Support Groups and Interventions

Our assessments of evidence for each medical benefit fall into one of these categories:

• Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
• Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
• Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
• Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
• Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
• Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

• Less symptom intensity during adjuvant chemotherapy following surgical treatment among women with breast cancer participating in a structured walking program and support group meetings compared to usual care in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷Mock V, Burke MB et al. A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncology Nursing Forum. 1994 Jun;21(5):899-907; discussion 908.

Also see some evidence of worse outcomes in Safety and precautions ›

In-person support groups

Modest evidence of less anxiety among people with breast cancer participating in in-person support groups

No evidence of an effect on anxiety among people participating in a group emotional and educational intervention in a preliminary study

• Less anxiety among people newly diagnosed with breast cancer participating in a support intervention of 1 week of a residential session followed by 4 days of follow-up 2 months later compared to standard follow-up routines in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁸Björneklett HG, Lindemalm C, Rosenblad A, Ojutkangas ML, Letocha H, Strang P, Bergkvist L. A randomised controlled trial of support group intervention after breast cancer treatment: results on anxiety and depression. Acta Oncologica. 2012 Feb;51(2):198-207.
• Less anxiety among women with early stage breast cancer, and with higher levels of pre-intervention cancer-specific distressemotional, social, spiritual, or physical pain or suffering that may cause a person to feel sad, afraid, depressed, anxious, or lonely; people in distress may also feel that they are not able to manage or cope with changes caused by normal life activities or by having a disease, such as cancer, participating in a couples support group compared to 8 sessions of an enhanced couple-focused group intervention in a mid-sized RCT⁹Manne SL, Siegel SD, Heckman CJ, Kashy DA. A randomized clinical trial of a supportive versus a skill-based couple-focused group intervention for breast cancer patients. Journal of Consulting and Clinical Psychology. 2016 Aug;84(8):668-81.
• No evidence of an effect on anxiety among breast cancer survivors meeting weekly for 4 weeks for an emotional and educational intervention focusing on cancer recurrence compared to controls in a small RCT¹⁰Miyashita M. A randomized intervention study for breast cancer survivors in Japan: effects of short-term support group focused on possible breast cancer recurrence. Cancer Nursing. 2005 Jan-Feb;28(1):70-8.

One-on-one peer support: no evidence of an effect on anxiety after recent surgery among people with newly diagnosed breast cancer participating in one-on-one peer support interventions in a preliminary study

• No evidence of an effect on anxiety during the 5 weeks after surgery among people with newly diagnosed breast cancer participating in one-on-one peer support interventions compared to usual care in a mid-sized RCT¹¹Lee R, Lee KS, Oh EG, Kim SH. A randomized trial of dyadic peer support intervention for newly diagnosed breast cancer patients in Korea. Cancer Nursing. 2013 May-Jun;36(3):E15-22.

• Better cognitive function more than 5 years after an intervention among women participating in a support group intervention after primary breast cancer treatment compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹²Björneklett HG, Rosenblad A et al. Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. Journal of Psychosomatic Research. 2013 Apr;74(4):346-53.

Also see some evidence of worse outcomes in Safety and precautions ›

In-person support groups:

Preliminary (conflicting) evidence of less depression or better mood among people with breast cancer participating in support groups

Preliminary evidence of less mood disturbance, greater confidant support, and greater marital satisfaction among people with early stage breast cancer whose partners participated in a brief psychoeducational group program, and of less mood disturbance among the partners

