SOCIETY FOR INTEGRATIVE ONCOLOGY
1st International Conference
November 17-19, 2004
New York City
A new, worldwide organization of oncology professionals studying and integrating effective complementary therapies in cancer care.
“Evaluating Expressive Writing as a Presurgical Stress Management Intervention for Breast Cancer Patients”
Panelists: Janet Marie Sterner, MPH, Ph.D. and Lorenzo Cohen, Ph.D., Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston, TX; M. David Low, MD, Ph.D. and Lemuel Moye, MD, Ph.D., The University of Texas Health Science Center at Houston School of Public Health, Houston, TX.
Many women facing breast cancer surgery experience anxiety and depression. There is a well-documented link between anticipatory distress and surgical complications which suggests that stress management interventions given before surgery may improve patient adjustment and facilitate recovery. Specifically, participants who write about a traumatic experience versus a neutral topic show improved psychological well-being and physical health.
In this study patients who participated in expressive writing were evaluated for decreased stress, sleep disturbance, pain intensity, and pain interference before and after surgery. The study also assessed whether the intervention reduced reliance on medication and shortened recovery.
Participants assigned to two groups were asked to write for 20 minutes daily for 4 consecutive days. Results showed no association with a change in overall distress, perceived stress, sleep disturbance, or pain.
Moreover, the groups did not differ in use of analgesic medications or recovery time. The study concluded that the data do not support the use of expressive writing as a presurgical stress management intervention for women with breast cancer. However, expressive writing may improve some aspects of sleep in cancer patients; thus supporting the need for further study.
This conference attendee was among others who were not surprised by the findings. In fact I thought I had missed something about the study: was the writing exercise really an isolated intervention, without psychosocial support to help these patients process the experience of their writing? The answer was ‘yes.’ Here’s pen and paper: write — but then what?
The process of writing is an emotional one, often raising the unconscious and evoking thoughts and feelings that we might not express verbally even to our closest loved ones. The prospect of having breast cancer surgery that alters one’s body permanently is an emotional one, often raising the unconscious and evoking thoughts and feelings, etc. Where are the dots connecting A to B, the helping hand that reaches out and leads these women from the emotional experience of writing to the emotional preparation for breast surgery?
Words written on paper before cancer surgery represent something more than words on paper… just what these women were expected to do with their feelings after writing is a question that should have been asked.
The problem with this study amplifies the need for a more holistic approach in medicine and scientific inquiry. When we ask the question, Does this work? we need to know the context of the ‘this’ that we are asking about. Science is slowly learning this as we study isolated ingredients of foods only to learn that some food and plant chemicals promote health in the context of their environment; when taken out of their environment some are not effective, and may even be harmful.
Let’s hope future studies look at the broader picture of human health, emphasizing the ‘human’ factor.
Prepared by Rita Calderon, LCSW
Mind-body psychotherapist and breast cancer survivor
SOCIETY FOR INTEGRATIVE ONCOLOGY
1st International Conference
November 17-19, 2004
New York City
A new, worldwide organization of oncology professionals studying and integrating effective complementary therapies in cancer care.
November 17-19, 2004
New York City
A new, worldwide organization of oncology professionals studying and integrating effective complementary therapies in cancer care.
“Evaluating Expressive Writing as a Presurgical Stress Management Intervention for Breast Cancer Patients”
Panelists: Janet Marie Sterner, MPH, Ph.D. and Lorenzo Cohen, Ph.D., Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston, TX; M. David Low, MD, Ph.D. and Lemuel Moye, MD, Ph.D., The University of Texas Health Science Center at Houston School of Public Health, Houston, TX.
Many women facing breast cancer surgery experience anxiety and depression. There is a well-documented link between anticipatory distress and surgical complications which suggests that stress management interventions given before surgery may improve patient adjustment and facilitate recovery. Specifically, participants who write about a traumatic experience versus a neutral topic show improved psychological well-being and physical health.
In this study patients who participated in expressive writing were evaluated for decreased stress, sleep disturbance, pain intensity, and pain interference before and after surgery. The study also assessed whether the intervention reduced reliance on medication and shortened recovery.
Participants assigned to two groups were asked to write for 20 minutes daily for 4 consecutive days. Results showed no association with a change in overall distress, perceived stress, sleep disturbance, or pain.
Moreover, the groups did not differ in use of analgesic medications or recovery time. The study concluded that the data do not support the use of expressive writing as a presurgical stress management intervention for women with breast cancer. However, expressive writing may improve some aspects of sleep in cancer patients; thus supporting the need for further study.
This conference attendee was among others who were not surprised by the findings. In fact I thought I had missed something about the study: was the writing exercise really an isolated intervention, without psychosocial support to help these patients process the experience of their writing? The answer was ‘yes.’ Here’s pen and paper: write — but then what?
The process of writing is an emotional one, often raising the unconscious and evoking thoughts and feelings that we might not express verbally even to our closest loved ones. The prospect of having breast cancer surgery that alters one’s body permanently is an emotional one, often raising the unconscious and evoking thoughts and feelings, etc. Where are the dots connecting A to B, the helping hand that reaches out and leads these women from the emotional experience of writing to the emotional preparation for breast surgery?
Words written on paper before cancer surgery represent something more than words on paper… just what these women were expected to do with their feelings after writing is a question that should have been asked.
The problem with this study amplifies the need for a more holistic approach in medicine and scientific inquiry. When we ask the question, Does this work? we need to know the context of the ‘this’ that we are asking about. Science is slowly learning this as we study isolated ingredients of foods only to learn that some food and plant chemicals promote health in the context of their environment; when taken out of their environment some are not effective, and may even be harmful.
Let’s hope future studies look at the broader picture of human health, emphasizing the ‘human’ factor.
Prepared by Rita Calderon, LCSW
Mind-body psychotherapist and breast cancer survivor
SOCIETY FOR INTEGRATIVE ONCOLOGY
1st International Conference
November 17-19, 2004
New York City
A new, worldwide organization of oncology professionals studying and integrating effective complementary therapies in cancer care.
