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Effects of cognitive behavioral therapy on quality of life and stress for breast cancer survivors: a meta-analysis
Abstract
INTRODUCTION: Cognitive behavioral therapy (CBT) has been shown to be effective in mitigating various psychosocial impacts from breast cancer. Long-term studies have yielded mixed findings on the outcome of CBT in breast cancer settings, especially with respect to quality of life (QOL) and the quantified degree of stress (QDS). EVIDENCE ACQUISITION: Medline, Cochrane, Embase, and Google Scholar databases were searched and randomized controlled trials relevant to the use of CBT and its variants in breast cancer patients were selected, and their pooled results meta-analyzed. EVIDENCE SYNTHESIS: Six studies qualified for inclusion in the meta-analysis. Results from the six pooled studies did not demonstrate that CBT improves QOL (standardized mean difference =-0.016, 95% CI=-0.898 to 0.866, P=0.972) or reduces QDS (standardized mean difference =-0.125, 95% CI=-0.268 to 0.017, P=0.084) for breast cancer survivors. However, interpretation of these results requires caution, given the small number of eligible studies, comprising a total of only 430 patients. Since the literature also includes trials of CBT combined with various other therapies, including hypnosis, exercise treatment, and stress management, with promising results in breast cancer settings, expanded clinical research is likely to demonstrate an overall benefit of CBT. CONCLUSIONS: Despite the meta-analysis fails to support the use of CBT to improve QOL or reduce stress for breast cancer survivors, CBT appears to be promising as a therapeutic intervention against many of the psychosocial impacts of breast cancer.
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“Therapies such as cognitive behavioral therapy (CBT) that have proven to be effective in non-cancer contexts often show little or no effects in cancer patients [76–79].”
Citations
Cited by
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Use of Mental Health Apps by Patients With Breast Cancer in the United States: Pilot Pre-Post Study
Chow, P. I., Showalter, S. L., Gerber, M. S., Kennedy, E. M., Brenin, D. R., Mohr, D. C., Lattie, E. G., Gupta, A., Ocker, G., & Cohn, W. F. (2020) · JMIR Cancer · doi:10.2196/16476 · Cited by 33
“Although therapies that emphasize skills acquisition, such as cognitive behavioral therapy and acceptance-based therapy, have demonstrated efficacy in reducing distress in patients with breast cancer [9-12], almost half of the patients with breast cancer report unmet supportive care needs [13-16].”
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“This aligns with findings showing nonsignificant between-person effects of CBT and MBSR on quality of life for breast cancer survivors (Zhang et al., 2016, 2019) but contrasts with other studies showing small between-person effects on quality of life with CBT for heart failure ( d = 0.31)…”
InfluentialChow, P. I., Drago, F., Kennedy, E. M., & Cohn, W. F. (2019) · JMIR Cancer · doi:10.2196/15750 · Cited by 31
“Interventions that emphasize skills acquisition, such as cognitive behavioral therapy and acceptance-based therapies (eg, mindfulness), have been shown to effectively reduce symptoms of depression in cancer survivors [17-20].”
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“These psychosocial impacts have been demonstrated to mitigated by cognitive behavioral therapy [5].”
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“This includes improvement of negative psychosocial impacts of breast cancer [30-32], reduction of stress and stress-related symptoms [31,33,34], anxiety [31], depression [10,31,35], fatigue [31,35-37], insomnia [37-39], and pain [34], as well as improvement in quality of life [9,37,40,41].”
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“20 21–24 Compassion-focused therapy (CFT) is a new approach in psychotherapy that uses attachment theory, evolution, and neurocognitive evidence to help patients understand their experiences and have compassion for themselves instead of avoiding or repressing unpleasant feelings.”
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“Meanwhile, it helps patients learn to actively cope with the disease, reduce avoidance behaviors, and thereby enhance their ability to cope with FCR and improve psychological resilience (35).”
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Metadata
- Authors
- Zhang, M., Huang, L., Feng, Z., Shao, L., & Chen, L.
- Affiliations
- First Affiliated Hospital Zhejiang University (CN)
- Venue
- Minerva Medica
- Publisher
- Edizioni Minerva Medica
- Published
- 2017-02
- Volume
- 108
- Issue
- 1
- Pages
- 84-93
- ISSN
- 0026-4806 (ISSN-L)
- 1827-1669
- OpenAlex
- W2529317167
- Cited by
- 30
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 3 · 2017: 2
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Minerva Medica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- cognitive behavioral therapy, breast cancer survivors, quality of life, psychological stress, psychosocial impact of cancer, psycho-oncology, stress management, hypnosis, exercise therapy
- MeSH terms
- Aged, Breast Neoplasms, Combined Modality Therapy, Female, Humans, Middle Aged, Quality Assurance, Health Care, Quality of Life, Stress, Psychological, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Survivors
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