• Fewer depressive symptoms among women with early stage breast cancer and higher levels of pre-intervention cancer-specific distress participating in a couples’ support group compared to 8 sessions of an enhanced couple-focused group intervention in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹³Manne SL, Siegel SD, Heckman CJ, Kashy DA. A randomized clinical trial of a supportive versus a skill-based couple-focused group intervention for breast cancer patients. Journal of Consulting and Clinical Psychology. 2016 Aug;84(8):668-81.
• No evidence of an effect on depression among people newly diagnosed with breast cancer participating in a support intervention of 1 week of a residential session followed by 4 days of follow-up 2 months later compared to standard follow-up routines in a mid-sized RCT¹⁴Björneklett HG, Lindemalm C, Rosenblad A, Ojutkangas ML, Letocha H, Strang P, Bergkvist L. A randomised controlled trial of support group intervention after breast cancer treatment: results on anxiety and depression. Acta Oncologica. 2012 Feb;51(2):198-207.
• Fewer depressive symptoms among people with breast cancer participating in a peer support intervention compared to controls, but the benefit did not continue after the intervention ended, in a mid-sized controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁵Mens MG, Helgeson VS, Lembersky BC, Baum A, Scheier MF. Randomized psychosocial interventions for breast cancer: impact on life purpose. Psycho-oncology. 2016 Jun;25(6):618-25.
• Improved mood at 12 months among African American women with nonmetastatic breast cancer participating in an 8-week support group intervention compared to controls in a small RCT¹⁶Taylor KL, Lamdan RM, Siegel JE, Shelby R, Moran-Klimi K, Hrywna M. Psychological adjustment among African American breast cancer patients: one-year follow-up results of a randomized psychoeducational group intervention. Health Psychology. 2003 May;22(3):316-23.
• Less mood disturbance, greater confidant support, and greater marital satisfaction among people with early stage breast cancer whose partners participated in a brief psychoeducational group program compared to controls in a small RCT¹⁷Bultz BD, Speca M, Brasher PM, Geggie PH, Page SA. A randomized controlled trial of a brief psychoeducational support group for partners of early stage breast cancer patients. Psycho-oncology. 2000 Jul-Aug;9(4):303-13.
• Less mood disturbance among partners of people with early stage breast cancer participating in a brief psychoeducational group program compared to controls in a small RCT¹⁸Bultz BD, Speca M, Brasher PM, Geggie PH, Page SA. A randomized controlled trial of a brief psychoeducational support group for partners of early stage breast cancer patients. Psycho-oncology. 2000 Jul-Aug;9(4):303-13.

One-on-one peer support:

Preliminary evidence of less depression among men with prostate cancer participating in one-on-one peer support

No evidence of an effect on depression during the 5 weeks after surgery among people with breast cancer participating in one-on-one peer support in a preliminary study

• Less depression after radical prostatectomy for prostate cancer among older men paired one-on-one with a trained support partner who had similar treatment and related side effects compared to usual health care in a small RCT¹⁹Weber BA, Roberts B et al. The impact of dyadic social support on self-efficacy and depression after radical prostatectomy. Journal of Aging and Health. 2007 Aug;19(4):630-45.
• No evidence of an effect on depression during the 5 weeks after surgery among people with newly diagnosed breast cancer participating in one-on-one peer support interventions compared to usual care in a mid-sized RCT²⁰Lee R, Lee KS, Oh EG, Kim SH. A randomized trial of dyadic peer support intervention for newly diagnosed breast cancer patients in Korea. Cancer Nursing. 2013 May-Jun;36(3):E15-22.

Support interventions for people with cancer and their family caregivers: no evidence of an effect on feelings of hopelessness among people with cancer participating in interventions including their family caregivers in a combined analysis of studies

• No evidence of an effect on hopelessness among people with cancer participating in interventions including their family caregivers compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 randomized clinical trials²¹Hu Y, Liu T, Li F. Association between dyadic interventions and outcomes in cancer patients: a meta-analysis. Supportive Care in Cancer. 2019 Mar;27(3):745-761.

In-person support groups: preliminary evidence of increased vigor after treatment for primary breast cancer among women participating in weekly support sessions

• Increased vigor after treatment for primary breast cancer, excluding stage 4, among women participating in weekly support sessions compared to standard care in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²²Richardson MA, Post-White J et al. Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health and Medicine. 1997 Sep;3(5):62-70.

Residential support intervention: insufficient (conflicting) evidence of less fatigue among women with breast cancer participating in residential support interventions

• Less physical, mental, and total fatigue more than 5 years after the intervention among women participating in a residential support group intervention after primary breast cancer treatment compared to controls in a mid-sized RCT²³Björneklett HG, Rosenblad A et al. Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. Journal of Psychosomatic Research. 2013 Apr;74(4):346-53.
• No evidence of an effect on fatigue among people with newly diagnosed breast cancer participating in a support intervention of 1 week of a residential session followed by 4 days of follow-up 2 months later and comprising informative educational parts, relaxation training, mental visualization, and nonverbal communication, compared to routine care in a mid-sized RCT²⁴Björneklett HG, Lindemalm C et al. A randomized controlled trial of a support group intervention on the quality of life and fatigue in women after primary treatment for early breast cancer. Supportive Care in Cancer. 2012 Dec;20(12):3325-34.

