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Outcomes From the Moving Beyond Cancer Psychoeducational, Randomized, Controlled Trial With Breast Cancer Patients

From the Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center at University of California, Los Angeles (UCLA); Department of Psychology; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA; Cousins Center for Psychoneuroimmunology, UCLA Neuropsychiatric Institute; UCLA Schools of Medicine and Public Health; Department of Psychology, University of Southern California, Los Angeles; Encino, CA; Department of Psychiatry, Georgetown University Medical Center, Washington, DC; Office of Cancer Survivorship, National Cancer Institute, Bethesda, MD.

Address reprint requests to Annette L. Stanton, PhD, Department of Psychology, 1285 Franz Hall, Box 951563, University of California, Los Angeles, Los Angeles, CA 90095-1563; e-mail: astanton{at}ucla.edu

PURPOSE: Evidence suggests that the re-entry phase (ie, early period after medical treatment completion) presents distinct challenges for cancer patients. To facilitate the transition to recovery, we conducted the Moving Beyond Cancer (MBC) trial, a multisite, randomized, controlled trial of psychoeducational interventions for breast cancer patients.

METHODS: Breast cancer patients were registered within 6 weeks after surgery. After medical treatment, they completed baseline measures and were randomly assigned to standard National Cancer Institute print material (CTL); standard print material and peer-modeling videotape (VID); or standard print material, videotape, two sessions with a trained cancer educator, and informational workbook (EDU). Two primary end points were examined: energy/fatigue and cancer-specific distress. Secondary end points were depressive symptoms and post-traumatic growth. Perceived preparedness for re-entry was analyzed as a moderator of effects.

RESULTS: Of 558 women randomly assigned to treatment, 418 completed the 6-month assessment and 399 completed the 12-month assessment. In analyses controlling for study site and baseline depressive symptoms, VID produced significant improvement in energy/fatigue at 6 months relative to CTL, particularly among women who felt less prepared for re-entry at baseline. No significant main effect of the interventions emerged on cancer-specific distress, but EDU prompted greater reduction in this outcome relative to CTL at 6 months for patients who felt more prepared for re-entry. Between-group differences in the primary outcomes were not significant at 12 months, and no significant effects emerged on the secondary end points.

CONCLUSION: A peer-modeling videotape can accelerate the recovery of energy during the re-entry phase in women treated for breast cancer, particularly among those who feel less prepared for re-entry.

Supported by funding from the National Cancer Institute (R01-CA63028). Supported through an American Cancer Society Clinical Research Professorship (P.A.G.).

Presented in part at the 40th Annual Meeting of the American Society of Clinical Oncology, June 5-8, 2004, New Orleans, LA, and the Annual Meeting of the American Psychological Association, July 28-August 1, 2004, Honolulu, HI.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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