psychosocial support in treating women with recurrent breast cancer or stage i, stage ii, or stage iv breast cancer

Conditions: Breast Cancer; Psychosocial Effects of Cancer and Its Treatment

Summary: rationale: meeting together with other breast cancer patients to receive psychosocial support and to learn to reduce stress may help patients cope with their diagnosis, have a better quality of life, and live more comfortably. purpose: this randomized clinical trial is studying how well psychosocial support works in treating women with recurrent breast cancer or stage i, stage ii, or stage iv breast cancer.

objectives: * evaluate theoretically derived psychosocial interventions (peer discussion support vs education and stress management vs usual-care control) targeted to enhance adjustment and functional status and lower morbidity among women diagnosed with and treated for recurrent or stage i, ii, or iv breast cancer. * evaluate the psychological, behavioral, and biological pathways and their effects in patients treated with these interventions. * evaluate the efficacy of these intervention in these patients. * evaluate the nature and extent of coping strategies in these patients. * evaluate the differences in patients treated with these intervention vs those patients electing not to be treated with these interventions. outline: this is a randomized study. patients are stratified according to disease stage (early vs late). patients with early-stage disease are randomized to 1 of 3 intervention arms. patients with late-stage disease are randomized to 1 of 2 intervention arms (ii or iii). * arm i (education and stress management): patients undergo a 1-hour group (6-10 patients per group) education session once a week for 8 weeks focusing on exchange of factual information between a facilitator and patients. the session includes a 45-minute lecture, discussing risks, diagnosis, and treatment of cancer; side effects from treatment; nutrition during treatment; and follow-up care, followed by a question/answer period and instruction in progressive relaxation techniques. patients then receive 3 monthly phone calls from a project staff member to answer questions about cancer, treatment, and follow-up care and to discuss the relaxation exercises. * arm ii (peer discussion): patients undergo a 1-hour group (6-10 patients per group) peer support session once a week for 8 weeks focusing on the provision of emotional support among patients and the maintenance of purpose in life. the session emphasizes on the sharing of experiences, the development of a common bond, and the promotion of altruism to similar others. patients then are given an opportunity to attend 3 monthly additional meetings to share critical experiences and problems they have experienced in the past month. * arm iii (control): patients receive usual care and are not asked to attend any meetings. all patients undergo a 2-hour baseline interview, a 1.5-hour post intervention interview, and a 1.5-hour final interview 8 months after randomization. projected accrual: a total of 350 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * diagnosed with breast cancer * first-time diagnosis of stage i or ii disease * no more than 2 months since prior breast cancer surgery * initial diagnosis of stage iv disease * distant recurrence of prior breast cancer * hormone receptor status not specified patient characteristics: * female * menopausal status not specified * reside within a 60-mile radius of the greater pittsburgh metropolitan area prior concurrent therapy: * see disease characteristics

Keywords: psychosocial effects of cancer and its treatment recurrent breast cancer stage i breast cancer stage ii breast cancer stage iv breast cancer