Breast Cancer Clinical Trial
Official title:
Psychobiological Pathways: Breast Cancer Interventions
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.
;
Allocation: Randomized, Primary Purpose: Supportive Care
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