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.