Online Stress Management May Benefit Newly Diagnosed Cancer Patients

CHICAGO-New technologies are now providing new opportunities for alleviating stress in cancer patients. A prospective study is showing that a Web-based stress management program can relieve distress and markedly improve quality of life in cancer patients. Investigators in Switzerland reported at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 2–6, that an online intervention can effectively deliver psychological support to patients at an early time in the course of their cancer care (abstract LBA10002).

“With this intervention we can deliver much needed psychological support in the comfort of the patients’ living rooms or other favorite Wi-Fi spots. 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 Switzerland.

The researchers used an 8-week Web-based stress management program developed by oncologists and psychologists. The intervention is based upon well-established cognitive behavioral 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, patients 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 psychologists were all based in Basel. However, the patients were located in Germany, Switzerland, and Austria. The patients also had the opportunity to email the psychologists directly.

Known as a “therapist-guided online intervention,” this online approach is fairly new. However, it is already becoming a standard approach for certain psychological disorders such as anxiety, and it appears to be as effective as traditional face-to-face therapy, according to the authors. They note that it is less time consuming for the therapist and more convenient for patients, particularly at a time when they are handling many other medical appointments.

Within 12 weeks of starting cancer treatment, 129 patients were randomized to the intervention or the control group. The majority of participants were women with early-stage breast cancer, but the study also included patients with lung, ovarian, and gastrointestinal cancers, as well as patients with lymphoma and melanoma.

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 2 months after the intervention. They predefined a nine-point difference in the FACIT-F score as a clinically meaningful improvement in quality of life. A score of 0–4 is considered low distress, whereas 5–10 is considered high distress. The control group did not receive psychological support during the first 2 months of enrolling in the study.

At 2 months, patients in the intervention group had a greater improvement in quality of life vs patients in the control group. There were no significant differences in anxiety or depression between the two groups.