Group Therapy Does not Extend Life in Breast Cancer

The initial study of group therapy in breast cancer by Dr. David Spiegel and a group of therapists from Stanford (Lancet Oct. 14, 1989) was terribly flawed. The study provided group therapy weekly for one year comparing the survival of patients who participated in such therapy and a control group who didn’t. The study reported a mean 36.6 months (SD 37.6) survival from randomization for the intervention group and 18.9 months (SD 10.8) for controls.

However, there were too few patients as well as poor patient selection for this study to be valid. At the start, just 50 people were assigned to the study group and 36 to controls. Before any group therapy could begin 14 patients dropped from the study group and 12 from the controls leaving just 36 and 24 patients in each group respectively. Weekly therapy lasted 12 months during which time there was no difference in attrition. The survival curves diverged over the next 3 years. Confounding the findings is the fact that control patients on average were diagnosed with breast cancer almost one year earlier than the study patients. That is, they entered the study having had the disease for almost 1 year longer. The difference in survival from diagnosis was therefore, far less than that cited by the study–which claimed to improve survival from entry into the study.

In the meantime Spiegel has made a career of this one study. Writing articles, lecturing, writing instruction manuals and texts on the survival benefit of counseling in cancer. The implication of all this was that patients could be empowered to extend their own survival though positive attitude towards the disease and counseling.

The current study in Cancer sets the record straight “Group Therapy Doesn’t Extend Life in Breast Cancer.” Thus while group therapy can help women deal with the psychological ramifications of the diagnosis, it doesn’t extend life. That claim was based on a single flawed study and the public relations machine of the researcher and other therapists.

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