Online or telephone support interventions: preliminary evidence of small decreases in fatigue among people with breast cancer participating in an online and phone-based support intervention

• Small decreases in fatigue and minimal change in fatigue interference with function among people with metastatic breast cancer with symptoms interfering with functioning participating in an intervention of 5 telephone sessions of education/support compared to baseline, and decreases comparable to an intervention of 5 telephone sessions of acceptance and commitment therapy in a small RCT²⁵Mosher CE, Secinti E et al. Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial. Supportive Care in Cancer. 2018 Jun;26(6):1993-2004.

Support groups including family caregivers: no evidence of an effect on fatigue among people with cancer participating in interventions including their family caregivers in a combined analysis of studies

• No evidence of an effect on fatigue among people with cancer participating in interventions including their family caregivers compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 randomized clinical trials²⁶Hu Y, Liu T, Li F. Association between dyadic interventions and outcomes in cancer patients: a meta-analysis. Supportive Care in Cancer. 2019 Mar;27(3):745-761.

• No evidence of an effect on pain among people with cancer participating in interventions including their family caregivers compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 randomized clinical trials²⁷Hu Y, Liu T, Li F. Association between dyadic interventions and outcomes in cancer patients: a meta-analysis. Supportive Care in Cancer. 2019 Mar;27(3):745-761.

Also see some evidence of worse outcomes in Safety and precautions ›

In-person support groups for women with breast cancer: modest evidence of greater well-being, more life purpose or satisfaction, and/or physical or psychological function among people with breast cancer participating in support groups but not a residential intervention focused on education and training

• Greater well-being among women with early stage breast cancer with higher levels of pre-intervention cancer-specific distressemotional, social, spiritual, or physical pain or suffering that may cause a person to feel sad, afraid, depressed, anxious, or lonely; people in distress may also feel that they are not able to manage or cope with changes caused by normal life activities or by having a disease, such as cancer participating in a couples’ support group compared to 8 sessions of an enhanced couple-focused group intervention in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²⁸Manne SL, Siegel SD, Heckman CJ, Kashy DA. A randomized clinical trial of a supportive versus a skill-based couple-focused group intervention for breast cancer patients. Journal of Consulting and Clinical Psychology. 2016 Aug;84(8):668-81.
• More reported life purpose among people with breast cancer participating in a peer support intervention compared to controls, but the benefit did not continue after the intervention ended, in a mid-sized controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial²⁹Mens MG, Helgeson VS, Lembersky BC, Baum A, Scheier MF. Randomized psychosocial interventions for breast cancer: impact on life purpose. Psycho-oncology. 2016 Jun;25(6):618-25.
• Better life satisfaction (maintained in the intervention group and declined in the control group) among people with breast cancer meeting weekly for 4 weeks for an emotional and educational intervention focusing on cancer recurrence compared to controls in a small RCT³⁰Miyashita M. A randomized intervention study for breast cancer survivors in Japan: effects of short-term support group focused on possible breast cancer recurrence. Cancer Nursing. 2005 Jan-Feb;28(1):70-8.
• Improved general and cancer-specific psychological function at 12 months among American women of African descent with nonmetastatic breast cancer participating in an 8-week support group intervention compared to controls in a small RCT³¹Taylor KL, Lamdan RM, Siegel JE, Shelby R, Moran-Klimi K, Hrywna M. Psychological adjustment among African American breast cancer patients: one-year follow-up results of a randomized psychoeducational group intervention. Health Psychology. 2003 May;22(3):316-23.
• Better physical performance and psychosocial adjustment during adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation chemotherapy following surgical treatment among women with breast cancer participating in a structured walking program and support group meetings compared to usual care in a small RCT³²Mock V, Burke MB et al. A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Oncology Nursing Forum. 1994 Jun;21(5):899-907; discussion 908.
• No evidence of an effect on functional and symptom scales of quality of life among people with newly diagnosed breast cancer participating in a support intervention of 1 week of a residential session followed by 4 days of follow-up 2 months later and comprising informative educational parts, relaxation training, mental visualization, and nonverbal communication, compared to routine care in a mid-sized RCT³³Björneklett HG, Lindemalm C et al. A randomized controlled trial of a support group intervention on the quality of life and fatigue in women after primary treatment for early breast cancer. Supportive Care in Cancer. 2012 Dec;20(12):3325-34.
• Improved functional and social quality of life after treatment for primary breast cancer, excluding stage 4, among women participating in weekly support sessions compared to standard care in a small RCT³⁴Richardson MA, Post-White J et al. Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health and Medicine. 1997 Sep;3(5):62-70.

