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Can Expressive Writing Influence Outcomes in Breast Cancer Patients?

A study conducted on a Danish population of breast cancer patients investigates the impact of expressive writing for improved physical outcomes.

Emotional expression is essential to physical well-being. While the evidence is mixed, some research indicates that repressive coping and emotional avoidance leads to the development of and a poor outcome for breast cancer. There is a definite need to explore possible interventions that are instrumental in aiding efficient emotional processing to improve physical outcomes for breast cancer survivors as well as patients. This will considerably impact the costs involved in providing treatment as well as for improving the quality of life for many battling a serious condition like breast cancer.

Researchers recently conducted a study on a nationwide sample of Danish women treated for early-stage breast cancer. The study was published in the PLoS ONE journal on February 23, 2018. The research, conducted on breast cancer patients, compared whether women assigned to the expressive writing intervention had improvement in self-reported symptoms and less utilization of health care compared to control group patients writing about a neutral topic.

The sample size included 507 women, who had been treated surgically (lumpectomy or mastectomy) over a period of six months within three weeks of being diagnosed with invasive breast cancer at stage I and II. Following the administration of a questionnaire at the beginning of the study, they were divided into two groups randomly –  the expressive writing group with 253 participants and a control group with 254 participants.

Participants were contacted at home by telephone by research assistants to write for 20 minutes once a week over a period of three weeks. The participants in the expressive writing group were asked to write about distressing or traumatic events and were told to explore their emotions and feelings about the events. They were free to write about their breast cancer experience or other distressing topics and also free to switch topics during the course of the intervention. The control group participants were to objectively write in detail about daily activities in an emotionally neutral manner. The study also took into consideration a number of moderating factors such as rumination, social constraints, repressive coping, and choice of writing topic.

The results showed no differences between the control and expressive writing groups in terms of disease treatment, demographic, moderator, or outcome variables. The results from this large randomized trial indicate that expressive writing does not have discernible effects in improving health outcomes for cancer patients and survivors and this is in line with previous research findings. There was some indication that expressive writing may be useful for patients who are highly in tuned with their emotions and who write specifically about their cancer. This association will have to be further examined in order to draw conclusions.

Written by Sonia Leslie Fernandez, Medical News Writer

Reference: Jensen-Johansen, M. B., O’Toole, M. S., Christensen, S., Valdimarsdottir, H., Zakowski, S., Bovbjerg, D. H., … & Zachariae, R. (2018). Expressive writing intervention and self-reported physical health out-comes–Results from a nationwide randomized controlled trial with breast cancer patients. PloS one13(2), e0192729.



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