Psychological support
Also called: support groups, supportive-expressive group therapy.
Last reviewed 2026-09-16. How this works.
Prolonging survival Grade D
No human evidence of benefit, or none that survived testing.
Support groups help people feel better, and the careful trials found they do not make people live longer.
The replication trial found 17.9 months against 17.6.
The claim
The claim is that joining a support group extends survival. It comes from one striking trial in 1989 and it has been repeated ever since.
What it does
The idea that the mind influences the course of cancer is the subject of the whole chapter. This entry is about one specific, testable version of it.
The evidence
The original trial randomised 86 women with metastatic breast cancer to weekly supportive-expressive group therapy or a control arm, and reported a mean survival advantage of about 18 months. It is one of the most quoted findings in this field.1
The survival analysis in that trial had not been planned in advance, which is recorded in the later replication paper. An analysis nobody planned to do, producing a striking result, is exactly the shape the rest of this book teaches readers to be careful with.2
The replication randomised 235 women across multiple centres. Median survival was 17.9 months in the intervention group against 17.6 months in the control group. Its authors concluded that this therapy does not prolong survival in women with metastatic breast cancer.2
The same trial found something worth keeping. It improved mood and the perception of pain, particularly in the women who were most distressed at the start, and the interaction between baseline distress and benefit was significant. The original author's own replication attempt reported mixed findings, and reviews now count several randomised trials with a majority finding no survival benefit.23
The studies this rests on
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Group psychosocial support and survival in metastatic breast cancer2
A randomised trial, open label, measured survival, 235 participants.
median survival 17.9 months against 17.6 months; mood and pain perception improved, particularly in those more distressed at baseline.
hazard ratio 1.06, interval 0.78 to 1.45. univariate; 1.23, interval 0.88 to 1.72, multivariate
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Supportive-expressive group therapy in metastatic breast cancer12
A randomised trial, open label, measured survival, 86 participants.
a mean survival advantage of approximately 18 months was reported, in an analysis that had not been planned in advance.
What is absent
No trial designed to test survival has found that group psychological support extends it. The benefit that survives replication is to mood and to pain, particularly in those most distressed, which is a real thing to offer and a different claim.
Scope: survival, any tumour type.
Established by trial scope, checked 2026-09-16. Result: the replication trial found median survival of 17.9 months against 17.6 and concluded the therapy does not prolong survival.23
What to ask
Is there a support group here, and is it something you would suggest for how I am coping?
The dish-to-person gap
Group support is not a compound that reaches a concentration in the blood, so the dish-to-person comparison does not apply.
When to call your team — no warning signs are recorded
If you have started something new, or are thinking about it, the people treating you can only weigh it if they know about it. That is true when nothing has been written down here, and it is most true then.
The register records no warning signs for this entry.
Interactions
A talking or behavioural treatment is not checked against treatment classes in this register.
The whole interaction list, and how to turn it into a pharmacy review request.
Find a trial instead
Support groups are widely available and this entry is about one specific claim made for them.
References
Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989;2(8668):888-891.
No persistent identifier recorded.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 22 note 4.
Goodwin PJ, Leszcz M, Ennis M, et al. The effect of group psychosocial support on survival in metastatic breast cancer. New England Journal of Medicine 2001;345(24):1719-1726.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 22 note 6. The author string is abbreviated in the source that was read and has not been expanded.
Spiegel D and colleagues. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer, 2007.
How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 22 note 7. The author string is abbreviated in the source that was read and has not been expanded.