In-person support groups for men with prostate cancer: preliminary evidence of increased functioning among men with prostate cancer participating in an intervention of pelvic floor muscle exercises and a support group

• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward increased functioning and reduced perception of illness intrusiveness after prostatectomy among men with prostate cancer participating in an intervention of pelvic floor muscle exercises and a support group compared to controls in a small RCT³⁵Zhang AY, Strauss GJ, Siminoff LA. Intervention of urinary incontinence and quality of life outcome in prostate cancer patients. Journal of Psychosocial Oncology. 2006;24(2):17-30.

Online or phone-based support groups for people with breast cancer: modest evidence of better well-being, better information before treatment, better attitude, and less helplessness/hopelessness among people with breast cancer engaging in online communities and groups

• Improved well-being—possibly through helping women expand and engage in wider social networks, connect with peers with cancer and gain information about cancer—among people with breast cancer engaging in online communities and groups compared to others or to baseline in a review of 85 intervention and observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies³⁶Falisi AL, Wiseman KP et al. Social media for breast cancer survivors: a literature review. Journal of Cancer Survivorship. 2017 Dec;11(6):808-821.
• Short-term more positive attitude and less helplessness/hopelessness 1 to 8 weeks after surgery among women with early-stage breast cancer receiving health education, enhancement of problem-solving skills, stress management, and psychological support compared to a support group in a mid-sized RCT³⁷Schou Bredal I, Kåresen R, Smeby NA, Espe R, Sørensen EM, Amundsen M, Aas H, Ekeberg Ø. Effects of a psychoeducational versus a support group intervention in patients with early-stage breast cancer: results of a randomized controlled trial. Cancer Nursing. 2014 May-Jun;37(3):198-207.
• Weak trends toward better quality of life and physical and psychological symptoms among Asian American people with breast cancer participating in a culturally tailored internet cancer support group moderated by a registered nurse compared to controls in a small RCT³⁸Chee W, Lee Y et al. A culturally tailored Internet cancer support group for Asian American breast cancer survivors: a randomized controlled pilot intervention study. J Telemed Telecare. 2017 Jul;23(6):618-626.
• A trend toward worse quality of life but no evidence of an effect on self-efficacy soon after diagnosis among women with breast cancer participating in an online peer-support intervention compared to an online educational intervention in a small RCT³⁹Salzer MS, Palmer SC et al. A randomized, controlled study of Internet peer-to-peer interactions among women newly diagnosed with breast cancer. Psycho-oncology. 2010 Apr;19(4):441-6.

Online or phone-based support groups for people with prostate cancer: modest evidence of better quality of life and function among people with prostate cancer participating in an online or phone-based support group

• Higher quality of life relationships scores at 3 months among men with localized prostate cancer participating in a monthly telephone-based group peer support for 5 months supported by self-management materials and exercise equipment compared to usual care in a mid-sized RCT⁴⁰Galvão DA, Newton RU et al. Randomized controlled trial of a peer led multimodal intervention for men with prostate cancer to increase exercise participation. Psycho-oncology. 2018 Jan;27(1):199-207.
• Better problem-solving skills among people with prostate cancer receiving greater reported social and/or peer support in a 3-month behavioral intervention of biofeedback pelvic floor muscle exercises and 1 of 4 further behavioral actions, with telephone support, compared to less reported social/peer support in a mid-sized RCT⁴¹Zhang AY, Burant C et al. Psychosocial mechanisms of a behavioral treatment for urinary incontinence of prostate cancer survivors. Journal of Psychosocial Oncology. 2020 Mar-Apr;38(2):210-227.
• Temporarily better quality of life among people with prostate cancer participating in a prostate cancer-specific online support group compared to controls in a small RCT⁴²Osei DK, Lee JW, Modest NN, Pothier PK. Effects of an online support group for prostate cancer survivors: a randomized trial. Urologic Nursing. 2013 May-Jun;33(3):123-33.

