Women who carry BRCA1 and 2 gene mutations have up to a 90 percent lifetime risk of breast or ovarian cancers. As a result, they must address difficult issues that can lead to depression and anxiety, including the perception of personal vulnerability to cancer, and communicating the inheritable vulnerability and its risks to their family. Moreover, they must assimilate much information swiftly to make significant life-altering decisions, such as whether or not to have surgery or chemotherapy in hopes of preventing the disease. Previous needs assessments have demonstrated that women affected by the genetic mutations are seeking support networks and therapy when no validated model currently exists.
In the first prospective study to evaluate the effects of a psychosocial intervention for women carrying BRCA1 or 2 mutations, Mary Jane Esplen, Ph.D. of the University Health Network and the University of Toronto and her colleagues followed 70 women who participated in 12 group sessions of "supportive-expressive group therapy."
The researchers say 67 women completed all 12 sessions. Those who participated in psychosocial-focused group therapy showed improvements in several psychosocial factors, including general anxiety, cancer anxiety, and depression. They add the group therapy appears to have helped women decide whether or not to pursue surgery by giving them an opportunity to fully examine their feelings and perspectives about treatment choices.
"Our group intervention was associated with improvements in the psychosocial variables of intrusion and depression," conclude the authors. "The groups," they explain, "appeared to be an ideal forum for exploring key issues, such as, the notification of test results to family, guilt around transmission of a mutation, and decision-making around risk-reducing options."
Article: "A Multicenter Study of Supportive-Expressive Group Therapy for Women with BRCA1/BRCA2 Mutations," Mary Jane Esplen, Jon Hunter, Molyn Leszcz, Ellen Warner, Steven Narod, Kelly Metcalfe, Gord Glendon, Kate Butler, Alexander Liede, Mary Anne Young, Stephanie Kieffer, Lisa DiProspero, Ellen Irwin, Jiahui Wong, CANCER; Published Online: October 11, 2004 (DOI: 10.1002/cncr.20661); Print Issue Date: November 15, 2004.
Journal
Cancer