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Web-based stress management for newly diagnosed cancer patients increased QoL

Chicago, June 2, 2017 – The results of a prospective, wait-list controlled intervention study for STREAM (abstract LBA10002)1, a web-based stress management for newly diagnosed cancer patients, showed that this program can relieve distress and markedly improve quality of life (QoL).

About the study

In the trial, 128 newly diagnosed cancer patients were randomized within 12 weeks of starting anti-cancer treatment to an immediate or delayed (control group) 8-week, web-based intervention. The intervention consisted of 8 modules with weekly written feedback by a psychologist based on well-established stress management manuals.
Median age was 52 years, 84 % were female. 91 % of patients were treated in the curative setting. In both groups, the researchers used validated scales to measure quality of life (FACIT-F), distress (DT), and anxiety/depression (HADS) at study entry and two months after the intervention. They predefined a nine-point difference in the FACIT-F score as a clinically meaningful improvement in quality of life. The control group did not receive psychological support during the first two months of enrolling in the study.
At two months, patients in the intervention group had a greater improvement in quality of life than patients in the control group – the mean FACIT-F score increased by a mean of 8.59 points more in the intervention group than in the control group. The distress score decreased from 6 to 4 points in the intervention group but stayed the same (6 points) in the control group. There were no significant differences in anxiety or depression between the two groups.


The STREAM intervention is an eight-week, web-based stress management program that can relieve distress and markedly improve quality of life for patients.
The program was developed by oncologists and psychologists. The intervention is based upon well-established cognitive behavior approaches used in face-to-face psychotherapy. It covers eight different topics, such as bodily reaction to stress, cognitive stress reduction, feelings, and social interactions. For each weekly topic, participants received written and audio information and then completed exercises and questionnaires.
Psychologists reviewed patients’ progress weekly and provided personalized, written guidance and support through a secure online portal. The patients also had the opportunity to write to the psychologists directly through the online program.
This remote therapy model known as »therapist-guided online intervention” is a new approach, and appears to be as effective as traditional face-to-face therapy, according to the authors. »It seems that patients and psychologists can still form a therapeutic bond through this online contact,” said lead study author Viviane Hess, MD, a medical oncologist at the University Hospital of Basel in Basel, Switzerland.

»When the doctor says cancer, it can bring on a wave of emotions, fear, and uncertainty. Cancer care and treatment must be paired with high-quality psychological support. Online tools are an excellent new way to provide this support to more patients, especially those who otherwise might not have the opportunity to see a therapist,” said Don S. Dizon, MD, FACP, ASCO Expert.

Impact of psychological inverventions

Two further studies were concerned with the impact of psychological interventions on the lives of patients.
In a phase II randomized clinical trial (abstract LBA10000)2, a psychological intervention (Conquer Fear) substantially lowered fear of recurrence immediately after the intervention, and after three and six months. General anxiety, cancer-specific distress, and QoL were better in the intervention group immediately after therapy.
The results of a randomized clinical trial (abstract 10001)3 demonstrated that a brief psychological intervention, called Managing Cancer And Living Meaningfully (CALM), could help patients and families manage the practical and emotional toll of advanced cancer. At three months, 52 % of patients who received CALM had a clinically important reduction in depressive symptoms (vs. 33 % of patients who received usual care). Patients in the intervention group also improved psychological well-being at three and six months and were more prepared for the end of life.

1 Hess V et al., abstract LBA10002: Web-based stress management for newly diagnosed cancer patients (STREAM): A randomized, wait-list controlled intervention study.
2 McNeil Beith J et al., abstract LBA 10000: Long-term results of a phase II randomized controlled trial (RCT) of a psychological intervention (Conquer Fear) to reduce clinical levels of fear of cancer recurrence in breast, colorectal, and melanoma cancer survivors.
3 Rodin G et al., abstract LBA 10001: Managing cancer and living meaningfully (CALM): A randomized controlled trial of a psychological intervention for patients with advanced cancer.



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