One-on-one peer support

Preliminary evidence of better self-efficacy among people with cancer participating in one-on-one peer support

Preliminary evidence of better information while preparing for treatment among women with gynecological cancer participating in nurse-led consultations plus peer-led telephone sessions

• Better self-efficacy for self-management of cancer during the 5 weeks after surgery among people with newly diagnosed breast cancer participating in a one-on-one peer support intervention compared to usual care in a mid-sized RCT⁴³Lee R, Lee KS, Oh EG, Kim SH. A randomized trial of dyadic peer support intervention for newly diagnosed breast cancer patients in Korea. Cancer Nursing. 2013 May-Jun;36(3):E15-22.
• Higher self-efficacy after radical prostatectomy among older men with prostate cancer paired one-on-one with a trained support partner who had similar treatment and related side effects compared to usual health care in a small RCT⁴⁴Weber BA, Roberts B et al. The impact of dyadic social support on self-efficacy and depression after radical prostatectomy. Journal of Aging and Health. 2007 Aug;19(4):630-45.
• Reported benefits for sensory/psychological concerns, procedural concerns and specific needs domains (health system and information needs) while preparing for radiotherapy with curative intent among women with gynecological cancer participating in 4 nurse-led consultations plus 4 peer-led telephone sessions compared to usual care in a mid-sized RCT⁴⁵Schofield P, Gough K et al. A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial – ANZGOG 1102. Gynecologic Oncology. 2020 Dec;159(3):785-793.

Support interventions for people with cancer and their family caregivers: good evidence of better social and emotional aspects of quality of life among people with cancer participating in interventions including their family caregivers

• Better measures of social and emotional aspects of quality of life, but not functional and physical aspects, among people with cancer participating in interventions including their family caregivers compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 randomized clinical trials⁴⁶Hu Y, Liu T, Li F. Association between dyadic interventions and outcomes in cancer patients: a meta-analysis. Supportive Care in Cancer. 2019 Mar;27(3):745-761.

Online support groups: preliminary evidence of a small effect for less sexual distress among women sexually distressed subsequent to gynecologic cancer participating in an online discussion forum

• A small effect for less sexual distress among women sexually distressed subsequent to gynecologic cancer treatment participating in a 12-week, professionally moderated, asynchronous discussion forum as well as the provision of psycho-educational materials addressing the psychosexual impact of gynecologic cancer compared to no intervention in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁴⁷Classen CC, Chivers ML et al. Psychosexual distress in women with gynecologic cancer: a feasibility study of an online support group. Psycho-oncology. 2013 Apr;22(4):930-5.

Residential support group: preliminary evidence of better body image among women after primary breast cancer treatment participating in a residential support group intervention

• Better body image more than 5 years after the intervention among women after primary breast cancer treatment participating in a residential support group intervention compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁴⁸Björneklett HG, Rosenblad A et al. Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. Journal of Psychosomatic Research. 2013 Apr;74(4):346-53.

One-on-one peer support

Preliminary evidence of benefit regarding sexuality needs among women with gynecological cancer receiving nurse-led consultations plus peer-led telephone sessions

No evidence of an effect on sexual function, sexuality needs, sexual self-confidence, masculine self-esteem, marital satisfaction, or intimacy after surgery among heterosexual couples in which the man had been diagnosed with prostate cancer participating in an intervention of either peer-delivered telephone support or nurse-delivered telephone counseling in a preliminary study

• Benefits regarding sexuality needs among women with gynecological cancer scheduled to receive radiotherapy with curative intent receiving 4 nurse-led consultations plus 4 peer-led telephone sessions compared to usual care in a mid-sized RCT⁴⁹Schofield P, Gough K et al. A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial – ANZGOG 1102. Gynecologic Oncology. 2020 Dec;159(3):785-793.
• No evidence of an effect on sexual function, sexuality needs, sexual self-confidence, masculine self-esteem, marital satisfaction, or intimacy after surgery among heterosexual couples in which the man had been diagnosed with prostate cancer participating in an intervention of either peer-delivered telephone support or nurse-delivered telephone counselling compared to usual care in a mid-sized RCT⁵⁰Chambers SK, Occhipinti S et al. A randomised controlled trial of a couples-based sexuality intervention for men with localised prostate cancer and their female partners. Psycho-oncology. 2015 Jul;24(7):748-56.

