Advanced breast cancer: What effect does group therapy have?

Joining a group therapy programme could improve the emotional wellbeing of women with advanced breast cancer. But the benefit lasts for only a few months.

Breast cancer can usually be treated successfully. However, for some women, the cancer spreads despite treatment or it is discovered later after it has already spread. This is called advanced or metastatic breast cancer. Advanced breast cancer involves a lot of pain, demanding treatments and a reduced chance of survival. Each of these pose large psychological challenges.

There are different ways for women to get psychological and social support: one-to-one individual counselling, psychological therapy or education, and group therapy offered by doctors or psychologists and other mental health professionals. It is estimated that less than 1 in 10 women with breast cancer (10%) participate in group therapy. Women with breast cancer also form self-help groups for mutual support.

Researchers from the Cochrane Collaboration wanted to do a systematic review to find out how women with advanced breast cancer fare after any of these psychological and social treatment options. Their search for evidence ended with five trials found. In these trials, a variety of forms of professional group therapy was found, in which about 600 women from Australia, Canada and the USA took part. All were professionally-led groups, not self-help programmes.

The goal of these programmes was to make women's experience with the condition easier, and to offer social support. One of the programmes continued for only a few months, while the others lasted about a year each. Three of the groups also offered additional social support. Two of the programmes included cognitive behaviour therapy. The principle there is to find out which beliefs, thoughts and actions individual people have that might be making it harder for them to cope with their situation. After that, the participants work to change these attitudes, patterns of thoughts and behaviours. Cognitive behaviour therapy has been shown to help with other health problems.

The conclusion of the researchers was that women with advanced breast cancer who participate in group therapy can have improved emotional wellbeing and self-esteem, even though the difference is not very big. Within months of the therapy being over, though, the impact was generally gone. The trials also found that the women who participated in group therapy experienced less pain. The researchers found no evidence that group therapy participants lived longer than women who did not participate in the programmes.

It is possible that some women benefit more from group therapy than others, and others might be more likely to experience negative emotional impact from them. More research is needed to show if group therapy has any impact on the woman's relationship with her partner, family and doctor.

© IQWiG (Institute for Quality and Efficiency in Health Care)