Healthy romantic relationships may decrease stress and inflammation for breast cancer survivors

Expert Guidelines

The National Comprehensive Cancer Network (NCCN) recommends screening and treatment of distress as part of the recommended standard of care. 

These recommendations include:

• Healthcare providers should inform patients, families and treatment teams that distress management is a key part of their medical care, and they should provide information about psychosocial services.
• Ideally, healthcare providers should screen patients for distress at every medical visit— minimally at a patient’s initial visit and then as clinically indicated, especially with changes in disease status (i.e., remission, recurrence, progression or treatment-related complications).
• Healthcare providers should assess and manage distress according to clinical practice guidelines.
• Experts in psychosocial aspects of cancer should be readily available, either as staff members or by referral.
• Assessments should include psychosocial issues (e.g., quality of life and patient and family satisfaction).

Patients should expect to receive distress screening and help at your doctor visits. If your distress isn’t addressed, ask for help. NCCN provides a "Distress During Cancer Care" pamphlet that provides more information.

The American Society for Clinical Oncology (ASCO) points out several therapies for anxiety and stress for patients to consider during or after cancer treatment:

• acupuncture
• massage
• meditation, particularly mindfulness stress-reduction programs
• music therapy
• stress management therapy.
• yoga 

Questions To Ask Your Health Care Provider

• Is my symptom(s) part of being distressed?
• What emotional or psychological support is available for me?
• What support is available for my partner and family?
• How do I find a therapist?
• What help for distress will my insurance cover?
• Are there resources for couples counseling?
• What strategies are most helpful for maintaining healthy relationships during this time?
• What approaches do you recommend for decreasing stress?

Open Clinical Trials

The following studies on the emotional effects of cancer are enrolling patients: 

Multiple cancers 

• NCT04739696: Developing a Virtual Stress Management Intervention for Spousal/Partnered Caregivers of Solid Tumor Cancer Patients. This study will look at the ability of a stress management program for employed caregivers to improve psychological distress in spouses or partners who are caregivers for people diagnosis with a solid tumor cancer of any stage.
• NCT03581357: Mobile Mindfulness Meditation Intervention for Cancer Survivors. This will study the impact and satisfaction of Mobile Mindfulness Meditation on anxiety, pain, fatigue, trauma, and sleep in cancer survivors.
• NCT03611309: Perioperative Palliative Care Surrounding Cancer Surgery for Patients & Their Family Members (PERIOP-PC). The study goal is to compare surgeon-palliative care team co-management, versus surgeon alone management, of patients and family members preparing for major upper gastrointestinal cancer surgery.
• NCT04604158: Evaluating the Effect of a Mobile Audio Companion (Elly) to Reduce Anxiety in Cancer Patients. This is a study in cancer patients to examine the feasibility of a mobile health application, Elly (Elly Health Inc.), to reduce levels of anxiety, stress, loneliness, and social isolation.
• NCT03344757: Health Gatherings - For Your Health After Cancer. look at the effects of a 10-week stress management in-person group program. The program will study emotions, stress, and stress management techniques (such as relaxation and coping techniques) on quality of life, distress, depression, and physical health in Spanish- speaking, Hispanic/Latino men diagnosed with Prostate Cancer (PC).

Breast cancer

• NCT05364450: Studying Types of Therapy for Coping With Fear of Recurrence Among Breast Cancer Survivors. Fear of breast cancer recurrence (FCR) is common. This study will test three types of online, group therapy for breast cancer survivors with FCR.
• NCT04583891: Mobile Apps to Reduce Distress in Breast Cancer Survivors Using an Adaptive Design. This project will look at using a mobile health app to address emotional distress in women with breast cancer, and test the impact of coaching as a way to increase engagement with the app. 

Prostate cancer

• NCT02871752: Reducing the Effects of Active Surveillance Stress, Uncertainty and Rumination Thru Engagement in Mindfulness Education (REASSUREME).  This study examines how well a couples-based mindfulness-based stress reduction (MBSR) works on positive and negative psychological responses to active surveillance (AS) and AS adherence.
• NCT03344757: Health Gatherings - For Your Health After Cancer. This study will look at the effects of a 10-week stress management in-person group program. The program will study the effects of stress, and stress management techniques on quality of life, distress, depression, and physical health in Spanish- speaking, Hispanic/Latino men diagnosed with prostate cancer.