• Small decreases in sleep disturbance but minimal change in sleep-related impairment among people with metastatic breast cancer with symptoms interfering with functioning participating in 5 telephone sessions of education/support compared to baseline in a small trial⁵¹Mosher CE, Secinti E et al. Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial. Supportive Care in Cancer. 2018 Jun;26(6):1993-2004.

In-person groups: modest evidence of less stress or distress after surgery among women with breast cancer participating in an in-person group

• Fewer symptoms of distress among people with breast cancer participating in lifestyle and support programs that help women develop and use positive coping strategies in a systematic review of 42 observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies⁵²Syrowatka A, Motulsky A et al. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Research and Treatment. 2017;165(2):229-245.
• Comparable improvements in emotional distress 1 to 8 weeks after surgery among women with early-stage breast cancer participating in either of 2 interventions: 1) health education, enhancement of problem-solving skills, stress management, and psychological support, or 2) a support group in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁵³Schou Bredal I, Kåresen R, Smeby NA, Espe R, Sørensen EM, Amundsen M, Aas H, Ekeberg Ø. Effects of a psychoeducational versus a support group intervention in patients with early-stage breast cancer: results of a randomized controlled trial. Cancer Nursing. 2014 May-Jun;37(3):198-207.
• Better coping skills (seeking support) and perceived social support, and weak trends toward better overall coping, less stress, and better death acceptance after treatment for primary breast cancer, excluding stage 4, among women participating in 6 weekly support sessions compared to standard care in a small RCT⁵⁴Richardson MA, Post-White J et al. Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health and Medicine. 1997 Sep;3(5):62-70.

Online support groups: insufficient (conflicting) evidence of an effect on stress or distress among women with breast cancer participating in an online support intervention

• Lower scores of perceived stress and posttraumatic stress disorder among women with primary breast carcinoma participating in a 12-week, online social support group (Bosom Buddies) compared to controls in a small RCT⁵⁵Winzelberg AJ, Classen C, Alpers GW, Roberts H, Koopman C, Adams RE, Ernst H, Dev P, Taylor CB. Evaluation of an internet support group for women with primary breast cancer. Cancer. 2003 Mar 1;97(5):1164-73.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward worse distress among women who were recently diagnosed with breast cancer participating in an online peer-support intervention compared to an internet-based educational intervention in a small RCT⁵⁶Salzer MS, Palmer SC et al. A randomized, controlled study of Internet peer-to-peer interactions among women newly diagnosed with breast cancer. Psycho-oncology. 2010 Apr;19(4):441-6.

One-on-one peer support: insufficient (conflicting) evidence of less distress among women with cancer or at risk of cancer receiving one-on-one peer support

• Lower distress and stress scores among women with a BRCA1 or BRCA2 gene mutation participating in an intervention of trained peer volunteers contacting women multiple times over a 4-month period to provide informational, emotional, and practical support compared to usual care in a mid-sized RCT⁵⁷White VM, Young MA et al. Randomized controlled trial of a telephone-based peer-support program for women carrying a BRCA1 or BRCA2 mutation: impact on psychological distress. Journal of Clinical Oncology. 2014 Dec 20;32(36):4073-80.
• No evidence of an effect on psychological distress among women with gynecological cancer scheduled to receive radiotherapy with curative intent participating in 4 nurse-led consultations plus 4 peer-led telephone sessions compared to usual care in a mid-sized RCT⁵⁸Schofield P, Gough K et al. A nurse- and peer-led psycho-educational intervention to support women with gynaecological cancers receiving curative radiotherapy: The PeNTAGOn randomised controlled trial – ANZGOG 1102. Gynecologic Oncology. 2020 Dec;159(3):785-793.

