Expressive Writing Therapy for Breast Cancer Survivors

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: M.D. Anderson Cancer Center

Disqualifiers: Inability to provide informed consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 6

Duration: 3 weeks

240 Participants Needed

Trial Summary

What is the purpose of this trial?

This clinical trial studies the effect of a culturally based brief expressive writing intervention in improving the health of Chinese immigrant stage 0-III breast cancer survivors. Culturally based brief expressive writing interventions may help researchers learn more about the experiences of Chinese immigrant breast cancer survivors and how writing about their experiences may affect their health.

Do I need to stop taking my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It focuses on expressive writing therapy for breast cancer survivors.

What data supports the effectiveness of the treatment Culturally Based Brief Expressive Writing Intervention for breast cancer survivors?

Research shows that expressive writing can improve quality of life and self-care abilities in breast cancer patients, with studies indicating benefits like better physical and mental health. These effects have been observed in various cultural contexts, including among Chinese breast cancer patients. ^{1 2 3 4 5}

Is expressive writing therapy safe for breast cancer survivors?

Research on expressive writing therapy for breast cancer survivors suggests it is generally safe and can offer physical and psychological benefits. Studies have shown improvements in quality of life without reporting any significant safety concerns. ^{1 2 3 5 6}

How is the Expressive Writing Therapy treatment different from other treatments for breast cancer survivors?

Expressive Writing Therapy is unique because it focuses on allowing breast cancer survivors to express their deepest thoughts and feelings about their experiences through writing, which can improve their quality of life and self-care abilities. Unlike traditional medical treatments, this therapy is a psychological intervention that helps patients process emotions and adapt cognitively to their condition. ^{1 2 3 5 6}

Research Team

Qian Lu, MD

Principal Investigator

M.D. Anderson Cancer Center

Eligibility Criteria

This trial is for foreign-born Chinese women, aged 18 or older, who have been living in the U.S. for at least six months and were diagnosed with stage 0-III breast cancer. Participants should have completed primary treatments like surgery or chemotherapy within the last five years.

Inclusion Criteria

I am a Chinese woman, over 18, who has lived in the U.S. for at least six months.

My breast cancer is at an early to mid-stage (0-III).

I finished my main cancer treatment within the last 5 years.

Exclusion Criteria

Inability to provide informed consent

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in expressive writing sessions, writing about their cancer experiences for 3 weekly 30-minute sessions

3 weeks

3 visits (virtual or in-person)

Follow-up

Participants are monitored for quality of life and stress biomarkers at 6 weeks, 6 months, and 12 months

12 months

3 visits (in-person or virtual)

Treatment Details

Interventions

• Culturally Based Brief Expressive Writing Intervention

Trial Overview The study is testing a culturally tailored brief expressive writing intervention to see if it improves health outcomes for Chinese immigrant breast cancer survivors by having them write about their experiences.

Participant Groups

Group I: Arm III (self-cultivation writing) Experimental Treatment 3 Interventions

Patients write about positive thoughts and feelings regarding their breast cancer experience for 3 weekly 30-minute sessions.

Group II: Arm II (self-regulation writing) Experimental Treatment 3 Interventions

Patients write about stress and coping, emotional disclosure, and benefit finding for 3 weekly 30-minute sessions.

Group III: Arm I (control writing) Active Control 3 Interventions

Patients write about facts regarding their cancer diagnosis and treatment for 3 weekly 30-minute sessions.

Culturally Based Brief Expressive Writing Intervention is already approved in United States for the following indications:

Approved in United States as Expressive Writing Intervention for:

• Improvement of health in Chinese immigrant stage 0-III breast cancer survivors

Who Is Running the Clinical Trial?

M.D. Anderson Cancer Center

Lead Sponsor

Trials

3,107

Recruited

1,813,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Findings from Research

A study involving 90 Chinese breast cancer survivors showed that expressive writing interventions, particularly writing about cancer facts, significantly improved quality of life (QOL) compared to writing about stress and coping efforts.

Writing about positive aspects of the cancer experience also improved QOL, but not as effectively as writing about cancer facts, indicating that both approaches can be beneficial for patients undergoing chemotherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of an expressive writing intervention on quality of life among Chinese breast cancer patients undergoing chemotherapy. Lu, Q., Dong, L., Wu, IHC., et al.[2022]

Expressive writing, involving four 20-minute sessions focused on emotional disclosure, significantly improved the quality of life for breast cancer patients undergoing chemotherapy, with noticeable effects observed two weeks after the intervention.

The study, which included 82 participants, also indicated that expressive writing positively influenced self-care self-efficacy over time, suggesting it is a beneficial and low-cost psychological intervention for patients lacking emotional support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Structured Expressive Writing on Quality of Life and Perceived Self-Care Self-Efficacy of Breast Cancer Patients Undergoing Chemotherapy in Central China: A Randomized Controlled Trial. Wang, R., Li, L., Xu, J., et al.[2023]

A study involving 118 mainland Chinese breast cancer patients found that expressive writing interventions significantly improved quality of life (QoL) over 6 months, particularly for those in the cancer-facts and emotional disclosure writing groups compared to a neutral control group.

The emotional disclosure writing group reported the highest QoL, while the cancer-facts group showed better physical well-being than the self-regulation writing group, highlighting the varying effectiveness of writing interventions based on the type of writing and the patients' cultural context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The benefits of expressive writing among newly diagnosed mainland Chinese breast cancer patients. Ji, LL., Lu, Q., Wang, LJ., et al.[2022]

Expressive writing is a beneficial intervention for women with breast cancer, helping them process emotions and experiences related to their illness, as shown in a study with seven participants who engaged in four writing sessions.

The study identified three key themes: writing as a process, writing as therapeutic, and writing as a means to help others, suggesting that this method can be effectively integrated into care plans for breast cancer patients and potentially other cancer groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Capturing the Experience: Reflections of Women With Breast Cancer Engaged in an Expressive Writing Intervention. Gripsrud, BH., Brassil, KJ., Summers, B., et al.[2018]

A pilot study involving 19 Chinese-speaking breast cancer survivors found that an expressive writing intervention significantly improved health outcomes, including quality of life and reduced posttraumatic stress, with medium to large effect sizes over a 6-month follow-up period.

The study demonstrated high compliance and perceived value among participants, highlighting the feasibility and cultural sensitivity of using expressive writing as a supportive strategy for minority cancer survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors. Lu, Q., Zheng, D., Young, L., et al.[2022]

A study involving 96 Chinese-speaking breast cancer survivors found that a writing intervention focusing on cancer facts led to the highest reported quality of life at the 6-month follow-up, challenging previous assumptions about the effectiveness of emotional writing for this population.

The self-regulation writing group showed improved emotional well-being compared to the emotional disclosure group, suggesting that cognitive-focused writing may be more beneficial for Asian American cancer survivors than purely emotional expression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Expressive writing among Chinese American breast cancer survivors: A randomized controlled trial. Lu, Q., Wong, CC., Gallagher, MW., et al.[2022]

References

1. Germany pubmed.ncbi.nlm.nih.gov

The impact of an expressive writing intervention on quality of life among Chinese breast cancer patients undergoing chemotherapy. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of Structured Expressive Writing on Quality of Life and Perceived Self-Care Self-Efficacy of Breast Cancer Patients Undergoing Chemotherapy in Central China: A Randomized Controlled Trial. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

The benefits of expressive writing among newly diagnosed mainland Chinese breast cancer patients. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Capturing the Experience: Reflections of Women With Breast Cancer Engaged in an Expressive Writing Intervention. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Expressive writing among Chinese American breast cancer survivors: A randomized controlled trial. [2022]