Web-Based Stress Management for Newly Diagnosed Patients With Cancer


An online stress management program may significantly improve the quality of life for patients newly diagnosed with cancer, according to a recent study.

While a diagnosis of cancer may cause major psychological distress for patients, a majority of patients lack psychological support during the period immediately after diagnosis. Internet interventions have shown the ability to help patients overcome many barriers of receiving face-to-face support.

A group of researchers from the University of Basel and University Hospital Basel (Switzerland) conducted a study to assess the feasibility and efficacy of a Web-based stress management program (STREAM) for newly diagnosed patients with cancer. The randomized controlled trial included 129 patients with cancer who had started first-line treatment within the previous 12 weeks from September 2014 through November 2016. Patients were assigned to a therapist-guided Web-based intervention (n = 65) or a wait-list (control group; n = 64), stratified according to pre-determined distress level (≥ 5 v < 5 on scale of 0 to 10).

The primary efficacy endpoint was quality of life after the intervention—measured by the Functional Assessment of Chronic Illness Therapy-Fatigue—and secondary endpoints included distress and anxiety or depression.

Results were published in the Journal of Clinical Oncology (online January 25, 2018; doi:10.1200/JCO.2017.74.8491).

Researchers noted that adherence to the program was strong, with 80% of patients using at least six of the eight modules offered in the intervention. Psychologists spent 13.3 minutes per week per patients for online guidance.

After the intervention, researchers reported that quality of life was significantly higher (mean, 8.59 points; 95% CI, 2.45-14.73; P = .007) and distress significantly lower (Distress Thermometer: mean, -0.85; 95% CI, -1.60 to -0.10; P = .03) in the intervention group compared with the control group.


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Researchers acknowledged that changes in anxiety or depression were not significant in the intention-to-treat population (Hospital Anxiety and Depression Scale: mean, -1.28; 95% CI, -3.02 to 0.45; P = .15).

"The results show that web-based self-help with regular email contact with a psychologist has the potential to efficiently support newly diagnosed cancer patients and thereby decisively improves cancer care," researchers wrote. "Digital natives are reaching the age at which the risk for age-related diseases such as cancer increases. Approaches that integrate the internet into patient care will therefore continue to increase in importance."—Zachary Bessette