, Clarke, David, Love, Anthony, McKenzie, Dean, Snyder, Raymond, Bloch, Sidney, Smith, Graeme, Kissane, David

Authors: Grabsch, Brenda , Clarke, David , Love, Anthony , McKenzie, Dean , Snyder, Raymond , Bloch, Sidney , Smith, Graeme , Kissane, David
Date: 2006
Type: Text , Journal article
Relation: Palliative & Supportive Care Vol. 4, no. 1 (2006), p. 47-56
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Description: Objective: Our purpose was to determine the frequency of psychiatric morbidity and to assess the quality of life of women with advanced breast cancer. Methods: The 227 women in the sample were recruited in Melbourne, Australia, and were interviewed (prior to intervention) for a randomized controlled trial of supportive-expressive group therapy. The main outcome measures were DSM-IV psychiatric diagnoses plus quality of life data based on the EORTC QLQ-C30 (core) and QLQ-BR23 (breast module) instruments. Results: Forty-two percent of the women (97/227) had a psychiatric disorder; 35.7% (81) of these had depression or anxiety or both. Specific diagnoses were minor depression in 58 women (25.6%), major depression in 16 (7%), anxiety disorder in 14 (6.2%), and phobic disorder in 9 (4%). Seventeen (7.5%) women had more than one disorder. In terms of quality of life, one-third felt less attractive, one-quarter were dissatisfied with their body image, and, in most, sexual interest had waned. Menopausal symptoms such as hot flashes affected less than one-third, whereas symptoms of lymphedema were experienced by 26 (11.5%). Significance: Women with advanced breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians need to be vigilant in monitoring psychological adjustment as part of a comprehensive biopsychosocial approach.
Description: 2003007264

Effect of cognitive-existential group therapy on survival in early-stage breast cancer

- Kissane, David, Love, Anthony, Hatton, Allison, Bloch, Sidney, Smith, Graeme, Clarke, David, Miach, Patricia, Ikin, Jillian, Ranieri, Nadia, Snyder, Raymond

Authors: Kissane, David , Love, Anthony , Hatton, Allison , Bloch, Sidney , Smith, Graeme , Clarke, David , Miach, Patricia , Ikin, Jillian , Ranieri, Nadia , Snyder, Raymond
Date: 2004
Type: Text , Journal article
Relation: Journal of Clinical Oncology Vol. 22, no. 21 (2004), p. 4255-4260
Full Text: false
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Description: PURPOSE: Cognitive-existential group therapy (CEGT) was developed to improve mood and mental attitude toward cancer in women with early-stage breast cancer receiving adjuvant chemotherapy. Given the debate about group therapy's association with increased survival in women with metastatic breast cancer, we were curious to check its effect at a much earlier stage in the cancer journey. PATIENTS AND METHODS: We randomly assigned 303 women with early-stage breast cancer who were receiving adjuvant chemotherapy to either 20 sessions of weekly group therapy plus three relaxation classes (n = 154) or to a control condition of three relaxation classes alone (n = 149). The primary outcome was survival. RESULTS: CEGT did not extend survival; the median survival time was 81.9 months (95% CI, 64.8 to 99.0 months) in the group-therapy women and 85.5 months (95% CI, 67.5 to 103.6 months) in the control arm. The hazard ratio for death was 1.35 (95% CI, 0.76 to 2.39; P = .31). In contrast, histology and axillary lymph node status were significant predictors of survival. Low-grade histology yielded a hazard ratio of 0.342 (95% CI, 0.17 to 0.69), and axillary lymph node-negative status yielded a hazard ratio of 0.397 (95% CI, 0.20 to 0.78). CONCLUSION: CEGT does not prolong survival in women with early-stage breast cancer.
Description: 2003007270

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