Support information in a workbook-journal: preliminary evidence of fewer symptoms of stress among women with breast cancer receiving a supportive community-based workbook-journal

• Fewer posttraumatic stress disorder symptoms either within 3 months of diagnosis or within 3 months of completing treatment among women with primary breast cancer receiving a supportive community-based workbook-journal containing compelling personal stories, local rural resources, coping strategies, and messages of hope compared to controls in a mid-sized RCT⁵⁹Angell KL, Kreshka MA, McCoy R, Donnelly P, Turner-Cobb JM, Graddy K, Kraemer HC, Koopman C. Psychosocial intervention for rural women with breast cancer: the Sierra-Stanford Partnership. Journal of General Internal Medicine. 2003 Jul;18(7):499-507.

Also see some evidence of worse outcomes in Safety and precautions ›

Future perspective: preliminary evidence of more future perspective among women with breast cancer participating in a residential support group

• More future perspective more than 5 years after the intervention among women after primary breast cancer treatment with a support group intervention compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶⁰Björneklett HG, Rosenblad A et al. Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. Journal of Psychosomatic Research. 2013 Apr;74(4):346-53.

Information needs: preliminary evidence of fewer unmet information needs among women at genetic risk of breast cancer participating in a one-on-one peer support

• Fewer unmet information needs among women with a BRCA1 or BRCA2 gene mutation participating in an intervention of trained peer volunteers contacting women multiple times over a 4-month period to provide informational, emotional, and practical support compared to usual care in a mid-sized RCT⁶¹White VM, Young MA et al. Randomized controlled trial of a telephone-based peer-support program for women carrying a BRCA1 or BRCA2 mutation: impact on psychological distress. Journal of Clinical Oncology. 2014 Dec 20;32(36):4073-80.

Side effects of prostate cancer treatment: modest evidence of less urinary leakage and less severe incontinence symptoms among men with prostate cancer with persistent urinary incontinence participating in an intervention of biofeedback and a support group

• After completing prostate cancer treatment, less daily urinary leakage (after 3 months of intervention) and less severe incontinence symptoms (after 3 and 5 months of intervention) among people with prostate cancer with persistent urinary incontinence participating in an intervention of biofeedback and a support group compared to usual care in a mid-sized RCT⁶²Zhang AY, Bodner DR et al. Effects of patient centered interventions on persistent urinary incontinence after prostate cancer treatment: a randomized, controlled trial. Journal of Urology. 2015 Dec;194(6):1675-81.
• Less urinary leakage frequency among people with prostate cancer receiving greater reported social and/or peer support in a 3-month behavioral intervention of biofeedback pelvic floor muscle exercises and 1 of 4 further behavioral actions, with telephone support, compared to less reported social/peer support in a mid-sized RCT⁶³Zhang AY, Burant C et al. Psychosocial mechanisms of a behavioral treatment for urinary incontinence of prostate cancer survivors. Journal of Psychosocial Oncology. 2020 Mar-Apr;38(2):210-227.

• Better health-related quality of life in themes of developing connections, togetherness, rebuilding self-esteem, and creating memories among adolescents with cancer participating in an adventure therapy program with social support in a remote area of Canada compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design⁶⁴Stevens B, Kagan S et al. Adventure therapy for adolescents with cancer. Pediatric Blood & Cancer. 2004 Sep;43(3):278-84.

• Weak trendsan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward better quality of life but more depression, and no evidence of an effect on well-being, loneliness or social support among people with distressing physical and mental conditions (not specific to cancer) participating in a befriending intervention compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 5 to 7 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial, depending on the outcome⁶⁵Siette J, Cassidy M, Priebe S. Effectiveness of befriending interventions: a systematic review and meta-analysis. BMJ Open. 2017 Apr 26;7(4):e014304.
• Better levels of plasma cortisol—a marker of physiological stress—among bereaved men participating in a semistructured 10-week bereavement support group once a week compared to controls in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶⁶Goodkin K, Feaster DJ et al. A bereavement support group intervention is longitudinally associated with salutary effects on the CD4 cell count and number of physician visits. Clinical and Diagnostic Laboratory Immunology. 1998 May;5(3):382-91.
• Fewer health-care visits over the 6-month follow-up period among bereaved men participating in a semistructured, 10-week, once weekly, 90-minutes per session bereavement support group compared to controls in a mid-sized RCT⁶⁷Goodkin K, Feaster DJ et al. A bereavement support group intervention is longitudinally associated with salutary effects on the CD4 cell count and number of physician visits. Clinical and Diagnostic Laboratory Immunology. 1998 May;5(3):382-91.