Do Community Cancer Groups Enhance Well-being?

Institution: Stanford University
Investigator(s): Matthew Cordova, Ph.D. -
Award Cycle: 1999 (Cycle V) Grant #: 5FB-0036 Award: $74,968
Award Type: Postdoctoral Fellowship
Research Priorities
Community Impact of Breast Cancer>Sociocultural, Behavioral, and Psychological Issues: the human side

Initial Award Abstract (1999)
This study is designed to evaluate whether breast cancer patients who have had past traumatic experiences have more difficulty adjusting to breast cancer than women who have not had such experiences, and whether cancer support groups improve their quality of life by allowing them to discuss their thoughts and feelings with others who are supportive. It is embedded within a larger BCRP-funded study designed to assess the strengths and weaknesses of two different community-based support group interventions for breast cancer patients which will be compared to a model developed in the university setting to study which aspects are most effective and who benefits the most. This proposal will benefit from the collaborative relationship between Stanford, The Wellness Community, and Cancer Support Community, two major cancer support programs providing group interventions for women with breast cancer in Northern California.

Because women with breast cancer who have a history of trauma are thought to have greater social, emotional, and physical stress, it is important for us to learn how community cancer support groups can improve quality of life for these women and to identify which groups work best. There is growing evidence that group programs may both improve the quality and extend the quantity of life for breast cancer patients. This study will enable us to refine and improve group interventions, and better match specific ones to those who will most benefit.

Ninety-six women with recently diagnosed breast cancer at the Cancer Support Community in San Francisco and The Wellness Community-East Bay in Walnut Creek will be asked to participate in the study. They will be randomly assigned at each site to the community group program or the Supportive-Expressive group therapy and asked to fill out questionnaires about their trauma history, emotional distress, social and family support, background, and evaluation of their group experience every four months for a year. They will also be asked to write about their thoughts and feelings about breast cancer and to provide saliva samples to measure their physiological response to stress. This information will be used to determine how well these groups work and for whom they work best.

There is a growing body of evidence that participating in support groups improves the quality of life of breast cancer patients. The existence of community support programs provides a means of offering such effective support rapidly and inexpensively, making it available to diverse populations of breast cancer patients. The combination of this community-based effort and university research program provides the potential for improving all of these programs and evidence to support health policy changes. This could lead to improved programs of group support throughout the state of California, offering comfort, guidance, and support to all women coping with breast cancer.

Final Report (2001)
This study is investigating the impact of prior traumatic experiences on adjustment to breast cancer and evaluating the strengths and weaknesses of two community-based support group interventions for women with breast cancer. Two major cancer support programs providing group interventions in the San Francisco area, The Wellness Community and the Cancer Support Community, are being compared to a model of support developed in the university setting (Stanford's supportive-expressive group therapy). Specifically, we are hoping to learn how past traumas and current social support influence how women think and feel about breast cancer, whether support groups are helpful to these women, and if so, what parts of support groups are most helpful.

We are in the final phase of recruiting and assessing participants and are preparing to run our last support group. Over 85% of the expected sample of 84 has been recruited to date. At each site, participants have been randomized to the Stanford group and to the community group at that site. Approximately one quarter of the total sample has completed a 12-month follow-up following the 16-week group intervention. We have presented findings from our preliminary work at 3 national conferences and are writing articles for dissemination in professional journals. Findings to date demonstrate that: 1) Women who perceive greater life-threat in their cancer experience and who possess greater resources to deal with this threat may be more likely to experience a sense of personal growth; 2) Cancer patients who write about their cancer experience using a combination of more cognitive and fewer emotion words report greater emotional distress; and 3) Cancer patients who have higher confidence in managing their feelings about cancer are more likely to use a fighting spirit to decrease their emotional distress.

We are recruiting participants for our final support group and are continuing follow-up assessments of women who have completed the 16-week intervention. This study is responsive to BCRP's priority issue of Sociocultural, Behavioral, and Psychosocial Issues Relevant to Breast Cancer. By identifying those breast cancer patients at highest risk for distress and carefully evaluating the effectiveness of three support group interventions for women with primary breast cancer, this study seeks to improve support services available to women with breast cancer throughout the state of California.

Social Constraints, Cognitive Processing, and Adjustment to Breast Cancer
Periodical:Journal of Consulting and Clinical Psychology
Index Medicus: J Consult Clin Psychol
Authors: Cordova MJ, Cunningham LL, Carlson CR, Andrykowski MA
Yr: 2001 Vol: 69 Nbr: 4 Abs: Pg:706-11

Social Constraints, Cognitive Processing, and Adjustment to Breast Cancer
Periodical:Journal of Consulting and Clinical Psychology
Index Medicus: J Consult Clin Psychol
Authors: Cordova MJ, Cunningham LL, Carlson CR, Andrykowski MA
Yr: 2001 Vol: 69 Nbr: 4 Abs: Pg:706-11

Posttraumatic Growth Following Breast Cancer: A Controlled Comparison Study
Periodical:Health Psychology
Index Medicus: Health Psychol
Authors: Cordova, Mathew J.; Cunningham, Lauren LC; Carlson, Charles R; Andrykowski, Michael A;
Yr: 2001 Vol: 20 Nbr: 3 Abs: Pg:176-185

Supportive-expressive group therapy and life extension of breast cancer patients
Periodical:Advances in mind-body medicine
Index Medicus: Adv Mind Body Med
Authors: Cordova M, Spiegel D
Yr: 2001 Vol: 17 Nbr: 1 Abs: Pg:38-41

Self-report and linguistic indicators of emotional expression in narratives as predictors of adjustment to cancer.
Periodical:Journal of Behavioral Medicine
Index Medicus: J Behav Med
Authors: Owen JE, Giese-Davis J, Cordova M, Kronenwetter C, Golant M, Spiegel D.
Yr: 2006 Vol: 29 Nbr: 4 Abs: Pg:335-45